Rocky Nurakbariansyah, D. Soebadi, W. Djatisoesanto, J. Renaldo
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.
目的:本研究旨在比较低强度体外冲击波治疗(Li-ESWT)和口服联合治疗与单独口服治疗对CP/CPPS患者减轻症状的疗效。材料与方法:根据PRISMA指南，从PubMed、Clinicaltrial.gov和Cochrane Library等截至2020年7月出版的电子数据库中进行系统检索。我们用纳入标准筛选rct，并用Cochrane偏倚风险工具评估质量。主要终点是美国国立卫生研究院慢性前列腺炎症状指数(NIH-CPSI)，并对三联疗法使用者进行亚组分析以提高可解释性。使用Review Manager 5.3进行分析。结果:共分析了2个RCTs，共91例CP/CPPS患者。合并分析显示，与单纯口服治疗组相比，联合治疗组在治疗终点的NIH-CPSI总分(MD -7.46, 95% CI -9.85 ~ -5.07, p<0.001)、NIH-CPSI成分疼痛评分(MD -3.48, 95% CI -5.04 ~ -1.93, p<0.0001)、泌尿系统症状评分(MD -0.96, 95% CI -1.47 ~ -0.45, p<0.001)和生活质量(QoL)影响评分(MD -2.94;95% CI为-3.68 ~ -2.20,p=<0.001)。结论:本综述显示，接受Li-ESWT联合治疗的患者的NIH-CPSI总评分低于单独接受口服治疗的患者，这一发现与评分的各个组成部分一致:疼痛、泌尿系统症状和对生活质量的影响。
{"title":"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","authors":"Rocky Nurakbariansyah, D. Soebadi, W. Djatisoesanto, J. Renaldo","doi":"10.32421/JURI.V28I2.741","DOIUrl":"https://doi.org/10.32421/JURI.V28I2.741","url":null,"abstract":"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.","PeriodicalId":13565,"journal":{"name":"Indonesian Journal of Urology","volume":"28 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2021-07-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"81230889","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Putri Iradita Islianti, H. Rahardjo, N. Rasyid, A. Rodjani
Objective: This study aimed to describe the urodynamic characteristics of post-transplant kidney patients with LUTS who were indicated for urodynamics. Material & Methods: This research is a cross-sectional study conducted at Cipto Mangunkusumo General Hospital between 2011-2017. Data were collected from patients who had undergone urodynamic examination after kidney transplantation due to LUTS/urinary retention. Data were collected from the patient’s medical record. Results: A total of 536 patients underwent kidney transplants at Cipto Mangunkusumo General Hospital from 2011-2017. Eleven patients (2%) developed LUTS and then underwent urodynamic examination with an average age of 41.4 (30.1 ± 52.6) years. Six patients (55%) had type 2 diabetes mellitus (DM) and 5 patients (45%) had hypertension (HT). A total of 6 out of 11 patients (54%) experienced urinary retention of which 4 subjects (67%) had decreased bladder compliance, 4 (67%) patients experienced detrusor overactivity (DO), 3 patients (50%) had bladder outlet obstruction (BOO), while 2 patients (33%) experienced detrusor underactivity (DU) respectively. Of 5 patients without urinary retention, decreased bladder compliance was found in 1 patient (20%), DO in 2 patients (40%), BOO in 1 patient (20%), and no subject experienced DU. In both groups, no subject was discovered to experience any urinary incontinence. Conclusion: Small number of post renal transplantation patients developed LUTS and half of which accompanied by urinary retention. Among these patients, urodynamic examination revealed detrusor overactivity as the most common underlying problem followed by decreased bladder compliance, BOO, and detrusor underactivity
{"title":"PREVALENCE OF LOWER URINARY TRACT SYMPTOMS POST KIDNEY TRANSPLANTATION AND ITS URODYNAMIC PROFILE","authors":"Putri Iradita Islianti, H. Rahardjo, N. Rasyid, A. Rodjani","doi":"10.32421/JURI.V28I2.683","DOIUrl":"https://doi.org/10.32421/JURI.V28I2.683","url":null,"abstract":"Objective: This study aimed to describe the urodynamic characteristics of post-transplant kidney patients with LUTS who were indicated for urodynamics. Material & Methods: This research is a cross-sectional study conducted at Cipto Mangunkusumo General Hospital between 2011-2017. Data