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PSA, TZI, RI OF PROSTATE AS RISK FACTORS OF URINARY RETENTION Renaldo, Johan; Hardjowijoto, Sunaryo; Djojodimedjo, Tarmono; Budiono, Budiono
Indonesian Journal of Urology Vol 20 No 2 (2013)
Publisher : Indonesian Urological Association

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.32421/juri.v20i2.16

Objective: To evaluate some parameters as the predictors of urine retention incident in Benign Prostate Hyperplasia (BPH) patients. Materials & Methods: From May to August 2012, a total of 24 BPH patients aged 47-69 years with lower urinary tract symptomps (LUTS) including 12 patients with urine retention were participated in the study. Prostate specific antigen (PSA) examination was performed on all patients. For urine retention patients, PSA was performed 2 weeks after catheterization as the procedure may affect PSA levels. Transrectal ultrasonography (TRUS) was examined to assess total prostate volume (VTP), transitional zone volume (VZT), transitional zone index (IZT = VZT / VTP), and resistive index of prostate capsulary arteries. Statistic was utilized using simple and multiple logistic regression. Receiver operating characteristic (ROC) was calculated to assess the usefulness of parameters as a predictor of urine retention. Results: There was no significant difference in age between LUTS and BPH patients with urine retention (p = 0,487). There was no relationship between PSA and transitional zone index to incidence of urine retention in BPH patients (PSA; p = 0,173 and TZI; p = 0,192). Multiple logistic regression analysis showed only resistive index of prostate capsulary arteries which correlates with urine retention incidence (p = 0,014), with area under ROC 0,865 (95% CI 0,721 to 1,008) and cut-off value of > 0,675 as a predictor of urine retention incidence. Conclusion: Resistive index of prostate capsulary arteries by transrectal ultrasonography (TRUS) is a predictor of urine retention incidence in BPH patients.Key words: prostate specific antigen, transitional zone index, resistive index of prostate capsulary arteries, benign prostate hyperplasia, lower urinary tract symptoms, urine retention.

THE EFFECT OF PERIOPERATIVE AND PROPHYLACTIC ANTIBIOTICS AGAINST THE INCIDENCE OF UTI AND SURGICAL SITE INFECTIONS AFTER HYPOSPADIAS SURGERY Kusuma, Raditya; Renaldo, Johan; Djojodimedjo, Tarmono; Hardjowijoto, Sunaryo
Indonesian Journal of Urology Vol 24 No 1 (2017)
Publisher : Indonesian Urological Association

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.32421/juri.v24i1.270

Objective: The aim of this study is to analyze the effect of perioperative and prophylactic antibiotics against the incidence of urinary tract infections (UTI) and surgical site infections (SSI) after hypospadias surgery (hypospadias repair operation). Materials & Methods: This study is an observational study of explanation with 24 hypospadias patients (2 groups) during the period of October 2015 to February 2016. Samples were divided into two groups, 12 patients received prophylactic antibiotics and 12 patients received perioperative antibiotics (random sampling). Inclusion criteria included patients with glandular hypospadias to proximal penile hypospadias, aged 6 months until 15 years and underwent hypospadias surgery with one surgical technique namely Tubularized Incised Plate (TIP). The examination of urine culture and evaluation of the wounds were performed on day 4, 10, and 20 day after surgery to determine the incidence of urinary tract infections and surgical site infections. Results: There is no significant difference in the incidence of UTI on on day 4, 10 and 20 in perioperative group and prophylaxis group with p=0.282 and p=0.500 at day 4 and 10 (p>0.05). There is no significant difference in the incidence of SSI on day 4, 10 and 20 in the group of perioperative antibiotic and prophylactic antibiotic with p=0.680 and p=0.217 at day 4 and 10 (p>0.05). Conclusion: There is no effect of the prophylactic antibiotic as well as perioperative antibiotic treatment on the incidence of UTI and SSI

THE EFFECT OF COMBINED α1-ADRENERGIC BLOCKERS AND PDE-5 INHIBITORS THERAPY ON IPSS, IIEF-5, QMAX AND PVR PATIENTS BPH WITH LUTS AND ERECTILE DYSFUNCTION Ridha, Muhammad; Hardjowijoto, Sunaryo; Renaldo, Johan
Indonesian Journal of Urology Vol 24 No 2 (2017)
Publisher : Indonesian Urological Association

