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INDONESIA
Indonesian Journal of Urology
Published by Universitas Airlangga
ISSN : 0853442X     EISSN : 23551402     DOI : 10.32421
Core Subject : Health,
The aim of Indonesian Journal of Urology is to encompass the whole spectrum of urology. The journal publishes papers on a wide range of urological issues such as oncology, functional urology, reconstructive urology, laparoscopy, robotic surgery, endourology, female urology, andrology, pediatric urology, and sexual medicine. We welcome authors for original article (research), review article, interesting case reports, special article, clinical practices, and medical illustrations that focus on the clinical area of urology.
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Articles 408 Documents
PERIPROSTATIC NERVE BLOCK AND INTRAPROSTATIC INFILTRATION ON TRUS-P GUIDED BIOPSY Rachman, Wendi; Safriadi, Ferry
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.v20i2.6

Abstract

Objective: This study is aimed to determine the effectiveness and complications of periprostatic block and intraprostatic infiltration anesthesia for transrectal prostate biopsy. Material & Method: Two consecutive group of patients, periprostatic block (group A) and intraprostatic infiltration (group B), underwent transrectal ultrasound (TRUS) guided prostate biopsy were entered into the study. Exclusion criteria were severe systemic infection, local infection (prostatitis, proctitis, anorectal abscess, and fissure), hemorrhoid (external and/or internal), and chronic pelvic pain (bladder pain syndrome (BPS) or other pelvic disease. Each group enrolled 58 patients. The patients were requested to choose indicate degree of pain on visual analog score (VAS) 3 times, during probe insertion (VAS1), during anesthesia (VAS2), and during the biopsy (VAS3). Complications from the procedures were recorded. The data were analyzed using Mann-Whitney and independent t-test. Results: There were no significant difference in average age of groups, 65,69 ± 7,019 years for group A and 65,34 ± 7,633 years for group B (p = 0,647). The VAS3 score of group B 5,17 ± 0,653 was significantly lower than group A 5,9 ± 0,612 (p < 0,001). The change in VAS score (VAS3-VAS2) in group B 0,55 ± 0,535 also significantly lower than group A 1,00 ± 0,530 (p = 0,004). The average days with pain were not significant on both group, group A 1,16 ± 0,362 day and group B 1,12 ± 0,329 day (p = 0,594). The duration of bleeding was significantly higher on group B 1,32 ± 0,562 day than group A 1,10 ± 0,307 day (p = 0,026). Conclusion: Intraprostatic infiltration resulted in less pain during prostate biopsy, but also reported more bleeding after the procedure than the periprostatic block.Keywords: Intraprostatic infiltration, periprostatic nerve block, transrectal ultrasound guided prostate biopsy.
AGE-RELATED CHANGES IN RENAL RESISTIVE INDEX AFTER ESWL Hermawan, Anton; Alif, Sabilal; djatisoesanto, wahjoe; Wulanhandarini, Tri; Budiono, Budiono
Indonesian Journal of Urology Vol 21 No 1 (2014)
Publisher : Indonesian Urological Association

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.32421/juri.v21i1.7

Abstract

Objective: To determine relation between age and resistive index (RI) changes occurring after extracorporeal shock wave lithotripsy (ESWL). Material & Method: We performed a prospective study in Soetomo Hospital Surabaya. Using duplex ultrasonography, RI was determined in 20 patients with calyceal kidney calculi and pelvic kidney calculi. RI of the interlobar renal arteries were measured in the region near the calculi (distance, less than 2 cm), one hour before ESWL and RI was measured again at 1 hour, 3 days and 7 days after ESWL. Changes in RI values and relation with age (≤ 60 years old and > 60 years old) were evaluated. Results: The renal RI increased significantly 1 hour and 3 days after ESWL, but returned to before ESWL values 7 days after ESWL in the both groups. Although there was positive correlation between age and RI before ESWL, but there was no correlation between age and RI changes after ESWL. Conclusion: Renal RI is higher with age > 60 years, after ESWL renal RI showed transient increase which returned to baseline after 7 days.Key words: Color Doppler Ultrasonography, extracorporeal shock wave lithotripsy, renal resistive index, calyceal kidney calculi, pelvic kidney calculi.
MANAGEMENT OF URETER STONES USING ESWL COMPARED TO URS Rusydi, Muhammad Omar; Rahardjo, Djoko
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.v20i2.8