were collected from patients who had undergone urodynamic examination after kidney transplantation due to LUTS/urinary retention. Data were collected from the patient’s medical record. Results: A total of 536 patients underwent kidney transplants at Cipto Mangunkusumo General Hospital from 2011-2017. Eleven patients (2%) developed LUTS and then underwent urodynamic examination with an average age of 41.4 (30.1 ± 52.6) years. Six patients (55%) had type 2 diabetes mellitus (DM) and 5 patients (45%) had hypertension (HT). A total of 6 out of 11 patients (54%) experienced urinary retention of which 4 subjects (67%) had decreased bladder compliance, 4 (67%) patients experienced detrusor overactivity (DO), 3 patients (50%) had bladder outlet obstruction (BOO), while 2 patients (33%) experienced detrusor underactivity (DU) respectively. Of 5 patients without urinary retention, decreased bladder compliance was found in 1 patient (20%), DO in 2 patients (40%), BOO in 1 patient (20%), and no subject experienced DU. In both groups, no subject was discovered to experience any urinary incontinence. Conclusion: Small number of post renal transplantation patients developed LUTS and half of which accompanied by urinary retention. Among these patients, urodynamic examination revealed detrusor overactivity as the most common underlying problem followed by decreased bladder compliance, BOO, and detrusor underactivity","PeriodicalId":13565,"journal":{"name":"Indonesian Journal of Urology","volume":"47 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2021-07-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"88506653","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Objective: This study aims to evaluate the learning curve of the urologist to perform supine PCNL and the perioperative outcome of patients based on a single surgeon’s experience. Material & Methods: 60 consecutive patients who underwent modified supine PCNL for renal stone were analyzed. A single experienced urological surgeon performed the supine PCNL. Mean operative time, drop in hemoglobin level, stone-free rate, complications, and length of hospital stay were analyzed to evaluate the learning curve of the surgeon. All parameters were compared among all six groups obtained from the 60 cases in chronological order. Besides, the outcomes of supine PCNL were also compared to prone PCNL. Results: Mean operative time from 60 cases of supine PCNL was 100 ± 27 minutes. The mean operative time was decreased over time, particularly after 20 cases. Significantly different mean operative times (89 ± 14 minutes vs. 126 ± 21 minutes, p < 0.001) in the groups of cases 21-60 compared to the group of 1–20 cases were observed. The total stone-free rate for supine PCNL from all cases was 68%. There was no difference regarding the reduction of hemoglobin level, stone-free rate, hospital stay, and complication rate. No major complication was found among study subjects. Supine PCNL showed similar outcome parameters compared to prone PCNL. Conclusion: The surgeon acquired the surgical competencies to perform supine PCNL after 20 cases. The supine PCNL could remove the kidney stone as effective and safe as prone PCNL.
目的:本研究旨在评估泌尿科医师仰卧位PCNL的学习曲线和基于单一外科医生经验的患者围手术期预后。材料与方法:对60例连续行改良仰卧PCNL治疗肾结石的患者进行分析。由一名经验丰富的泌尿外科医生进行仰卧位PCNL。分析平均手术时间、血红蛋白水平下降、结石清除率、并发症和住院时间，以评估外科医生的学习曲线。按时间顺序比较从60例中获得的所有六组的所有参数。此外，还比较了仰卧位PCNL与俯卧位PCNL的预后。结果:60例仰卧PCNL平均手术时间为100±27分钟。平均手术时间随着时间的推移而减少，特别是在20例之后。21 ~ 60例组与1 ~ 20例组的平均手术时间(89±14 min vs 126±21 min, p < 0.001)差异有统计学意义。所有病例中仰卧位PCNL的总无石率为68%。两组在血红蛋白水平降低、无结石率、住院时间和并发症发生率方面均无差异。研究对象中未发现重大并发症。仰卧位PCNL与俯卧位PCNL的结局参数相似。结论:经过20例手术，术者已具备进行仰卧位PCNL的手术能力。仰卧位取石术与俯卧位取石术一样安全有效。