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.32421/juri.v24i2.379

Purpose: Assess the efficacy of combined α1-adrenergic blocker (tamsulosin 0,4 mg) and PDE5 inhibitor (tadalafil 5 mg) therapy compared to tadalafil or tamsulosin alone in treating patient BPH with LUTS and ED. Material and methods: A randomised, double blind experimental study assessed 36 sexually active men with ED and LUTS suggestive of BPH. All patients were randomized to 3 groups: tamsulosin 0,4 mg (n=12), tadalafil 5mg (n=12), and combination of tamsulosin 0,4 mg and tadalafil 5 mg (n= 12), once daily for 6 weeks. Changed in IPSS scores and QoL index, IIEF-5 scores, Qmax, PVR and blood pressure were assessed and compared to baseline. Complication and serious adverse event were also monitored. Outcomes were assessed using ranked analysis of variance (ANOVA) and Kruskall-Wallis depends on data distribution and homogenity.Results: Tamsulosin 0,4 mg once daily for 6 weeks were significantly improved IPSS score and QoL index and Qmax from baseline. Tadalafil 5 mg once daily for 6 weeks were significantly improved IPSS score, QoL index and IIEF-5 index from baseline. Combined tamsulosin and tadalafil therapy were significantly improved IPSS score, QoL index, IIEF-5 index and Qmax from baseline. Significantly better improvement on IIEF-5 dan Qmax from baseline were observed on the combination of tamsulosin and tadalafil compared to monotherapy with tamsulosin or tadalafil after 6 weeks in patients BPH with LUTS and erectile dysfunction. There was no significant decreased in systolic and diastolic blood pressure from combined treatment compared to single treatment.Conclusions: Combined tamsulosin and tadalafil therapy was significantly better in improving IIEF aObjective: Assess the efficacy of combined α1-adrenergic blocker (tamsulosin 0.4 mg) and PDE5 inhibitor (tadalafil 5 mg) therapy compared to tadalafil or tamsulosin alone in treating patient Benign Prostate Hyperplasia (BPH) with lower urinary tract symptom (LUTS) and erectile dysfunction (ED). Material & methods: A randomised, double blind experimental study assessed 36 sexually active men with ED and LUTS suggestive of BPH. All patients were randomized to 3 groups: tamsulosin 0.4 mg (n=12), tadalafil 5mg (n=12), and combination of tamsulosin 0.4 mg and tadalafil 5 mg (n= 12), once daily for 6 weeks. Changed in IPSS scores and QoL index, IIEF-5 scores, Qmax, PVR and blood pressure were assessed and compared to baseline. Complication and serious adverse event were also monitored. Outcomes were assessed using ranked analysis of variance (ANOVA) and Kruskall-Wallis depends on data distribution and homogenity. Results: Tamsulosin 0.4 mg once daily for 6 weeks were significantly improved IPSS score, QoL index and Qmax from baseline. Tadalafil 5 mg once daily for 6 weeks were significantly improved IPSS score, QoL index and IIEF-5 index from baseline. Combined tamsulosin and tadalafil therapy were significantly improved IPSS score, QoL index, IIEF-5 index and Qmax from baseline. Significantly better improvement on IIEF-5 dan Qmax from baseline were observed on the combination of tamsulosin and tadalafil compared to monotherapy with tamsulosin or tadalafil after 6 weeks in patients BPH with LUTS and erectile dysfunction. There was no significant decreased in systolic and diastolic blood pressure from combined treatment compared to single treatment. Conclusion: Combined tamsulosin and tadalafil therapy was significantly better in improving IIEF and Qmax, but not significantly better in improving IPSS and PVR compared to monotherapy with tamsulosin or tadalafil alone. Combined therapy was well tolerated without serious adverse effect.nd Qmax, but not significantly better in improving IPSS and PVR compared to monotherapy with tamsulosin or tadalafil alone. Combined therapy was well tolerated without serious adverse effect.

