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"ABSTRAK Pendahuluan: Salah satu faktor yang dapat mempengaruhi komplikasi perioperatif TURP adalah jenis cairan irigasi yang digunakan. Penelitian ini bertujuan untuk mengetahui komplikasi perioperatif dan perubahan hasil pemeriksaan laboratorium rutin pada TURP yang menggunakan cairan irigasi dextrose 5 ; berikut hubungannya dengan karakteristik pasien, volume cairan irigasi, dan temuan intra-operatif. Metode: Metode yang digunakan dalam penelitian ini adalah potong lintang prospektif dengan 32 subyek pasien benign prostatic hyperplasia BPH , yang menjalani tindakan TURP di RSUD Karawang Jawa Barat; pada periode Juli-Agustus 2017. Data yang diambil meliputi karakteristik pasien, volume cairan irigasi intraoperatif, durasi reseksi, volume jaringan yang direseksi, parameter laboratorium sebelum dan sesudah TURP hemoglobin, hematokrit, lekosit, gula darah sewaktu, natrium, kalium, klorida , electrocardiography ECG sebelum dan sesudah TURP; serta komplikasi perioperatif TURP ekstravasasi cairan irigasi, perforasi buli, cidera ureter, perforasi kapsul prostat,anemia pasca operasi yang membutuhkan transfusi, sindrom TUR, retensi urin akut, retensi bekuan darah, dan infeksi . Data penelitian ditampilkan dalam bentuk tabel distribusi frekuensi dan persentase; sedangkan analisis hubungan kemaknaannya menggunakan metode t-test dan chi-square test, dengan nilai p yang dianggap bermakna adalah kurang dari 0,05.Hasil: Dari 32 subyek penelitian, didapatkan data rata-rata volume dextrose 5 yang digunakan untuk irigasi saat TURP adalah 33,17 liter dengan kisaran volume irigasi antara 10 - 52 liter. Uji statistik pada hasil pemeriksaan laboratorium sebelum dan sesudah TURP menunjukkan bahwa nilai rata-rata hemoglobin sebelum operasi adalah 12,75 g / dL dan pasca operasi 11,99 g / dL yang berbeda bermakna p = 0,000 . Rata-rata nilai hematokrit sebelum operasi dan sesudah operasi adalah 38,25 dan 35,97 , yang berbeda bermakna p = 0,000 . Rata-rata nilai leukosit sebelum dan sesudah operasi adalah 7773.47 / uL dan 10466.62/ uL yang berbeda bermakna p = 0,000 . Nilai natrium rata-rata sebelum dan sesudah operasi adalah 138,09 mmol / L dan 135,97 mmol / L yang berbeda bermakna p = 0,000 . Nilai gula darah sewaktu GDS rata-rata sebelum dan operasi adalah 111 mg dan 123,94 mg yang berbeda bermakna p = 0,000 . Komplikasi perioperatif TURP dalam penelitian ini adalah anemia pasca operasi yang memerlukan yang transfusi, pada 1 pasien 3,13 . Secara statistik, karakteristik pasien dan volume cairan irigasi tidak berhubungan dengan komplikasi perioperatif yang terjadi. Kesimpulan: Dextrose 5 dapat menjadi cairan irigasi alternatif pada TURP; jika dipandang dari insidensi komplikasi perioperatif yang rendah dan data hasil pemeriksaan laboratorium rutin sebelum dan sesudah tindakan. Secara statistik; parameter laboratorium yang berbeda bermakna sebelum dan sesudah TURP adalah hemoglobin, hematokrit, lekosit, natrium, dan gula darah sewaktu; namun secara klinis tidak signifikan mempengaruhi komplikasi perioperatif yang terjadi. ABSTRACT Introduction One of the factors that may affect perioperative complications is the type of irrigation fluid used at TURP. This study aims to evaluate the perioperative complications and changes in routine laboratory examination of TURP with 5 dextrose irrigation fluid as well as its relationship to the patient profile, the volume of the irrigation fluid, and intra operative findings. Methods A prospective cross sectional method was done towards 32 Benign Prostatic Hyperplasia BPH patients who undergoing TURP in Karawang General Hospital, West Jawa, since July 2017 until August 2017. We documented patient profile operative details including volume of the irrigation fluid, resection time, and weight of resected tissue before and after TURP laboratory parameters hemoglobin, haematocrit, leukocytes, blood sugar at the time, sodium, potassium, chloride and electrocardiography ECG also perioperative TURP complications extravasation of irrigation fluid, bladder perforation, ureter injury, perforation of the prostate capsule, postoperative anemia requiring blood transfusion, TUR syndrome, acute urinary retention, blood clot retention, and infection prospectively. Research data is presented in the form of frequency distribution table, and the hypothesis test analysis using t test and chi Square test. Results From 32 study subjects, it was found that the average of 5 dextrose dextrose volume used for irrigation when TURP is 33.17 liters with irrigation volume ranges from 10 52 liters. T test statistics on laboratory tests before and after TURP showed that mean preoperative hemoglobin values were 12.75 g dL and post operative 11.99 g dL, were significantly different p 0.000 . The mean hematocrit value before surgery was 38.25 and postoperative was 35.97 , which was significantly different p 0.000 . The average preoperative leukocyte values were 7773.47 uL and post operative 10466.62 uL which also differed significantly p 0.000 . Mean sodium values before surgery were 138.09 mmol L and post operative 135.97 mmol L, were significantly different p 0.000 . The mean current time glucose value of blood before surgery was 111 mg and post operative 123.94 mg , was significantly different in the statistical test p 0.000 . The perioperative complications of TURP obtained in this study was postoperative anemia requiring a transfusion of 1 patient 3.13 . The relationship of patient profile and intra operative findings with perioperative complication were not statistically significant. Conclusion , Dextrose 5 could be alternative irrigation fluid for TURP considering the lower rates of perioperative complication and the evaluation of routine laboratory results before and after surgery. Statistically, laboratory parameters whose results differ significantly between before and after surgery are hemoglobin, hematocrit, leukocytes, sodium, and blood sugar at the time but not associated with clinically significant perioperative complication."