{"title":"TRANSITION FROM PRONE TO SUPINE PERCUTANEOUS NEPHROLITOTOMY: EVALUATING THE LEARNING CURVE FROM THE SINGLE SURGEON EXPERIENCE","authors":"Z. Ali, A. Afriansyah","doi":"10.32421/JURI.V28I2.680","DOIUrl":"https://doi.org/10.32421/JURI.V28I2.680","url":null,"abstract":"Objective: This study aims to evaluate the learning curve of the urologist to perform supine PCNL and the perioperative outcome of patients based on a single surgeon’s experience. Material & Methods: 60 consecutive patients who underwent modified supine PCNL for renal stone were analyzed. A single experienced urological surgeon performed the supine PCNL. Mean operative time, drop in hemoglobin level, stone-free rate, complications, and length of hospital stay were analyzed to evaluate the learning curve of the surgeon. All parameters were compared among all six groups obtained from the 60 cases in chronological order. Besides, the outcomes of supine PCNL were also compared to prone PCNL. Results: Mean operative time from 60 cases of supine PCNL was 100 ± 27 minutes. The mean operative time was decreased over time, particularly after 20 cases. Significantly different mean operative times (89 ± 14 minutes vs. 126 ± 21 minutes, p < 0.001) in the groups of cases 21-60 compared to the group of 1–20 cases were observed. The total stone-free rate for supine PCNL from all cases was 68%. There was no difference regarding the reduction of hemoglobin level, stone-free rate, hospital stay, and complication rate. No major complication was found among study subjects. Supine PCNL showed similar outcome parameters compared to prone PCNL. Conclusion: The surgeon acquired the surgical competencies to perform supine PCNL after 20 cases. The supine PCNL could remove the kidney stone as effective and safe as prone PCNL.","PeriodicalId":13565,"journal":{"name":"Indonesian Journal of Urology","volume":"8 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2021-07-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"79234372","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Objective: Aim of this study is to identify risk factors associated with erectile dysfunction in post-transurethral prostate resection (TURP) patients for the management of benign prostatic hyperplasia (BPH). Material & Methods: During 2019, 22 patients met the TURP indication criteria in the urology polyclinic of Koja Hospital for symptomatic BPH management. All patients underwent transabdominal ultrasonography to confirm prostate volume and underwent laboratory tests to measure serum prostate-specific antigen (PSA). History of comorbidities such as diabetes mellitus, cardiovascular events, and hypertension was recorded. The patient's sexual function was determined using the International Index of Erectile Function questionnaire (IIEF-5) before surgery and six months postoperatively, where erectile dysfunction was established for scores below 21. Mean comparisons were made to see if there was a significant change in IIEF score six months postoperatively. Results: There were 22 subjects as samples with a mean age of 63 ± 3.8 years, prostate volume 47.64 ± 5.5 mL and a median PSA level of 3.3 [1-47] ng/dL. The comorbidities found in the subjects were diabetes mellitus (22.7%), cardiovascular events (36.4%), and hypertension (27.3%). The mean IIEF-5 score before surgery was 14.55 ± 0.78 and was not significantly different (p= 0.225) with a reevaluation six months after surgery of 14.18 ± 0.76. Conclusion: There was no change in the severity of erectile dysfunction in patients undergoing TURP surgery.