Abstract

Objective: To evaluate the management of ureterolithiasis using Extracorporeal Shock Wave Lithotripsy (ESWL) EDAP Sonolith Technomed compared to ureteroscopy (URS) with holmium:YAG laser lithotripsy. Material & Method: Research was conducted at Central Pertamina Hospital Jakarta by comparative analysis. The data was taken from patients’ medical records diagnosed with ureterolithiasis who had been treated from January to Desember 2009.Results: Central Hospital Pertamina Jakarta had treated 127 patients with urolithiasis from January to December 2009. Most frequent therapeutic modality was URS, which was followed by ESWL.Double J stents were used in 19,8% of the treatmentin combination with URS, more common than ESWL. Stone free rate in urolithiasis was not significantly different between treatment with URS and ESWL, although stone free rate of URS was higher than ESWL.Use of DJ stent didn’t affect stone free rate of urolithiasis from two of these modalities.Conclusion: Stone free rate of these modalities was below of stone free rate at literatures published, because evaluation from stone free rate of this research was taken after the treatment or 1-2 days after the treatment with imaging of KUB and USG.Keywords: Urolithiasis, extracorporeal shock wave lithotripsy, ureteroscopic,DJ stent, stone free rate.
CHANGES IN ERECTILE FUNCTION BEFORE AND AFTER PROSTATE BIOPSY wibisono, Wibisono; Soebadi, Doddy Musbadianto; Alif, Sabilal; Pudjirahardjo, Widodo
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.v20i2.9

Abstract

Objective: To evaluate erectile function before and after transrectal ultrasound (TRUS) guided prostate biopsy using International Index of Erectile Function-5 (IIEF-5) and Erection Hardness Score (EHS) instrument. Material & Method: We conducted a study on 17 BPH LUTS patients who underwent TRUS guided prostate biopsy from January to April 2011 in Urological Minimal Invasive Installation (IIU) Dr. Soetomo Hospital. Out of 17 patients, three patients had mild ED, while 14 other patients had normal erectile function before the procedure. After TRUS guided prostate biopsy, we performed erectile function assessment using the IIEF-5 and EHS at weeks I, II, and IV. Results: Pathological examination of all specimens from prostate biopsy results revealed BPH. There were 2 patients with hematuria and 1 patient with rectal bleeding shortly after the biopsy, which resolved spontaneously less than 24 hours. Based on the IIEF-5 there were 4 patients (23,5%) with decreased erectile function in the evaluation of first week after prostate biopsy, and it reduced to 2 patients (11,7%) whose erectile function was still decreasing in the evaluation week II, while in fourth week evaluation there was 1 patient (5,9%) with decreased erectile function. Based on EHS data obtained, there were 5 patients (29,4%) with decreased scores in evaluations week II, and in the evaluation of week IV there were no patients having erectile function problems compared with EHS data before prostate biopsy. Conclusion: TRUS guided prostate biopsy can have temporary effect on erectile function.Keywords: Erectile dysfunction, prostate biopsy, international index of erectile function-5, erection hardness score.
THE USE FGSI AS PREDICTIVE OF UROLOGICAL SIRS PATIENTS Purnomo, Basuki Bambang
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.v20i2.10

Abstract

Objective: To demonstrate the usefulness of Fournier’s Gangrene Severity Index (FGSI) score for differentiating the outcome between Systemic Inflammatory Response Syndrome (SIRS) patients with upper and lower urological abnormalities. Material & Method:A retrospective study of case records from year 2009-2012 of SIRS patients with urological abnormalities at Saiful Anwar General Hospital (SAGH) Malang was carried out. The data were collected from the Medical Record Division in SAGH Malang. SIRS was clinicaly diagnosed based on medical history, physical examination and laboratory findings. SIRS without urological abnormalities were excluded from the analysis. The FGSI, which was developed to assign a numerical score that describes the severity of disease, was used in our study. This index presents patients vital signs (temperature, heart and respiratory rates) and metabolic parameters (sodium, potassium, creatinine, and bicarbonate levels, hematocrit, and white blood cell count). Patients with SIRS and urological abnormalities were divided according to upper tract and lower tract urological abnormalities. Total FGSI score was classified as mild (0-8), moderate (9-17), severe (> 17). The data were assessed according to whether the patient survived or died.Results:75 of the 203 evaluated patients died. From those 75 patients, 67% were male and 33% were female, 75% with upper urological abnormalities and 25% with lower abnormalities (p < 0,05). From those 203 patients; the results were analyzed with binary logistical regression and Spearman correlation analysis using SPSS 15 softwarewith 95% confidence interval (CI). There is significant relationship between FGSI and outcome of the patient with upper urological abnormalities and lower urological abnormalities, with correlation coefficient more high in relationship between FGSI and outcome of the patient with upper urological abnormalities (0,4 vs 0,1). Conclusion: FGSI is simple and objective outcome predictor to differentiate survival between SIRS patients with upper urological abnormalities and lower urological abnormalities. There is a significant difference in outcome between SIRS patient with upper urological abnormalities and lower urological abnormalities even with same level of FGSI score.Keywords: Fournier’s gangrene severity index, systemic inflammatory response syndrome, upper urological abnormalities, lower urological abnormalities, outcome predictor.
DIURETIC DOPPLER ULTRASOUND FOR EVALUATING OBSTRUCTED AND NON-OBSTRUCTED KIDNEY Fajrial, Ahmad Fajrial; Soebadi, Doddy M; Djojodimedjo, Tarmono; S, Muhammad Yamin; Pudjirahardjo, Widodo
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.v20i2.11