"Gejala saluran kemih bawah LUTS pada laki laki seringkali dikaitkan dengan pembesaran prostat jinak BPH yang menyebabkan obstruksi infravesika yang sering diikuti oleh trabekulasi sehingga terjadi gangguan fungsi kandung kemih Reseksi prostat transuretra TURP adalah tindak baku emas yang bertujuan untuk menghilangkan obstruksi ini Namun gejala LUTS masih banyak dikeluhkan setelah dilakukan TURP Penelitian cross sectional ini dilakukan untuk mencari hubungan antara gejala LUTS pasca TURP dengan derajat trabekulasi dan volume kandung kemih di RSUP H Adam Malik Medan Selama tahun 2013 didapatkan 39 pasien BPH rata rata umur 68 36 7 638 tahun dengan retensi urin berulang yang dilakukan tindakan TURP Dari keseluruhan sampel kelompok yang terbanyak ditemukan adalah derajat trabekulasi sedang 35 9 dan volume kandung kemih 200 cc 46 2 Dua puluh dua sampel 56 4 mengeluhkan LUTS ringan dengan rerata IPSS total 6 28 3 986 Derajat trabekulasi dan volume mempunyai korelasi positif kuat 0 661 dan 0 723 p value.

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Lower urinary tract symptoms LUTS in older male is often associated with benign prostate hyperplasia BPH and caused bladder outlet obstruction BOO with the consequential trabeculation that impair bladder contractility and viscoelasticity Transurethral resection of the prostate TURP is the gold standard for relieving BPH caused BOO Nevertheless many still complained of persisting symptoms even after undergoing TURP This cross sectional study was conducted to analyze the correlation between bladder volume and trabeculation in determining LUTS after TURP in BPH patient In 2013 bladder trabeculation and volume was measured during TURP from 39 BPH patients with recurrent urinary retention and were re evaluated 6 months after The most common findings were moderate trabeculation 35 9 bladder volume 200cc 46 2 and mild degree LUTS 56 4 after TURP with mean IPSS 6 28 3 986 Bladder trabeculation and volume are positively and strongly correlated with LUTS after TURP 0 661 and 0 723 respectively p value 0 01 Analytical linear regression found that these two variables are significant factors in determining LUTS after TURP with positive predictive value of 62 In conclusion bladder trabeculation and volume had strong significant correlation with LUTS after TURP although there are other possible determining factors that are not included in the study"

"Pendahuluan dan tujuan: Hiperplasia prostat jinak merupakan penyakit yang melemahkan yang menyebabkan 90% pria berusia 80 tahun menderita sindrom saluran kemih bagian bawah. Dalam studi ini, kami mencoba untuk mengevaluasi hasil dari reseksi transurethral prostat pada pasien hiperplasia prostat jinak untuk menguraikan manfaatnya. Metode: Penelitian ini dilakukan secara retrospektif. Subjek dalam penelitian ini adalah pasien yang didiagnosis BPH. Pasien dibagi menjadi dua kelompok (<80gr dan> 80gr). Data yang diperoleh dalam penelitian ini dianalisis secara statistik menggunakan Independent T-Test dan Mann-Whitney. Hasil: Kami tidak menemukan perbedaan yang signifikan pada skor IPSS dan QoL pada kedua kelompok. Skor IPSS dan kualitas hidup pasca operasi juga menunjukkan tidak ada perbedaan yang signifikan antara pasien kelompok 1 dan 2. Kesimpulan: Kami menemukan bahwa volume prostat tidak berhubungan dengan kualitas hidup pasien, yang diilustrasikan oleh indeks IPSS dan QoL setelah TURP. Selain itu, TURP dapat dilakukan pada semua pasien terlepas dari ukuran prostatnya. Lebih lanjut, TURP memiliki keuntungan komplikasi yang lebih rendah untuk pasien dengan ukuran prostat> 80 gr.

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Introduction and objectives: Benign prostatic hyperplasia is a debilitating disease which causes 90% of 80 years old male suffers from lower urinary tract syndrome. In this study, we tried to evaluate the outcome of transurethral resection of the prostate in benign prostatic hyperplasia patients to elaborate its benefit.

Methods: This study is conducted retrospectively. Subject in this study are patients who are diagnosed with BPH. Patients is divided into two groups (<80gr and >80gr). Data obtained in this study is statistically analyzed using Independent T-Test and Mann-Whitney.

Results: We found no significant differences in the IPSS and QoL score in both groups. Postoperative IPSS and QoL score also showed no significant differences between group 1 and 2 patients.

Conclusion: We found that prostate volume is not correlated with patient quality of life, which illustrated by IPSS and QoL index after TURP. In addition, TURP can be conducted in any patients regardless of their prostate size. Furthermore, TURP has the advantage of lower complication for patients with prostate size >80 gr."