{"title":"ERECTILE DYSFUNCTION AFTER TRANSURETHRAL PROSTATE RESECTION (TURP) IN PATIENTS WITH LOWER URINARY TRACT SYMPTOMS AT KOJA HOSPITAL, JAKARTA","authors":"M. Huseini, Waluyo Eko Sutarto","doi":"10.32421/JURI.V28I2.679","DOIUrl":"https://doi.org/10.32421/JURI.V28I2.679","url":null,"abstract":"Objective: Aim of this study is to identify risk factors associated with erectile dysfunction in post-transurethral prostate resection (TURP) patients for the management of benign prostatic hyperplasia (BPH). Material & Methods: During 2019, 22 patients met the TURP indication criteria in the urology polyclinic of Koja Hospital for symptomatic BPH management. All patients underwent transabdominal ultrasonography to confirm prostate volume and underwent laboratory tests to measure serum prostate-specific antigen (PSA). History of comorbidities such as diabetes mellitus, cardiovascular events, and hypertension was recorded. The patient's sexual function was determined using the International Index of Erectile Function questionnaire (IIEF-5) before surgery and six months postoperatively, where erectile dysfunction was established for scores below 21. Mean comparisons were made to see if there was a significant change in IIEF score six months postoperatively. Results: There were 22 subjects as samples with a mean age of 63 ± 3.8 years, prostate volume 47.64 ± 5.5 mL and a median PSA level of 3.3 [1-47] ng/dL. The comorbidities found in the subjects were diabetes mellitus (22.7%), cardiovascular events (36.4%), and hypertension (27.3%). The mean IIEF-5 score before surgery was 14.55 ± 0.78 and was not significantly different (p= 0.225) with a reevaluation six months after surgery of 14.18 ± 0.76. Conclusion: There was no change in the severity of erectile dysfunction in patients undergoing TURP surgery.","PeriodicalId":13565,"journal":{"name":"Indonesian Journal of Urology","volume":"13 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2021-07-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"78423318","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Muhammad Risan, Indrawarman Soeroharjo, R. Danarto, P. Yuri
Objective: To described a needle renal lifting technique using an 18-gauge needle to adjunct ureterorenoscopy (URS) in the management of complicated proximal ureteral stones. Case(s) Presentation: A 46 years old man presented with right flank pain for 1 month. This patient was diagnosed with ureteral stone and ureteral kinking that prohibits access to the proximal side of the ureter. Due to difficult access to the proximal ureter, we perform a needle renal lifting technique which is initialized by puncturing the middle renal calyx with 18-gauge needle. Then, the proximal end of the needle was pushed to the caudal direction to move the kidney to the cephalic direction and straighten the kinked ureter. After that procedure, the URS sheat can easily enter the proximal ureter to the stone site. Discussion: The success rate of this procedure is based on the operator skills to access the calyx and perform URS simultaneously. Like a previous technique, needle renal lifting is effective only when the kidney is mobile. Conclusion: The needle renal lifting technique can be used to adjunct URS in the management of complicated ureteral stones which prohibited access to the proximal ureter.
{"title":"NEEDLE RENAL LIFTING TECHNIQUE IN MANAGEMENT OF COMPLICATED PROXIMAL URETERAL LITHOTRIPSY: A CASE REPORT","authors":"Muhammad Risan, Indrawarman Soeroharjo, R. Danarto, P. Yuri","doi":"10.32421/JURI.V28I2.715","DOIUrl":"https://doi.org/10.32421/JURI.V28I2.715","url":null,"abstract":"Objective: To described a needle renal lifting technique using an 18-gauge needle to adjunct ureterorenoscopy (URS) in the management of complicated proximal ureteral stones. Case(s) Presentation: A 46 years old man presented with right flank pain for 1 month. This patient was diagnosed with ureteral stone and ureteral kinking that prohibits access to the proximal side of the ureter. Due to difficult access to the proximal ureter, we perform a needle renal lifting technique which is initialized by puncturing the middle renal calyx with 18-gauge needle. Then, the proximal end of the needle was pushed to the caudal direction to move the kidney to the cephalic direction and straighten the kinked ureter. After that procedure, the URS sheat can easily enter the proximal ureter to the stone site. Discussion: The success rate of this procedure is based on the operator skills to access the calyx and perform URS simultaneously. Like a previous technique, needle renal lifting is effective only when the kidney is mobile. Conclusion: The needle renal lifting technique can be used to adjunct URS in the management of complicated ureteral stones which prohibited access to the proximal ureter. \u0000 ","PeriodicalId":13565,"journal":{"name":"Indonesian Journal of Urology","volume":"34 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2021-07-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"86975305","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Objective: This study aimed to know independent prognostic factors to predict the recovery time of bladder cancer patients after radical cystectomy. So that it would be a consideration to determine patient feasibility before surgery and after surgery management. Material & Methods: This study was an observational analytical study with a retrospective approach to examine the relationship between pre-surgery variables of the bladder cancer patients and the duration of treatment post radical cystectomy. Results: From the results of this study, it is known that the average length of postoperative care for older patients (above 65 years) was lower when compared to patients under 65 years with averages of 17.08 and 18.03 days respectively p-value of this analysis was 0.781. Patients with low hemoglobin, albumin, and HALP scores had longer postoperative hospitalization periods but with P values of 0.384, 0.276, and 0.603, the ileal conduit has the longest hospitalization treatment period between the two other procedures, with a P-value of 0.904. It was found that the average length of postoperative care for underweight patients was 16.5 days and for patients with normal BMI was 19.59 days. The difference between these averages showed a p-value of 0.396 it is known that the average length of postoperative care for older patients (above 65 years) was lower when compared to patients under 65 years with averages of 17.08 and 18.03 days respectively. The p-value of this analysis was 0.781 it was found that patients with low hemoglobin, albumin, and HALP scores had longer postoperative treatment periods, p-value 0.384, 0.276, and 0.603. The average duration of postoperative care for patients who applied the ERAS protocol tended to be faster (15.67 days) compared to patients who did not apply the ERAS protocol (18.16 days). Nevertheless, the p-value of this difference was 0.518. Conclusion: This study concludes that there is no prognostic factor that can independently predict the duration of treatment of bladder cancer patients post-radical cystectomy. Therefore in-depth assessment of various factors is required before performing radical cystectomy to achieve the best postoperative recovery rates.