HAEMATURIA AND COLIC CORRELATION AS CLINICAL PREDICTORS IN URETERAL STONES PATIENTS AT UROLOGY OUTPATIENT UNIT SOETOMO HOSPITAL WITHIN JANUARY 2011 - DECEMBER 2015 PERIOD Laksmana, Wisnu; Renaldo, Johan; Djojodimedjo, Tarmono
Indonesian Journal of Urology Vol 24 No 2 (2017)
Publisher : Indonesian Urological Association

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.32421/juri.v24i2.385

Objective: Determine the relationship between clinical symptoms of colic pain and haematuria as a predictor of ureteral stones incident at Dr Soetomo Hospital within a period of five years. Material & methods: This study is a descriptive analytic study using the sensitivity-specificity test with retrospective design. Data were collected from patient's medical records with a ureteral stone diagnosis at outpatient unit Dr Soetomo Hospital within 2011-2015. Results: Renal colic or ureter colic without haematuria had 88.32% specificity and 53.07% sensitivity in the incidence of ureteral stones at Urology Outpatient Unit Dr Soetomo Hospital within 2011-2015 period. Haematuria without colic complaint had 29.37% sensitivity and 90.17% specificity in the incidence of ureteral stones. Colic and haematuria compared with colic had 55.76% sensitivity for the incidence of ureteral stones and 70.09% specificity. While colic and haematuria compared with haematuria had a sensitivity of 77.41% for the incidence of ureteral stones and 65.92% specificity. Colic and haematuria compared to other complaints has a 58.77% sensitivity for ureteral stones incidence and 94.66% specificity. Conclusion: Colic and haematuria are clinical predictors that have a better value than the complaints of colic without haematuria and haematuria without colic, in the ureteral stones incident at Urology Outpatient Unit Dr Soetomo Hospital within 2011-2015 period. This is consistent with the literature that mentions prominent complaint in the incidence of ureteral stones is their colic pain caused by the stone through the ureteral passage, and followed by haematuria for their mucosal surface injury.

THE EFFECT OF DEXAMETHASONE ON SPERMATOGONIUM AND SERTOLI CELL OF IPSILATERAL TESTIS IN UNILATERAL TESTICULAR TORSION WISTAR RAT Efendi, Ferdyan Rachmat; Renaldo, Johan; Djojodimedjo, Tarmono
Indonesian Journal of Urology Vol 25 No 2 (2018)
Publisher : Indonesian Urological Association

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.32421/juri.v25i2.466

Objective: To investigate the effect of dexamethasone on spermatogonium and sertoli cell of ipsilateral testis in unilateral testicular torsion strain wistar rat. Material & Method: Experimental study with post-test only control group design. The present study was conducted on 30 Wistar male rats aged 10 – 12 weeks grouped into 5 groups. Group I was the normal/sham operation group (KN), group II was left testicular torsion for 4 hours group and followed by manual detorsion (K1), group III was left testicular torsion for 10 hours group and followed by manual detorsion (K2), group IV was left testicular torsion for 4 hours group and given dexamethasone 10 mg/kg body weight subcutaneously 30 minutes before manual etorsion (D1), and group V was left testicular torsion for 10 hours group and given dexamethasone 10 mg/kg body weight subcutaneously 30 minutes before manual detorsion. All rats had left orchidectomy 4 hours after detorsion. The number of spermatogonium and sertoli cells were counted in histological seminiferous tubular testis that have obtained Haematoxylin Eosin staining. Data were analyzed by ANNOVA followed by Post Hoc Tukey for spermatogonium and Kruskal Wallis followed by Mann Whitney test for sertoli cell. Differences were considered significant at p <0.05. Results: There was significant difference in the mean number of spermatogonium between K1 & D1 group. Otherwise, there was no significant difference in the mean number of spermatogonium between K2 & D2. There was significant difference in the mean number of Sertoli cells between K1 & D1 group, likewise that between K2 & D2 group. Conclusion: These results suggest that dexamethasone has protective effect in spermatogonium and sertoli cell in testicular torsion for 4 hours.