"Tujuan penelitian ini adalah untuk melihat efek temperatur cairan irigasi terhadap perubahan temperatur inti badan selama prosedur Transurethral Resection of the Prostate (TURP). Suatu uji klinis acak terkontrol dilakukan terhadap 32 penderita pembesaran prostat jinak (Benign Prostatic Hyperplasia = BPH) yang menjalani prosedur TURP di RSUPNCM Jakarta, antara bulan September 2003 dan Januari 2004. Secara acak berselang-seling, penderita penelitian dimasukkan ke dalam kelompok standar (menggunakan cairan irigasi setara temperatur kamar + 23.60C) dan kelompok isotermik (menggunakan cairan irigasi yang dihangatkan sampai setara dengan temperatur badan + 37.20C). Jenis cairan irigasi yang digunakan oleh kedua kelompok adalah aquabidest. Kemudian dilakukan pencatatan terhadap usia penderita, lama reseksi, berat jaringan prostat yang direseksi, volume total cairan irigasi yang digunakan, temperatur kamar operasi serta temperatur inti badan sebelum dan sesudah prosedur TURP. Uji hipotesis untuk kedua kelompok menggunakan uji t, dengan nilai p < 0,05 dianggap bermakna. Hasil penelitian menunjukkan bahwa terdapat penurunan temperatur inti badan selama prosedur TURP, baik pada kelompok standar maupun pada kelompok isotermik (keduanya p = 0,000), tetapi tidak satupun penderita dari kedua kelompok tersebut yang masuk dalam kriteria hipotermi. Rerata penurunan temperatur inti badan pada kelompok standar (0,990C) lebih besar dibandingkan dengan kelompok isotermik (0,750C), tetapi secara statistik tidak berbeda bermakna (p > 0,05). Dari penelitian ini dapat disimpulkan bahwa penggunaan cairan irigasi selama prosedur TURP baik dengan temperatur yang setara dengan temperatur badan maupun yang setara dengan temperatur kamar, sama-sama menyebabkan penurunan temperatur inti badan pada tingkat yang kurang lebih sama. (Med J Indones 2005; 14: 152-6)

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The objective of this study was to determine the effect of irrigating fluid temperature on core body temperature changes in patients undergoing transurethral resection of the prostate (TURP). A cross sectional study was conducted on 32 patients with Benign Prostatic Hyperplasia (BPH) who underwent TURP at our institution between September 2003 and January 2004. Patients were randomized to one of two groups. Standard group consisted of 16 patients who received room temperature irrigating fluid (± 23.6 0C) throughout TURP. Isothermic group consisted of 16 patients whose procedure was performed using warmed irrigating fluid (± 37.2 0C). The irrigating fluid used for both groups was aquabidest. The age, resection time, weight of resected prostate, amount of irrigating fluid used, temperature in the operating theatre, core body temperature at beginning and at conclusion of TURP were recorded for each patient. The t test was used for comparison between both groups and a p value of 0.05 or less was considered significant. The result of this study showed a decrease of core body temperature during TURP, using either room temperature or warmed irrigating fluid (both p = 0.000). None of the patients in either group demonstrated any criteria of hypothermia. The average decrease of core body temperature in standard group (0.99 0C) was greater than in isothermic group (0.75 0C), but it was not significantly different (p > 0.05). In conclusion, our study revealed that using either room temperature irrigating fluid or warmed irrigating fluid during TURP could decrease core body temperature at approximately similar level, with no incidence of hypothermia. (Med J Indones 2005; 14: 152-6)"

"Tujuan penelitian ini adalah untuk melihat efek temperatur cairan irigasi terhadap perubahan temperatur inti badan selama prosedur Transurethral Resection of the Prostate ( TURP ).Suatu uji klinis acak terkontrol dilakukan terhadap 32 penderita pembesaran prostat jinak (Benign Prostatic Hyperplasia = BPH) yang menjalani prosedur TURP di RSUPNCM Jakarta, antara bulan September 2003 dan Januari 2004. Secara acak berselang-seling, penderita penelitian dimasukkan ke dalam kelompok standar (menggunakan cairan irigasi setara temperatur kamar) dan kelompok isotermik (menggunakan cairan irigasi yang dihangatkan sampai setara dengan temperatur badan). Jenis cairan irigasi yang digunakan oleh kedua kelompok adalah aquabidest. Kemudian dilakukan pencatatan terhadap usia penderita, lama reseksi, berat jaringan prostat yang direseksi, total volume cairan irigasi yang digunakan, temperatur kamar operasi serta temperatur inti badan sebelum dan sesudah prosedur TURP. Uji hipotesis untuk kedua kelompok menggunakan uji t, dengan nilai p < 0,05 dianggap bermakna.Hasil penelitian menunjukkan bahwa terdapat penurunan temperatur inti badan selama prosedur TURP, baik pada kelompok standar maupun pada kelompok isotermik (keduanya p = 0,000 ), tetapi tidak satupun penderita dari kedua kelompok tersebut yang masuk dalam kriteria hipotermi. Rerata penurunan temperatur inti badan pada kelompok standar ( 0,99 °C ) lebih banyak dibandingkan dengan kelompok isotermik ( 0,75 °C ), tetapi secara statistik tidak berbeda bermakna (p > 0,05 ).Dari penelitian ini dapat disimpulkan bahwa penggunaan cairan irigasi selama prosedur TURP baik dengan temperatur yang setara dengan temperatur badan maupun yang setara dengan temperatur kamar, sama - sama menyebabkan penurunan temperatur inti badan pada tingkat yang kurang lebih sama.