{"title":"PROGNOSTIC FACTORS TOWARD BLADDER CANCER PATIENT RECOVERY AFTER RADICAL CYSTECTOMY SURGERY","authors":"Rendy Triyaka, A. Z. Hendri","doi":"10.32421/JURI.V28I2.678","DOIUrl":"https://doi.org/10.32421/JURI.V28I2.678","url":null,"abstract":"Objective: This study aimed to know independent prognostic factors to predict the recovery time of bladder cancer patients after radical cystectomy. So that it would be a consideration to determine patient feasibility before surgery and after surgery management. Material & Methods: This study was an observational analytical study with a retrospective approach to examine the relationship between pre-surgery variables of the bladder cancer patients and the duration of treatment post radical cystectomy. Results: From the results of this study, it is known that the average length of postoperative care for older patients (above 65 years) was lower when compared to patients under 65 years with averages of 17.08 and 18.03 days respectively p-value of this analysis was 0.781. Patients with low hemoglobin, albumin, and HALP scores had longer postoperative hospitalization periods but with P values of 0.384, 0.276, and 0.603, the ileal conduit has the longest hospitalization treatment period between the two other procedures, with a P-value of 0.904. It was found that the average length of postoperative care for underweight patients was 16.5 days and for patients with normal BMI was 19.59 days. The difference between these averages showed a p-value of 0.396 it is known that the average length of postoperative care for older patients (above 65 years) was lower when compared to patients under 65 years with averages of 17.08 and 18.03 days respectively. The p-value of this analysis was 0.781 it was found that patients with low hemoglobin, albumin, and HALP scores had longer postoperative treatment periods, p-value 0.384, 0.276, and 0.603. The average duration of postoperative care for patients who applied the ERAS protocol tended to be faster (15.67 days) compared to patients who did not apply the ERAS protocol (18.16 days). Nevertheless, the p-value of this difference was 0.518. Conclusion: This study concludes that there is no prognostic factor that can independently predict the duration of treatment of bladder cancer patients post-radical cystectomy. Therefore in-depth assessment of various factors is required before performing radical cystectomy to achieve the best postoperative recovery rates.","PeriodicalId":13565,"journal":{"name":"Indonesian Journal of Urology","volume":"16 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2021-07-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"73010771","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Objective: We determine the utility of Prostate Specific Antigen (PSA) for predicting the presence of skeletal metastasis on Bone Scan (BS) in prostate cancer patients. Material & Methods: Retrospective analysis of medical records of 70 consecutive prostate cancer patients subjected to bone scan during the last 2 years was done. 5 cases were excluded due to the following reasons: Serum PSA not available, hormonal or other therapy given prior to serum PSA measurement, and/or Bone Scan, and symptomatic for bone metastasis. In remaining 65 cases, PSA value and bone scan were evaluated. Results: BS was found to be positive in 20/65 (31%) and negative in 45(69%) patients. 24 (37%) had serum PSA > 100 ng/ml, 25 (38.5%) had PSA of 20‐100 ng/ml and only 16 (24.5%) had PSA < 20 ng/ml. Conclusion: Serum PSA < 20 ng/ml have high predictive value in ruling out skeletal metastasis. Our data are in corroboration with results from previous studies that BS should be performed only if PSA > 20 ng/ml. Using this cut‐off, unnecessary investigation can be avoided. Avoiding BS asymptomatic in this group of patients would translate into a significant cost‐saving and reduction in their psychological and physical burden.
