Daniel Mahendra Krisna, Daniel Mahendra
Faculty Of Medicine Duta Wacana Christian University

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Health Related Quality of Life and Residual Symptoms in Prostatic Surgical Treatment at Bethesda Hospital Yogyakarta: a Retrospective Study Krisna, Daniel Mahendra; Hariatmoko, Hariatmoko; Pinzon, Rizaldy Taslim
Althea Medical Journal Vol 4, No 3 (2017)
Publisher : Althea Medical Journal

Show Abstract | Download Original | Original Source | Check in Google Scholar | Full PDF (237.415 KB) | DOI: 10.15850/amj.v4n3.968

Abstract

Background: The incidence of Prostate Enlargement (PE) has been increasing over the years. The satisfaction towards the treatment result and life quality (QOL) improvement must be the key point of PE treatment. QOL is affected by many conditions, such as age, socioeconomic status, comorbid disease, and type of surgery. The objective of the study was to assess the QOL in PE patients post surgery, to explore the predictor factor, and to assess the satisfaction related to urinary functionality in the Indonesian context. Methods: A retrospective study was conducted and the subjects were all PE patients who underwent surgical treatment. EQ-5D-5L/EQ-VAS and Index Quality of Life (IQL) were used to assess the patient’s QOL & treatment satisfaction. The subjects were divided into several sub-groups based on age, type of surgery, comorbid condition, type of ward, funding source, histopathological result, and the year of treatment. The collected data wee analyzed using Mann-Whitney test, Kruskal Wallis test, or Chi-square test, Spearman’s rho test and multiple linear regression. Results: All the 149 subjects were at the average age of 69.09 years . There were no significant statistical differences in QOL between age, comorbid conditions, and histopathology result. Health insurance (HI) was significantly associated with QOL. There were improvements of IQL subjects. The most symptoms remaining was frequency (47.4%).Conclusions: Life improvement must be the major purpose of PE therapy. The association between HI with QOL suggests that a better HI in developing countries can ensure a better quality of life outcome.
THE INCIDENCE AND CORRELATION OF CHRONIC PROSTATITIS WITH PSA IN BPH PATIENT Krisna, Daniel Mahendra; Hariatmoko, Hariatmoko; Pinzon, R
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.v25i2.418

Abstract

Objective: The aim of this study is to determine the incidence of incidental chronic prostatitis proven by biopsy in prostate enlargement patients and to correlate with Prostate Specific Antigen (PSA) level serum. Material & Methods: This was a retrospective study with cross-sectional method. All of the prostate enlargement subjects with urinary retention and treated by surgical therapy were taken into inclusion criteria. The patient with acute prostatitis proven by biopsy and uncompleted medical records were excluded. Statistical analysis used Spearman correlation test. Results: The mean values of age and PSA were 70.24 years and 27.2 ng/mL. The patients characteristic such as surgery waiting time were 81 patients in 1-3 days, the most common length of stay were 3 patients (4%) for 1-3 days. The most common biopsy result was Benign Prostatic Hyperplasia (BPH) in 55 patients (61.5%). 64 patients (70.3%) were treated by Trans Urethral Resection of Prostate (TURP) and 14 patients (9.9%) had secondary surgery. There was a correlation between chronic prostatitis with PSA levels in BPH patients (p=0.000). Conclusion: Chronic prostatitis is often found incidentally in BPH patients and affecting PSA serum level. The existence of chronic prostatitis in BPH may predict the progress of prostate growth.
Incidence of Electrolyte Disturbance after TURP Procedure Krisna, Daniel Mahendra; Maulana, Akhada
Cermin Dunia Kedokteran Vol 45, No 7 (2018): Onkologi
Publisher : PT. Kalbe Farma Tbk.