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The objective of the study is to determine the effect of irrigating fluid temperature on core body temperature changes in patients undergoing transurethral resection of the prostate (TURP ).

A prospective trial was conducted on 32 patients with diagnosis Benign Prostatic Hyperplasia (BPH ) who underwent TURP at our institution between September 2003 and January 2004. Patients were randomized to one of two groups. Standard group consisted of 16 patients who received room temperature irrigating fluid (± 23.6 °C) throughout TURP. Isothermic group consisted of 16 patients whose procedure was performed using warmed irrigating fluid ( ± 37.2 °C ). The irrigating fluid used for both groups was aquabidest. The age, resection time, weight of resected prostate, amount of irrigating fluid used, temperature in the operating theatre, core body temperature at beginning and conclusion of TURP were recorded for each patient. All p value was calculated with the t test and a p value of 0.05 or less was considered significant.

The result of this study showed that there was a decrease of core body temperature during TURP, using either room temperature irrigating fluid or warmed irrigating fluid ( both p = 0.000 ). None of the patients in either group demonstrated any criteria of hypothermia. The average decrease of core body temperature in standard group ( 0.99 °C ) was greater than in isothermic group ( 0.75 °C ), but it was not significantly different (p > 0.05 ).

In conclusion, our study revealed that using either room temperature irrigating fluid or warmed irrigating fluid during TURP could decrease core body temperature at approximately similar level."

"[ABSTRAKTujuan: Insiden kanker prostat secara global terus meningkat. Meskipun dapat dilakukan deteksi dini kanker prostat, perlu dipahami bahwa progresivitas penyakit ? menjadi metastasis ? berbeda untuk setiap pasien. Penelitian ini bertujuan untuk mengamati aspek-aspek yang mungkin berperan sebagai faktor prediktif metastasis pada kanker prostat tidak terpalpasi.Material dan Metode: Data dikumpulkan dari Rumah Sakit Umum Pusat Nasional Cipto Mangunkusumo dan Rumah Sakit Pusat Kanker Nasional Dharmais sejak tahun 1995-2013. Pasien dengan kanker prostat tidak terpalpasi kemudian dibagi menjadi dua kelompok: dengan metastasis dan tanpa metastasis. Usia, volume prostat, nilai prostate-spesific antigen (PSA), Gleason score sum group, stadium tumor, Karnofsky performance score (KPS), kadar hemoglobin, dan kadar kreatinin serum merupakan faktor yang dianalisis dalam penelitian ini. Data dianalisis menggunakan analisis bivariat dan uji regresi logistik. Hanya pasien dengan data lengkap yang dimasukkan dalam penelitian ini.Hasil: Didapatkan 91 pasien dengan data lengkap, 59 pasien (64,83%) tanpa metastasis dan 32 pasien (35,16%) dengan metastasis. Terdapat perbedaan statistik yang signifikan antara kelompok tanpa metastasis dan kelompok dengan metastasis, yakni untuk PSA (13.7ng / mL vs 71.5ng / mL; p = 0,001), kadar hemoglobin (13,60 g / dL vs 12,25 g / dL; p = 0,002), dan KPS (90 vs 90 ; p = 0,004). Perbedaan yang signifikan secara statistik juga didapatkan pada kelompok GSS (35 dan 24 pada kelompok tanpa metastasis vs 12 dan 20 pada kelompok dengan metastasis; p = 0,047). Usia, volume prostat, stadium tumor, dan kadar kreatinin antara kedua kelompok tidak memiliki perbedaan signifikan secara statistik (p> 0,05). Nilai pretreatment PSA adalah satu-satunya faktor prediktif untuk metastasis dengan odds ratio 1.014 (95% CI, 1,005-1,022; p = 0,002).Kesimpulan: Sebagian besar pasien kanker prostat tidak terpalpasi terdeteksi pertama kali tanpa metastasis. Nilai pretreatment PSA yang diperoleh pada kunjungan awal pasien dapat digunakan sebagai faktor prediktif metastasis di masa depan.