{"title":"PREDICTIVE VALUE OF SERUM PROSTATE SPECIFIC ANTIGEN IN DETECTING BONE METASTASIS IN PROSTATE CANCER","authors":"R. Danarto, I. Astuti, S. Haryana","doi":"10.32421/JURI.V28I2.570","DOIUrl":"https://doi.org/10.32421/JURI.V28I2.570","url":null,"abstract":"Objective: We determine the utility of Prostate Specific Antigen (PSA) for predicting the presence of skeletal metastasis on Bone Scan (BS) in prostate cancer patients. Material & Methods: Retrospective analysis of medical records of 70 consecutive prostate cancer patients subjected to bone scan during the last 2 years was done. 5 cases were excluded due to the following reasons: Serum PSA not available, hormonal or other therapy given prior to serum PSA measurement, and/or Bone Scan, and symptomatic for bone metastasis. In remaining 65 cases, PSA value and bone scan were evaluated. Results: BS was found to be positive in 20/65 (31%) and negative in 45(69%) patients. 24 (37%) had serum PSA > 100 ng/ml, 25 (38.5%) had PSA of 20‐100 ng/ml and only 16 (24.5%) had PSA < 20 ng/ml. Conclusion: Serum PSA < 20 ng/ml have high predictive value in ruling out skeletal metastasis. Our data are in corroboration with results from previous studies that BS should be performed only if PSA > 20 ng/ml. Using this cut‐off, unnecessary investigation can be avoided. Avoiding BS asymptomatic in this group of patients would translate into a significant cost‐saving and reduction in their psychological and physical burden.","PeriodicalId":13565,"journal":{"name":"Indonesian Journal of Urology","volume":"1 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2021-07-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"79785759","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Objective: To evaluate the effectiveness of the ultrasonic lithotriptor compared to the combined ultrasonic-pneumatic lithotriptor in percutaneous nephrolithotomy (PCNL). Material & Methods: A systematic search was conducted focusing on studies evaluating nephrolithiasis patients who underwent PCNL using pneumatic, ultrasonic, ultrasonic-pneumatic, or laser lithotriptor. The search was conducted in the PUBMED and Science-direct databases from early to September 2020. Results: There were 406 journals in the initial search. On further selection, 3 randomized controlled trials (RCT) were obtained, with a total of 251 patients. The stone-free rate of three studies had low heterogeneity, I2=0% (P=0.34), so a fixed effect statistical model was used. There was no significant difference (P=0.44) between the stone-free rates from the ultrasonic lithotriptor group and the combination with an odds ratio of 1.26 (95% CI = 0.70-2.26). High heterogeneity was obtained with I2=71% (P=0.03) for the mean fragmentation time, so random effect statistical model was used. There was no significant difference (P=0.56) between the mean fragmentation time of the ultrasonic lithotriptor and combination group with a mean difference of -3.69 (95% CI = -16.09-8.71). Conclusion: The ultrasonic lithotriptor did not have a significant difference in stone-free rate, and mean fragmentation time compared to the combined ultrasonic-pneumatic lithotriptor in PCNL. More RCT studies are needed.