THE EFFECT OF ERYTHROPOIETIN SUPPLEMENTATION ON SPERM MOTILITY AND MORPHOLOGY IN WISTAR RAT AFTER LIGATION RELEASE OF THE VAS DEFERENS Pramanta, Aditya; Renaldo, Johan; Soebadi, Doddy M
Indonesian Journal of Urology Vol 26 No 2 (2019)
Publisher : Indonesian Urological Association

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.32421/juri.v26i2.501

Objective: The patency rates after vasectomy reversal ranges from 71-97%, but there is 26-72% possibility of persistent infertility. Dysfunction or obstruction of the epididymis and oxidative stress are thought to be the important cause of male infertility by disrupting spermatozoa maturation process, causing poor sperm quality. Human erythropoietin or better known as EPO is a glycoprotein hormone that has been purified since three decades ago. Research on the EPO has evolved and become a major research topic the researchers aimed as a therapeutic agent. The cloning and expression of erythropoietin has developed recombinant erythropoietin as a drug that serves as an anti-oxidant, anti-apoptotic and anti-inflammatory. This study aimed to determine the effect of erythropoietin supplementation on sperm motility and morphology in Wistar rat after the release of the vas deferens’ ligation. Material & Methods: Twenty four male Wistar rats were randomly divided into four groups (6 each). On the vasectomy group, the vas deferens were serially ligated for 7 weeks using a non-absorbable suture. The vasectomy reversal group get the same surgical treatment and after 7 weeks the ligation were released. While as in the erythropoietin group, recombinant eryhtropoietin (1000 IU/kg) was administered intraperitoneally three times for 1 week after releasing the ligation. Normal control animals received no surgical manipulation and followed by sperm retrieval for analysis. Eosin-stained slides were prepared to assess the motility and morphology of sperm cells and observed under a light microscope. Results: Ligation of vas deferens significantly decreased sperm motility and morphology. Releasing the ligation of the vas deferens did not improve the sperm motility and morphology. Supplementing eryhtropoietin 1000 IU/kg 3 times for a week after releasing the ligation did not improve the sperm motility and morphology. Conclusion: Erythropoietin supplementation did not improve the sperm motility and morphology in Wistar rat after releasing the ligation of vas deferens.

THE EFFECT OF N-ACETYL CYSTEINE TO SPERM MOTILITY, VIABILITY, AND CONCENTRATION OF SPRAGUE DAWLEY RATS WITH NICOTINE INHALATION EXPOSURE Waskito, Dwi; Renaldo, Johan; Soebadi, Doddy M
Indonesian Journal of Urology Vol 26 No 1 (2019)
Publisher : Indonesian Urological Association

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.32421/juri.v26i1.548

Objective: To prove and analyze the difference of sperm motility, viability, and concentration of Sprague Dawley rats which were exposed to nicotine inhalation, with rats treated with N-acetyl cysteine (NAC) orally and exposed to nicotine inhalation. Material & Methods: Twenty seven rats were allocated into three group. Control group (C) (aquadest inhalation 1 mL/kgBW/day), treatment group 1 (N) (nicotine inhalation 1 mg/kgBW/day), and treatment group 2 (N-NAC) (nicotine inhalation 1 mg/kgBW/day and oral NAC administration 150 mg/kgBW/day), with all treatment were given for 30 days. Orchidectomy was performed on day 31 to collect semen sample for sperm analysis (motility, viability, and concentration). Results: There was a significant decrease in all parameters from N group compared to C group. Significant increase were found in sperm motility and viability parameters in the N-NAC treatment group compared to N group. While the sperm concentration parameters of the N-NAC group had a non-significant increase compared to N group. Conclusion: Exposure to nicotine inhalation decreased sperm motility, viability, and concentration of Sprague Dawley strain rats, and NAC had a protective effect on sperm of rats which was exposed to nicotine inhalation.

COMPARISON OF EFFICACY AND SAFETY SILODOSIN 8 MG ONCE DAILY AND SILODOSIN 4 MG TWICE DAILY IN BPH PATIENTS WITH LUTS Diansyah, Ramzie Nendra; Renaldo, Johan; Djatisoesanto, Wahjoe; Hakim, Lukman
Indonesian Journal of Urology Vol 26 No 1 (2019)
Publisher : Indonesian Urological Association