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ABSTRACTObjective: Prostate cancer incident is globally increasing. Despite early detection of prostate cancer, the progressivity of the disease itself toward metastatic disease remains different for each patient. The purpose of this study is to observe aspects that may have roles as predictive factors for metastasis in nonpalpable prostate cancer.Materials and Methods: Data was collected from National Hospital Cipto Mangunkusumo and Dharmais National Cancer Center Hospital from 1995-2013. Patients with nonpalpable prostate cancer then divided into two groups: metastasis-free group and metastasis group. Age, prostate volume, pretreatment Prostate-specific antigen (PSA) value, Gleason score sum group, tumor stadium, Karnofsky performance score (KPS), hemoglobin level, and serum creatinine level were factors that were analyzed in the study. The data was analyzed using bivariate analysis and logistic regression test. Only patients with complete data are included in the study.Results: There are 91 patients with complete data, 59 patients (64.83%) were patients without metastasis and 32 patients (35.16%) were with metastasis. There was significant statistical difference between no metastasis group with metastasis group for PSA (13.7ng/mL vs71.5ng/mL; p = 0.001), hemoglobin level (13.60 g/dL vs 12.25 g/dL; p = 0.002), and KPS (90vs90; p = 0.004). There was also significant statistical difference in GSS groups (35 and 24 in metastasis-free group vs 12 and 20 in metastasis group; p = 0.047). Age, prostate volume, tumor stadium, and creatinine level had no statistical difference between the two groups (p > 0.05). Pretreatment PSA value was the only predictive factor for metastasis with odds ratio 1.014 (95% CI, 1.005 to 1.022; p = 0.002).Conclusion: Most nonpalpable prostate cancer patients are first detected without metastasis. Pretreatment PSA value that was obtained at their initial visit might be used as predictive factor for metastasis for them in the future.;Objective: Prostate cancer incident is globally increasing. Despite early detection of prostate cancer, the progressivity of the disease itself toward metastatic disease remains different for each patient. The purpose of this study is to observe aspects that may have roles as predictive factors for metastasis in nonpalpable prostate cancer.Materials and Methods: Data was collected from National Hospital Cipto Mangunkusumo and Dharmais National Cancer Center Hospital from 1995-2013. Patients with nonpalpable prostate cancer then divided into two groups: metastasis-free group and metastasis group. Age, prostate volume, pretreatment Prostate-specific antigen (PSA) value, Gleason score sum group, tumor stadium, Karnofsky performance score (KPS), hemoglobin level, and serum creatinine level were factors that were analyzed in the study. The data was analyzed using bivariate analysis and logistic regression test. Only patients with complete data are included in the study.Results: There are 91 patients with complete data, 59 patients (64.83%) were patients without metastasis and 32 patients (35.16%) were with metastasis. There was significant statistical difference between no metastasis group with metastasis group for PSA (13.7ng/mL vs71.5ng/mL; p = 0.001), hemoglobin level (13.60 g/dL vs 12.25 g/dL; p = 0.002), and KPS (90vs90; p = 0.004). There was also significant statistical difference in GSS groups (35 and 24 in metastasis-free group vs 12 and 20 in metastasis group; p = 0.047). Age, prostate volume, tumor stadium, and creatinine level had no statistical difference between the two groups (p > 0.05). Pretreatment PSA value was the only predictive factor for metastasis with odds ratio 1.014 (95% CI, 1.005 to 1.022; p = 0.002).Conclusion: Most nonpalpable prostate cancer patients are first detected without metastasis. Pretreatment PSA value that was obtained at their initial visit might be used as predictive factor for metastasis for them in the future.;Objective: Prostate cancer incident is globally increasing. Despite early detection of prostate cancer, the progressivity of the disease itself toward metastatic disease remains different for each patient. The purpose of this study is to observe aspects that may have roles as predictive factors for metastasis in nonpalpable prostate cancer.Materials and Methods: Data was collected from National Hospital Cipto Mangunkusumo and Dharmais National Cancer Center Hospital from 1995-2013. Patients with nonpalpable prostate cancer then divided into two groups: metastasis-free group and metastasis group. Age, prostate volume, pretreatment Prostate-specific antigen (PSA) value, Gleason score sum group, tumor stadium, Karnofsky performance score (KPS), hemoglobin level, and serum creatinine level were factors that were analyzed in the study. The data was analyzed using bivariate analysis and logistic regression test. Only patients with complete data are included in the study.Results: There are 91 patients with complete data, 59 patients (64.83%) were patients without metastasis and 32 patients (35.16%) were with metastasis. There was significant statistical difference between no metastasis group with metastasis group for PSA (13.7ng/mL vs71.5ng/mL; p = 0.001), hemoglobin level (13.60 g/dL vs 12.25 g/dL; p = 0.002), and KPS (90vs90; p = 0.004). There was also significant statistical difference in GSS groups (35 and 24 in metastasis-free group vs 12 and 20 in metastasis group; p = 0.047). Age, prostate volume, tumor stadium, and creatinine level had no statistical difference between the two groups (p > 0.05). Pretreatment PSA value was the only predictive factor for metastasis with odds ratio 1.014 (95% CI, 1.005 to 1.022; p = 0.002).Conclusion: Most nonpalpable prostate cancer patients are first detected without metastasis. Pretreatment PSA value that was obtained at their initial visit might be used as predictive factor for metastasis for them in the future.;Objective: Prostate cancer incident is globally increasing. Despite early detection of prostate cancer, the progressivity of the disease itself toward metastatic disease remains different for each patient. The purpose of this study is to observe aspects that may have roles as predictive factors for metastasis in nonpalpable prostate cancer.Materials and Methods: Data was collected from National Hospital Cipto Mangunkusumo and Dharmais National Cancer Center Hospital from 1995-2013. Patients with nonpalpable prostate cancer then divided into two groups: metastasis-free group and metastasis group. Age, prostate volume, pretreatment Prostate-specific antigen (PSA) value, Gleason score sum group, tumor stadium, Karnofsky performance score (KPS), hemoglobin level, and serum creatinine level were factors that were analyzed in the study. The data was analyzed using bivariate analysis and logistic regression test. Only patients with complete data are included in the study.Results: There are 91 patients with complete data, 59 patients (64.83%) were patients without metastasis and 32 patients (35.16%) were with metastasis. There was significant statistical difference between no metastasis group with metastasis group for PSA (13.7ng/mL vs71.5ng/mL; p = 0.001), hemoglobin level (13.60 g/dL vs 12.25 g/dL; p = 0.002), and KPS (90vs90; p = 0.004). There was also significant statistical difference in GSS groups (35 and 24 in metastasis-free group vs 12 and 20 in metastasis group; p = 0.047). Age, prostate volume, tumor stadium, and creatinine level had no statistical difference between the two groups (p > 0.05). Pretreatment PSA value was the only predictive factor for metastasis with odds ratio 1.014 (95% CI, 1.005 to 1.022; p = 0.002).Conclusion: Most nonpalpable prostate cancer patients are first detected without metastasis. Pretreatment PSA value that was obtained at their initial visit might be used as predictive factor for metastasis for them in the future.;Objective: Prostate cancer incident is globally increasing. Despite early detection of prostate cancer, the progressivity of the disease itself toward metastatic disease remains different for each patient. The purpose of this study is to observe aspects that may have roles as predictive factors for metastasis in nonpalpable prostate cancer.Materials and Methods: Data was collected from National Hospital Cipto Mangunkusumo and Dharmais National Cancer Center Hospital from 1995-2013. Patients with nonpalpable prostate cancer then divided into two groups: metastasis-free group and metastasis group. Age, prostate volume, pretreatment Prostate-specific antigen (PSA) value, Gleason score sum group, tumor stadium, Karnofsky performance score (KPS), hemoglobin level, and serum creatinine level were factors that were analyzed in the study. The data was analyzed using bivariate analysis and logistic regression test. Only patients with complete data are included in the study.Results: There are 91 patients with complete data, 59 patients (64.83%) were patients without metastasis and 32 patients (35.16%) were with metastasis. There was significant statistical difference between no metastasis group with metastasis group for PSA (13.7ng/mL vs71.5ng/mL; p = 0.001), hemoglobin level (13.60 g/dL vs 12.25 g/dL; p = 0.002), and KPS (90vs90; p = 0.004). There was also significant statistical difference in GSS groups (35 and 24 in metastasis-free group vs 12 and 20 in metastasis group; p = 0.047). Age, prostate volume, tumor stadium, and creatinine level had no statistical difference between the two groups (p > 0.05). Pretreatment PSA value was the only predictive factor for metastasis with odds ratio 1.014 (95% CI, 1.005 to 1.022; p = 0.002).Conclusion: Most nonpalpable prostate cancer patients are first detected without metastasis. Pretreatment PSA value that was obtained at their initial visit might be used as predictive factor for metastasis for them in the future., Objective: Prostate cancer incident is globally increasing. Despite early detection of prostate cancer, the progressivity of the disease itself toward metastatic disease remains different for each patient. The purpose of this study is to observe aspects that may have roles as predictive factors for metastasis in nonpalpable prostate cancer.Materials and Methods: Data was collected from National Hospital Cipto Mangunkusumo and Dharmais National Cancer Center Hospital from 1995-2013. Patients with nonpalpable prostate cancer then divided into two groups: metastasis-free group and metastasis group. Age, prostate volume, pretreatment Prostate-specific antigen (PSA) value, Gleason score sum group, tumor stadium, Karnofsky performance score (KPS), hemoglobin level, and serum creatinine level were factors that were analyzed in the study. The data was analyzed using bivariate analysis and logistic regression test. Only patients with complete data are included in the study.Results: There are 91 patients with complete data, 59 patients (64.83%) were patients without metastasis and 32 patients (35.16%) were with metastasis. There was significant statistical difference between no metastasis group with metastasis group for PSA (13.7ng/mL vs71.5ng/mL; p = 0.001), hemoglobin level (13.60 g/dL vs 12.25 g/dL; p = 0.002), and KPS (90vs90; p = 0.004). There was also significant statistical difference in GSS groups (35 and 24 in metastasis-free group vs 12 and 20 in metastasis group; p = 0.047). Age, prostate volume, tumor stadium, and creatinine level had no statistical difference between the two groups (p > 0.05). Pretreatment PSA value was the only predictive factor for metastasis with odds ratio 1.014 (95% CI, 1.005 to 1.022; p = 0.002).Conclusion: Most nonpalpable prostate cancer patients are first detected without metastasis. Pretreatment PSA value that was obtained at their initial visit might be used as predictive factor for metastasis for them in the future.]"