Abstract

Objective: The objective of this study was to evaluate the implementation of diuretic Doppler Ultrasound (DDU) to differentiate the obstructed and non-obstructed kidney. Material & Method: From 28 patients, we gathered data of 48 kidneys in accordance with the inclusion criteria. We evaluated the Doppler Ultrasound Resistive Index (RI) before and after administration of diuretic, using the renogram as the comparison. The result of renogram was categorized into total obstruction (n = 19), partial obstruction (n = 18), and non-obstructive dilatation (n = 3). The statistical analysis was performed using Anova test followed by Tukey HSD test. We also performed diagnostic test, the total and partial obstruction were categorized within obstructed group (n = 37) whereas normal and non-obstructed dilated kidney categorized as non-obstructed group (n = 11). Results: Average change of RI (ΔRI) was 0,542 ± 0,0457 for total obstruction, 0,0428 ± 0,0439 for partial obstruction, 0,0275 ± 0,0392 for normal kidney, -0,0300 ± 0,0361 for non obstructed dilated kidney. The result of normality and homogeneity test indicated the data were normally distributed. One-way Anova test revealed significant differences of ΔRI between groups. The subsequent Tukey HSD test indicated that there were significant differences in total and partial obstruction groups, compared to non-obstructive dilated kidney group. Based on ΔRI cut-off point (0,035) the diagnostic characteristics were 88,5% sensitivity and 72,3% specificity. Conclusion: RI of Diuretic Doppler Ultrasound is a valuable examination to evaluate obstructed and non-obstructed kidney. The cut-off point of 0,035 indicated probability of obstructive kidney. Keywords: Resistive index, renogram, obstructive kidney, non-obstructive kidney. 
TERAZOSIN EVALUATION AS MALE LUTS TREATMENT USING IPSS SUB-SCORING RATIO Tanggo, Christian Ronald K.; Safriadi, Ferry
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.v20i2.12

Abstract

Objective: To evaluate the improvement of Lower Urinary Tract Symptoms (LUTS) in males treated with terazosin based on sub scoring ratio of the International Prostatic Symptoms Score (IPSS). Material & Method: Sixty eight male with LUTS subjected to terazosin 1 mg daily and divided into two groups based on IPSS sub scoring ratio. After 3 months improvement of the symptoms were evaluated using the IPSS. Data analysis was done using paired T-test. The conclusion was based on significance level p<0,05. Results: The IPSS score was improving on both failure to void group (IPSS- v/s >1) and failure to store group (IPSS- v/s ≤1) after 3 months of Terazosin therapy (mean= 9,56 versus 6,94). Statistically superior improvement was observed on failure to voiding group (p=0,0003) (95CI:1,30-3,93). Conclusion: Terazosin is best given to male LUTS with IPSS- v/s >1 although both groups respond well.Keywords:International prostatic symptoms score, sub score, failure to voiding, failure to storage, male, lower urinary tract symptoms.
TAMSULOSIN OR SOLIFENACIN IN LUTS PATIENTS DUE TO DJ-STENT INSERTION Subkhan, Subkhan; Djojodimedjo, Tarmono; Hakim, Lukman; 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.v20i2.13