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.32421/juri.v26i1.552

Objective: This study was aimed to compare the efficacy and side effect of silodosin 8mg once daily and silodosin 4mg twice daily in BPH-LUTS patients after 4 and 12 weeks. Material & Methods: Single blind randomized controlled trials in 60 male patients aged ≥45 years with BPH-LUTS from July 2017 to October 2017 was divided into groups who received 8mg of silodosin once daily and those who received 4mg of silodosin twice daily. Efficacy and adverse events were evaluated after 4 and 12 weeks of treatment. Results: There was no significant difference of mean age of the two groups was 67.93 ± 6.49 years and 69.07 ± 6.28 years respectively (p 0.49). Both doses of this drug decreased the International Prostate Symptom Score (IPSS) and significantly increased the maximum urinary flow (Qmax) (p<0.05) but there was no significant differences between the two groups (p>0.05). Ejaculation disorder was the most common side effect in all groups (6.7% and 5%) and there was no significant difference between the two groups (p>0.05). Conclusion: The administration of 8mg of once daily silodosin has similar efficacy as 4mg twice daily silodosin. There were no adverse events differences in the two groups. Ejaculation disorder is the most common adverse event of silodosin administration.

Risk Factors of Urethro-cutaneous Fistula Development in Hypospadias Surgery Permana, Wien; Tarmono, Tarmono; Renaldo, Johan
Jurnal Kedokteran Brawijaya Vol 31, No 3 (2021)
Publisher : Fakultas Kedokteran Universitas Brawijaya

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.21776/ub.jkb.2021.031.03.9

Urethrocutaneous fistula development is the most common complication found hypospadias surgery. Several factors associated with the incidence of fistulas are the age at the time the surgery. The type of hypospadias, the degree of chordae, the operative technique applied and catheter type. This study aimed to determine the risk factors associated with the urethro-cutaneous fistula development in hypospadias surgery. The results showed that from 310 hypospadias patients undergoing urethroplasty, urethra cutaneous fistula development occurred among 105 patients (30.6%) with a mean age of surgery 10.89+6.27 years. Hypospadias type has a significant difference with the incidence of urethro-cutaneous fistula development (p = 0.027). Age (p = 0.615), degree of chordae (P=0.805), operative technique (P=0.901) and catheter type (P=691) do not have a significant impact to urethro-cutaneous fistula development. It can be concluded that operative urethroplasty has a risk of urethra-cutaneous fistula that associated with hypospadias type.

COMPARATIVE EFFICACY OF COMBINED LOW-INTENSITY EXTRACORPOREAL SHOCKWAVE THERAPY AND ORAL THERAPY VS ORAL THERAPY ALONE FOR CHRONIC PELVIC PAIN SYNDROME: A META-ANALYSIS OF RANDOMIZED CONTROLLED TRIAL Nurakbariansyah, Rocky; Soebadi, Doddy M.; Djatisoesanto, Wahjoe; Renaldo, Johan
Indonesian Journal of Urology Vol 28 No 2 (2021)
Publisher : Indonesian Urological Association

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.32421/juri.v28i2.741

Objective: This study aimed to compare the efficacy of Low-Intensity Extracorporeal Shockwave Therapy (Li-ESWT) and oral therapy combination compared to sole oral therapy for reducing symptoms in CP/CPPS patients. Material & Methods: A systematic search was conducted from the electronic database including PubMed, Clinicaltrial.gov, and Cochrane Library, published up to July 2020 following the PRISMA guideline. We screened RCTs with the inclusion criteria and assessed the quality with the Cochrane Risk of Bias tool. The primary outcome was the National Institute of Health Chronic Prostatitis Symptom Index (NIH-CPSI) and subgroup analysis for triple therapy users was conducted to improve interpretability. The analysis was performed using Review Manager 5.3. Results: A total of 2 RCTs consisted of 91 CP/CPPS patients were analyzed. Pooled analysis showed that compared to the oral therapy only group, combination therapy had a significant lower NIH-CPSI total score at the endpoint of the treatment (MD -7.46, 95% CI -9.85 to -5.07, p<0.001) and NIH-CPSI component pain score (MD -3.48, 95% CI -5.04 to -1.93, p<0.0001), urinary symptoms score (MD -0.96, 95% CI -1.47 to -0.45, p<0.001), and quality of life (QoL) impact score (MD -2.94; 95% CI -3.68 to -2.20, p=<0.001). Conclusion: This review revealed that patients undergoing combination Li-ESWT therapy have lower total NIH-CPSI scores than patients receiving oral therapy alone, this finding is consistent with each component of the score: pain, urinary symptoms, and impact on QoL.

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