"[Pendahuluan: Sejak tahun 70-an hingga sekarang, skor Gleason merupakan parameter penting pada penatalaksanaan kanker prostat. Biopsi prostat yang umum dipakai untuk membedakan antara kondisi jinak dan ganas semakin menjadikan skor Gleason berperan penting dalam menentukan tatalaksana selanjutnya. Meskipun demikian, terdapat diskrepansi antara skor Gleason yang diambil secara biopsi dan paskaoperasi.Tujuan: Untuk menentukan perbedaan skor Gleason sebelum dan setelah dilakukan prostatektomi radikal, dan untuk mencari faktor-faktor yang berperan dalam peningkatan skor Gleason.Metode: Dilakukan evaluasi laporan patologi dari spesimen prostat yang didapatkan secara biopsi dan paska prostatektomi radikal antara Januari 2004 sampai Desember 2013. Kriteria eksklusi dari studi ini adalah laporan-laporan yang tidak mencantumkan skor Gleason ataupun diagnosis selain adenokarsinoma prostat.Hasil: Studi ini menginklusikan 36 subjek dengan adenokarsinoma prostat yang telah menjalani prostatektomi radikal. Skor Gleason 6 merupakan skor tersering yang dilaporkan pada biopsi, sedangkan skor Gleason 7 merupakan skor tersering yang dilaporkan pada spesimen prostatektomi radikal. Diantara subjek, 58,3% (n=21) memiliki perbedaan antara skor Gleason biopsi dan prostatektomi radikal; 11,1% (n=4) memiliki penurunan dan 47,2% (n=17) mengalami peningkatan. Dengan menggunakan analisis statistik dijumpai bahwa rendahnya densitas PSA (PSAD) memiliki korelasi dengan likelihood peningkatan (r=0,658, p=0,006).Kesimpulan: Sebagian besar pasien memiliki perbedaan antara skor Gleason hasil biopsi dan paskaoperasi dimana terlihat kecenderungan peningkatan dibandingkan dengan penurunan skor. PSAD merupakan faktor yang berkorelasi dengan peningkatan skor Gleason., Introduction: Since its introduction in mid 70 until now, Gleason Score is an important parameter in the treatment of prostate cancer. The common practice of prostate biopsy to differentiate between malignant and benign condition of the prostate, hence makes Gleason score plays important role in determine the next step of treatment. Still there is a discrepancy between Gleason score taken from biopsy and postoperatively.Aim: To determine the Gleason score difference before and after radical prostatectomy, and to find factors that has a role in the upgrading of Gleason score.Methods: We evaluated pathology reports of prostate specimens obtained from biopsy and after radical prostatectomy between January 2004 until December 2013. Exclusion criteria of this study were reports that failed to mentioned Gleason score or a diagnosis apart from adenocarcinoma of the prostate.Results: This study enrolled 36 subjects with adenocarcinoma of the prostate who underwent radical prostatectomy. Gleason score 6 was the most reported score in initial biopsy while Gleason score 7 was the most reported in radical prostatectomy specimen. Among the subjects 58.3% (n=21) had diferrences of Gleason score between biopsy and radical proistatectomy; 11.1% (n=4) had a downgrading and 47.2% (n=17) had an upgrading. Using statistical analysis we found out that low prostate specific antigen densities (PSAD) had correlation with upgrading likelihood (r 0.658, p = 0.006)Conclusion: More than half of our patient had differences between biopsy Gleason score and postoperative scores with majority showed a likelihood of upgrading rather than downgrading, PSAD was the factors that correlates with upgrading in Gleason score.]"