Show Abstract | Download Original | Original Source | Check in Google Scholar | Full PDF (158.08 KB) | DOI: 10.55175/cdk.v45i7.639

Abstract

Introduction. Trans Urethral Resection of the Prostate (TURP) as a gold standard treatment for benign prostatic hyperplasia (BPH) is performed with fluid irrigation that may cause electrolyte disturbance due to excessive fluid absorption; and may lead to increased mortality. This study is to determine the incidence of electrolyte disturbances and risk factors in TURP procedure. Materials & Methods. A descriptive retrospective study was conducted at Bhayangkara Hospital Mataram in January 2014-January 2016. The subjects were all BPH patients who underwent TURP surgery. Data were retrieved from medical records. All TURP procedures used distilled water as irrigation fluid. Presurgery and postsurgery electrolyte level, digital rectal grading and weight of resection tissue were recorded. Deranged electrolyte was defined as presence of any or both serum sodium < 130 or > 145 mmol/L and serum potassium <3,5 or > 5,5 mmol/L. Student’s T-test was applied to determine significant change between pre and post surgery variables. Results. Of 32 subjects, the mean age was 63.39 years and the mean weight of resected tissue was 63.03 grams. Sodium, potassium, chloride, and hemoglobin level were decreased post surgery (mean reduction 2.00, p = 0.000; 0.25, p = 0.000 ; 27.81, p = 0.021;1.050, p = 0.025, respectively). In 10 subjects, only significant decreased serum chloride and hemoglobin were found (mean reduction 4.5, p = 0.017; 1.46, p = 0.048, respectively). Sodium and potassium serum level were significantly decreased in non deranged electrolyte group (mean reduction 1.8, p = 0.01; 0.27, p = 0.00, respectively). No significant correlation between electrolyte imbalance with age and digital rectal examination grading. Conclusion. Electrolyte serum levels were significantly decreased after TURP procedure.Latar Belakang. Trans Urethral Resection of the Prostate (TURP) adalah suatu prosedur reseksi jaringan prostat, membutuhkan irigasi yang dapat menimbulkan gangguan elektrolit dan hemodinamika karena absorbsi cairan melalui vena selama irigasi. Gangguan elektrolit ini dapat meningkatkan morbiditas dan mortalitas. Tujuan penelitian ini adalah untuk mengetahui insidensi perubahan elektrolit dan faktor risikonya. Metode. Penelitian deksriptif retrospektif di Rumah Sakit Bhayangkara Mataram dengan subyek semua pasien BPH yang menjalani prosedur TURP pada periode Januari 2014- Januari 2016. Data sekunder diambil dari rekam medis yaitu kadar elektrolit pra bedah, kadar elektrolit pasca bedah, tingkatan BPH berdasarkan colok dubur. Semua prosedur TURP menggunakan air distilasi sebagai cairan irigasi. Gangguan elektrolit didefinisikan sebagai kadar natrium < 130 atau> 145 mmol/L atau kadar kalium <3,5 atau> 5,5 mmol/L. Student’s T-test digunakan uji kemaknaan perubahan pasca bedah. Hasil. Subyek 32 pasien, rerata usia 63.39 tahun dan rerata berat jaringan reseksi 63.03 gram. Terdapat penurunan kadar natrium, kalium, klorida, dan hemoglobin pasca bedah (rerata penurunan kadar serum Na 2.00, p = 0.000; serum K 0.25, p = 0.000 ; serum Cl 27.81, p = 0.021; dan serum Hb 1.050, p = 0.025). Terdapat 10 subyek dengan kategori gangguan elektrolit, klorida dan Hb signifikan (rerata penurunan kadar serum Cl 4.5, p = 0.017; dan serum Hb 1.46, p = 0.048). Pada kategori non gangguan elektrolit ditemukan penurunan natrium dan kalium yang signifikan (rerata penurunan kadar serum Na 1.8, p = 0.01; dan serum K 0.27, p = 0.00). Tidak ada korelasi dengan usia dan dengan tingkat penyakit berdasarkan colok dubur. Simpulan. Terdapat penurunan signifikan kadar elektrolit selama prosedur TURP.