Abstract

Objective: To evaluate the efficacy of tamsulosin or solifenacin for treatment of Lower Urinary Tract Symptoms (LUTS) due to an indwelling ureteral stent. Material & Method: In this study, we enrolled 24 patients who had polyurethane DJ-stent inserted for urinary stone disease or ureteral stenosis. Patients were divided into 3 equal groups as follows and study medications were started on postoperative day 7. Group I received tamsulosin 0,4 mg once daily, group II received solifenacin 5 mg once daily, and group III only received placebo. LUTS were evaluated using International Prostatic Symptoms Score (IPSS) questionnaire at 7 and 14 days after the procedure and stent insertion. The evaluation of IPSS score included not only total score but also irritative and obstructive subcores. Results: All 24 patients fulfilled the inclusion and exclusion criteria, mean age of tamsulosin group was 54,3 years old, solifenacin group was 45,3 years old and placebo was 46,7 years old. There was significant difference in the total IPSS and irritative subscores between groups who received either tamsulosin or solifenacin (group I and II), whereas the obstructive subscore showed a difference though not statistically significant. Conclusion: Tamsulosin or solifenacin significantly improved irritative symptoms of LUTS in patients with an indwelling ureteral stent.Keywords: Lower urinary tract symptoms, DJ-stent, tamsulosin, solifenacin.
PREOPERATIVE KETOROLAC EFFECT ON POSTOPERATIVE PAIN ON TURP PATIENTS Hadi, Choirul; Utomo, Trisula
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.v20i2.14

Abstract

Objective: The aim of this study is to study the effect of preoperative Ketorolac on postoperative pain after transurethral prostatectomy at Sardjito Hospital Yogyakarta. Material & Methods: This is a cross sectional, analytic, prospective study. We divided benign prostatic hyperplasia patients, from October 2011 until February 2012 into two groups. Group I was given Ketorolac 30 mg intravenously twice daily starting one day before operation and in the morning before procedure. Group II did not receive Ketorolac preoperatively. Patients underwent transurethral operation with spinal anesthesia. We assessed postoperative pain at 24 hours using Visual Analogue Scale (VAS). Results: Twenty four patients were included in this study with mean age 66 years old with the youngest 45 years old and the oldest 80 years old (SD 8,77744). Group I (17 patients), VAS score 1 to 7 with median 3 and mean 3,4118 (SD 1,66053). Group II (7 patients) VAS score 1 to 8 with median 3 and mean 3,8571 (SD 2,8357). We count it using Mann-Whitney U (p = 0,951). Conclusion: There is no significance difference in post-operative pain after transurethral prostatectomy with preoperative ketorolac administration.Keywords: Ketorolac, bupivacaine, visual analogue scale, transurethral prostatectomy.
RELATIONSHIP BETWEEN TZI AND TZV WITH IPSS, QMAX, AND BOO Satyagraha, Paksi; Djojodimedjo, Tarmono; Wirjopranoto, Soetojo; 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.v20i2.15

Abstract

Objective: This study evaluate the relationship between the IPSS score, Qmax,  and degree of bladder outlet obstruction with transitional zone volume (TZV) and transitional zone index (TZI) in clinical BPH patient. Material & Methods: This is an observational cross sectional study which 26 patients included with clinical BPH between September 2011 until January 2012. General information and other variables are recorded (total prostate volume, TZV, TZI, IPSS score, Qmax and degree of bladder outlet obstruction (BOO) according to Schaefer normogram. The data will be descriptive and analytically analyzed. Results: 26 patients with clinical BPH are included in this study, with average age is 64,7 (± 5,98) years. The average volume of the total prostate volume and TZV are 30,35 (± 15,35) gram and 15,31 (± 11,77) gram. Meanwhile the average of TZI is 0,4 (± 0,13). After the normal distribution test was performed, all data is analyzed with Pearson correlation test. A strong correlation was found between IPSS and total prostate volume (r = 0,526, p = 0,006), TZV (r = 0,671, p = 0,000) and TZI (r = 0,812, p = 0,000). A strong correlation is also found between TZI and BOO (r = 0,560, p = 0,003). Meanwhile weak correlation is found between Qmax and total prostate volume (r = -0,105, p = 0,608), TZV (r = -0,103, p = 0,616) and TZI (r = - 0,084, p = 0,734). Another weak correlation is shown between total prostate volume (r = 0,233, p = 0,253) and TZV (r = 0,37, p = 0,062) with degree of BOO according to Schaefer nomogram. Conclusion: TZV has significant correlation with IPSS score, but no significant correlation with Qmax and degree of BOO in patients with clinical BPH. Meanwhile TZI has a significant correlation with IPSS and degree of BOO in patients with clinical BPH. TZI could be performed as a single non invasive procedure to determine BOO in patients with clinical BPH.Keywords: Prostatic hyperplasia, transition zone, ultrasonography, urodynamics.

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