"[Tujuan: Mengidentifikasi korelasi dan insiden metastasis tulang pada pasien kanker prostat dengan Gleason Score (GS) dan Prostate Specific Antigen (PSA) yang rendah.Material dan Metode: Studi deskriptif retrospektif pada pasien kanker prostat di Rumah Sakit Cipto Mangunkusumo periode 2006-2011. Ada 478 pasien dengan kanker prostat. Pasien kanker prostat dengan PSA rendah, telah menjalani pemeriksaan histopatologi, dan bone scan diikutsertakan dalam studi, sehingga didapatkan 358 pasien sebagai subjek penelitian.Nilai PSA diukur dengan sandwich electrochemiluminescent immunoassay. Pemeriksaan histopatologi diklasifikasikan menurut sistem grading Gleason dan dibagi menjadi 3 kategori: diferensiasi baik (GS ≤6), diferensiasi sedang (GS 7), dan diferensiasi buruk (GS 8-10). Bone scan dikerjakan dengan dengan agen radiofarmaka (Tc99m methylenendiphosphonate) dan kemudian gambar ditangkap dengan kamera gamma.Hasil: Rerata usia 67.52±7.8 tahun, rerata GS 7.7±1.3, dan median PSA adalah 56.9 (rentang: 0,48-17000 ng/mL). Ada 11 orang pasien (3,0%) dengan bone scan positif dengan PSA <20 ng/mL dan GS<8. Lebih lanjut, ada 2 pasien (0,6%) dengan GS≤6 dan PSA<10 ng/mL memperlihatkan metastasis ke tulang.Kesimpulan: Pada studi ini, ada sebagian kecil pasien mengalami metastasis tulang dengan PSA (PSA<10 mg/mL) dan GS (GS≤6) rendah., Objective This study was aimed to identify correlation and incidence of bone metastases in prostate cancer patient with low Gleason Score GS and Prostate Specific Antigen PSA Materials and Methods A descriptive restrospective study to patients with prostate cancer in Cipto Mangunkusumo Hospital in 2006 2011 There were 478 patient with prostate cancer Patients with prostate cancer who had PSA value histological examination and bone scan were included in the study resulting in 358 eligible patients for the study PSA value was measured using the sandwich electrochemiluminescent immunoassay Histological examination was graded according to Gleason rsquo s grading system and divided into 3 category well differentiated GS le 6 moderately differentiated GS 7 and poorly differentiated GS 8 10 Bone scan was done using radiopharmaceuticals agent Tc 99m methylenen diphosphonate and then the image was captured using gamma camera Results The mean age was 67 52 7 8 mean GS was 7 7 1 3 and median PSA was 56 9 range 0 48 17000 ng mL There were 11 patients 3 0 with positive bone scan with PSA]"