目的:比较超声气压联合碎石机与超声气压联合碎石机在经皮肾镜取石术中的应用效果。材料与方法:系统地检索了评估肾结石患者采用气动、超声、超声-气动或激光碎石机进行PCNL的研究。从2020年9月初到9月，在PUBMED和Science-direct数据库中进行了搜索。结果:初步检索到406种期刊。进一步选择，获得3项随机对照试验(RCT)，共251例患者。三项研究的结石清除率异质性较低，I2=0% (P=0.34)，故采用固定效应统计模型。超声碎石机组结石清除率与联合碎石机组无显著差异(P=0.44)，优势比为1.26 (95% CI = 0.70-2.26)。平均破碎时间I2=71% (P=0.03)，异质性较高，故采用随机效应统计模型。超声碎石机与联合碎石机的平均破碎时间差异无统计学意义(P=0.56)，平均差值为-3.69 (95% CI = -16.09 ~ 8.71)。结论:超声碎石机与超声-气动联合碎石机在PCNL的脱石率、平均碎石时间等方面无显著差异。需要更多的随机对照试验研究。
{"title":"THE EFFECTIVENESS OF ULTRASONIC LITHOTRIPTOR COMPARED TO COMBINED ULTRASONIC AND PNEUMATIC LITHOTRIPTOR IN PERCUTANEOUS NEPHROLITHOTOMY (PCNL) SURGERY: A SYSTEMATIC REVIEW AND META-ANALYSIS","authors":"Anggana Suryatmana, D. Soebadi, T. Djojodimedjo","doi":"10.32421/JURI.V28I2.742","DOIUrl":"https://doi.org/10.32421/JURI.V28I2.742","url":null,"abstract":"Objective: To evaluate the effectiveness of the ultrasonic lithotriptor compared to the combined ultrasonic-pneumatic lithotriptor in percutaneous nephrolithotomy (PCNL). Material & Methods: A systematic search was conducted focusing on studies evaluating nephrolithiasis patients who underwent PCNL using pneumatic, ultrasonic, ultrasonic-pneumatic, or laser lithotriptor. The search was conducted in the PUBMED and Science-direct databases from early to September 2020. Results: There were 406 journals in the initial search. On further selection, 3 randomized controlled trials (RCT) were obtained, with a total of 251 patients. The stone-free rate of three studies had low heterogeneity, I2=0% (P=0.34), so a fixed effect statistical model was used. There was no significant difference (P=0.44) between the stone-free rates from the ultrasonic lithotriptor group and the combination with an odds ratio of 1.26 (95% CI = 0.70-2.26). High heterogeneity was obtained with I2=71% (P=0.03) for the mean fragmentation time, so random effect statistical model was used. There was no significant difference (P=0.56) between the mean fragmentation time of the ultrasonic lithotriptor and combination group with a mean difference of -3.69 (95% CI = -16.09-8.71). Conclusion: The ultrasonic lithotriptor did not have a significant difference in stone-free rate, and mean fragmentation time compared to the combined ultrasonic-pneumatic lithotriptor in PCNL. More RCT studies are needed. \u0000 ","PeriodicalId":13565,"journal":{"name":"Indonesian Journal of Urology","volume":"75 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2021-07-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"82153116","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Objective: To evaluate the effectiveness of TNF-α inhibitor therapy in Bladder Pain Syndrome/Interstitial Cystitis (BPS/IC) patients compared to placebo, assessed using Global Response Assessment (GRA). Material & Methods: A systematic review and meta-analysis. Subjects were patients with moderate to severe diagnosis of BPS/IC who were given TNF-α inhibitor versus placebo, with the Global Response Assessment (GRA) (patient-reported self-reported BPS/IC treatment response scale). A systematic literature search was carried out on the English databases PubMed/MEDLINE and Science Direct, published until September 2020. Data were extracted independently and assessed the bias and quality of each selected article. Results: Initially there were 124 studies. After further selection, 2 RCT studies were included in the criteria for this study. The number of samples obtained was 85 patients. There is 1 study that used 400 mg of certolizumab pegol subcutaneously and 1 study used adalimumab 80 mg subcutaneously and followed by 40 mg subcutaneously for 2 weeks. Both studies had statistically low heterogeneity with I2 = 0% (P = 0.34), so fixed effect statistical model was used to determine the result. Furthermore, there was no significant difference (P = 0.32) between the number of GRA responders from the TNF-α inhibitor and placebo therapy groups, with odds ratio of 1.61 (CI = 0.65-4.00). Conclusion: TNF-α inhibitor therapy did not increase GRA responders when compared to placebo.
{"title":"THE EFFECTIVENESS OF TNF-Α INHIBITOR THERAPY IN BLADDER PAIN SYNDROME/INTERSTITIAL CYSTITIS PATIENTS: A SYSTEMATIC REVIEW AND META-ANALYSIS","authors":"Ahmad Kholis, Soetojo, W. Djatisoesanto","doi":"10.32421/JURI.V28I2.744","DOIUrl":"https://doi.org/10.32421/JURI.V28I2.744","url":null,"abstract":"Objective: To evaluate the effectiveness of TNF-α inhibitor therapy in Bladder Pain Syndrome/Interstitial Cystitis (BPS/IC) patients compared to placebo, assessed using Global Response Assessment (GRA). Material & Methods: A systematic review and meta-analysis. Subjects were patients with moderate to severe diagnosis of BPS/IC who were given TNF-α inhibitor versus placebo, with the Global Response Assessment (GRA) (patient-reported self-reported BPS/IC treatment response scale). A systematic literature search was carried out on the English databases PubMed/MEDLINE and Science Direct, published until September 2020. Data were extracted independently and assessed the bias and quality of each selected article. Results: Initially there were 124 studies. After further selection, 2 RCT studies were included in the criteria for this study. The number of samples obtained was 85 patients. There is 1 study that used 400 mg of certolizumab pegol subcutaneously and 1 study used adalimumab 80 mg subcutaneously and followed by 40 mg subcutaneously for 2 weeks. Both studies had statistically low heterogeneity with I2 = 0% (P = 0.34), so fixed effect statistical model was used to determine the result. Furthermore, there was no significant difference (P = 0.32) between the number of GRA responders from the TNF-α inhibitor and placebo therapy groups, with odds ratio of 1.61 (CI = 0.65-4.00). Conclusion: TNF-α inhibitor therapy did not increase GRA responders when compared to placebo.","PeriodicalId":13565,"journal":{"name":"Indonesian Journal of Urology","volume":"1 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2021-07-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"88664509","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Objective: This study aims to investigate mRNA expression of PD-1 and PD-L1 in patients with bladder cancer. Material & Methods: In this study, we examined 30 samples from paraffin embedded tissue blocks, samples were divided into two groups, 15 were NIMBC, and 15 were MIBC according to their histopathological result. mRNA expression of PD-1 and PD-L1 were conducted using Real Time-Polymerase Chain Reaction (qRT-PCR) and statistical significance was set at a p-value < 0.05. Results: Statistical analysis using the Mann-Whitney test found a significant difference in mRNA expression of PD-1 and PD-L1 in NMIBC compared to MIBC groups. Conclusion: mRNA expression of PD-1 and PD-L1 were higher in MIBC compared to NMIBC. PD-1 and PD-L1 as immune checkpoints are potential immunotherapy for patients with advance stage bladder cancer. Immunotherapy could be a substitute or combined with other treatments such as chemotherapy or radiotherapy.
{"title":"mRNA EXPRESSION OF PD-1, PD-L1, AND IMMUNOTHERAPY IN BLADDER CANCER","authors":"M. Mauny, Raden Danarto, D. S. Heriyanto","doi":"10.32421/JURI.V28I2.686","DOIUrl":"https://doi.org/10.32421/JURI.V28I2.686","url":null,"abstract":"Objective: This study aims to investigate mRNA expression of PD-1 and PD-L1 in patients with bladder cancer. Material & Methods: In this study, we examined 30 samples from paraffin embedded tissue blocks, samples were divided into two groups, 15 were NIMBC, and 15 were MIBC according to their histopathological result. mRNA expression of PD-1 and PD-L1 were conducted using Real Time-Polymerase Chain Reaction (qRT-PCR) and statistical significance was set at a p-value < 0.05. Results: Statistical analysis using the Mann-Whitney test found a significant difference in mRNA expression of PD-1 and PD-L1 in NMIBC compared to MIBC groups. Conclusion: mRNA expression of PD-1 and PD-L1 were higher in MIBC compared to NMIBC. PD-1 and PD-L1 as immune checkpoints are potential immunotherapy for patients with advance stage bladder cancer. Immunotherapy could be a substitute or combined with other treatments such as chemotherapy or radiotherapy.","PeriodicalId":13565,"journal":{"name":"Indonesian Journal of Urology","volume":"1 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2021-07-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"85570073","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
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