"Penelitian ini bertujuan untuk mendapatkan gambaran "pengaruh Kegel's exercise terhadap keluhan dribbling pada pasien pasca transurethral resection of the prostate (TURP)". Penelitian ini merupakan penelitian quasi - eksperimental dengan pre - test and post - test with control group. Hipotesis yang dibuktikan dalam penelitian ini adalah "Ada perbedaan pengaruh Kegel's exercise terhadap perubahan keluhan dribbling pasien pasca TURP sebelum dan sesudah Kegel's exercise pada kelompok intervensi dengan kelompok kontrol di Makassar. Sampel penelitian adalah responden yang dirawat di Rumah Sakit Umum Pemerintahan (RSUP) Dr. Wahidin Sudirohusodo dan Rumah sakit (RS) Tingkat II Pelamonia yang memenuhi kriteria inklusi. Jumlah sampel pada kelompok intervensi sejumlah 10 responden, sedangkan kelompok kontrol 10 responden. Hasil penelitian ada perbedaan yang signifikan rata - rata lama keluhan dribbling antara kelompok intervensi dan kelompok kontrol (pada alpha 5 %, p = 0,007) dan ada perbedaan yang signifikan rata - rata lama keluhan dribbling responden yang patuh melakukan Kegel's exercise dengan responden yang tidak patuh melakukan Kegel's exercise (pada alpha 5 %, p = 0,004). Simpulan dari penelitian ini adalah Kegel's exercise terbukti dapat menurunkan keluhan dribbling pasien pasca TURP.

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This study aimed to see the effect of Kegel's Exercise on Dribbling Complaint of Post Transurethral Resection of the Prostate (TURP) patient in Makassar. In this study was used the quasi-experimental with pre and post test with the control group. The hypotheses of this study which was there is differences effect of Kegel's exercise for intervention and control group before and after the Kegel's exercise in dribbling complaint of post TURP patient is proven. The sample was the patients who are hospitalized in Dr. Wahidin Sudirohusodo hospital and Pelamonia hospital fulfill the inclusion criteria. There were 10 responden each for intervention and control groups.

The study results there was a significant difference of the average of dribbling complaint duration between intervention and control groups (alpha 5%, p= 0.007) and that there is a significant difference of the average of dribbling complaint duration between those who do the exercise regularly and who do not do it regularly (alpha 5 %, p = 0,004). In conclusion, the Kegel's exercise had proven to reduce the dribbling complaint on post TURP patient."

"Tujuan: Melaporkan pengalaman TUR-P menggunakan NaCl 0,9% sebagai irigasi (sistem bipolar) dan efeknya terhadap kadar hemoglobin, hematokrit dan natrium.Bahan dan Cara: Studi ini adalah studi prospektif non randomisasi. Enam puluh pasien PPJ memenuhi kriteria penelitian (30 sistem bipolar, 30 sistem monopolar), dinilai lama operasi, jumlah cairan irigasi, berat chip prostat, penurunan kadar hemoglobin, hematokrit, natrium dan ada tidaknya TUR sindrom.Hasil : Terdapat perbedaan yang bermakna antara volume prostat pada kedua grup. Pada sistem bipolar rerata lama operasi adalah 39,66+12,02 menit dan 54,33+19,01 menit pada sistem monopolar, rerata berat chip yang direseksi 14,09+11,25 gram pada sistem bipolar dan 24,26+18,15 gram pada sistem monopolar. Rerata penurunan hemoglobin 0,7601 pada sistem bipolar dan 1,09g/dl pada sistem monopolar, rerata penurunan natrium 2,3mEg11 pada sistem bipolar dan 1,7meg11 pada sistem ronopolar. Tidak terdapat korelasi yang bermakna antara lama operasi dengan penurunan hemoglobin dan natrium pada kelompok sistem bipolar sedangkan pada sistem monopolar terdapat korelasi yang bermakna antara lama operasi dengan penurunan hemoglobin(p:0,04), dan penurunan natrium(p:0,008). Tidak dijumpai adanya TUR sindrom pada kedua kelompok.Simpulan: Dari pengalaman awal ini, disimpulkan bahwa TUR-P dengan sistem bipolar merupakan prosedur yang aman dan tidak memerlukan keahiian tambahan. Penelitian lanjutan dengan studi prospektif randomisasi untuk membandingkan sistem ini dengan sistem monopolar sangat dianjurkan.

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Objectives: To report our experience in TUR-P using normal saline as irrigation (bipolar system) and its effect towards patient's hemoglobin, hematocryte and sodium content. Materials and methods: This study was performed in a prospective non-randomized fashion. Sixty BPH patients were included (30 patients were done with bipolar system, 30 patients with monopolar system). The parameters recorded were operation time, amount of irrigation, resected tissue weight, hemoglobin, hematocryte and sodium decline and presence of TUR syndrome.

Results : There was a significant difference in prostate volume between the two groups. Mean operation time was 39,66+12,02 mnt in the bipolar group and 54,33+19,01 mnt in the monopolar group, resected tissue weight was 14,09+11,25 grams in the bipolar group and 24,26+18,15 grams in the monopolar group. Hemoglobin decline was 0,7601 in the bipolar group and 1,09 in the monopolar group, sodium decline was 2,3mEg11 in the bipolar group and 1,7meg11 in the monopolar group. There was no significant correlation between operation time with hemoglobin and sodium decline in the bipolar group whilst in the monopolar group there was significant correlation between operation time with hemoglobin decline (p:0,04), and sodium decline (p:0,008). There was no TUR syndrome seen in either groups.

Conclusions: TUR-P with bipolar system is a new technology which is safe and requires no additional skills. Further investigation using randomized controlled trial to compare this technology with monopolar system is recommended."