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"Karsinoma kandung kemih merupakan keganasan nomor empat terbanyak. Dampak beban ekonomi karsinoma kandung kemih cukup nyata, sehingga diperlukan deteksi dini keganasan kandung kemih untuk menurunkan beban ekonomi. Sistoskopi merupakan pemeriksaan baku emas untuk identifikasi karsinoma kandung kemih, tetapi pemeriksaan tersebut invasif dan menyebabkan ketidaknyamanan bagi pasien. Sitologi urin tidak invasif, tetapi hasilnya tidak bisa didapatkan dengan cepat dan terdapat ketergantungan interpretasi pemeriksa.Tujuan penelitian ini adalah untuk membandingkan nilai diagnosis dua penanda tumor, yaitu ELISA NMP-22, ELISA UBC urin, serta kombinasi keduanya pada pasien karsinoma kandung kemih. Penelitian uji diagnostik ini terdiri dari 25 orang pasien dengan indikasi sistoskopi dan trans ureteral resection bladder tumor (TUR-BT)/biopsi tumor. Pasien yang memenuhi kriteria masukan dan tolakan dilakukan pengambilan urin pasien kemudian dilakukan pemeriksaan ELISA NMP-22 dan ELISA UBC urin. Hasil pemeriksaan ELISA NMP-22 dan ELISA UBC urin akan dibandingkan dengan pemeriksaan sistoskopi disertai dengan hasil histopatologi.Permeriksaaan ELISA NMP-22 urin dengan cut-off 10 U/ml mempunyai sensitivitas 62,3% dan spesifisitas 83,3%, nilai prediksi positif 81,8% dan nilai prediksi negatif71,4%,likelihood ratio positif3,73 dan likelihood ratio negatif0,45. Jika kasus sistitis dieksklusi maka didapatkan sensitivitas adalah 69,2%, spesifisitas 75%, nilai prediksi positif 81,8%, nilai prediksi negatif 60%, likelihood ratio positif 2,76 , likelihood ratio negatif0,42. Pemeriksaan ELISA UBC dengan cut-off 12 ug/Lmempunyai sensitivitas 38,5% dan spesifisitas 91,7%, nilai prediksi positif 83,3% dan nilai prediksi negatif57,9%,likelihood ratio positif4,63 dan likelihood ratio negatif0,67. Jika kasus sistitis dieksklusi maka didapatkan sensitivitas adalah 38,5%, spesifisitas 87,5%, nilai prediksi positif 83,3%, nilai prediksi negatif 46,7%, likelihood ratio positif 3,08 , likelihood ratio negatif0,70. Kombinasi pemeriksaan ELISA NMP-22 dengan UBC urin mempunyai sensitivitas 76,9% dan spesifisitas 75%, nilai prediksi positif 76,9% dan nilai prediksi negatif75%,likelihood ratio positif3,08 dan likelihood ratio negatif0,31. Jika kasus sistitis dieksklusi maka didapatkan nilai sensitivitas adalah 78,5%, spesifisitas 71,4 %, nilai prediksi positif 84,6 %, nilai prediksi negatif 62,5%, likelihood ratio positif2,74 , likelihood ratio negatif0,30. Kami menyimpulkan kombinasi pemeriksaan ELISA NMP-22 dengan ELISA UBC urin lebih baik karena mempunyai sensitivitas paling tinggi sehingga adanya tumor di kandung kemih baik primer maupun rekuren tidak akan luput dari diagnosis, meskipun harus dipastikan lagi dengan pemeriksaan sistoskopi.

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Bladder cancer is the forth most common cancer. Bladder cancer posseses a significant economic burden so that early detection of baldder cancer may decrease the economic burden. Cystoscopy is the reference standard for identification of bladder carcinoma, but it is invasive andcauses significant discomfortto the patient. Urinary cytology is noninvasive but time consuming and hampered by inter-observer variations. The aim of this study is to compare the diagnostic value of the urine NMP-22 ELISA test, UBC-ELISA test and combination of both tests on suspect bladder carcinoma patients.This diagnostic study included25 patients who were indicated for cystoscopy and trans uretheral resection bladder tumor / tumor biopsy. From patients who met requirements for the inclusion and exclusion criteria, the urine voided sample was taken and used for NMP-22 ELISA test and UBC ELISA test. The results of NMP-22 ELISA test and UBC ELISA test were evaluated against the cystoscopy and histological findings as the reference standard.The result of diagnostic study of NMP-22 ELISA test with cut-off 10 U/mlshowed that it had a sensitivity of 62,3% and a specificity of 83,3%, a positive predictive value of 81,8% and a negative predicitive value of 71,4%, a positive likelihood ratio of 3,73 and a negative likelihood ratio of 0,45. If the cystitis case was excluded, it had a sensitivity of 69,2%, and a specificity of 75%, a positive predictive value of 81,8%, and a negative predicitive value of 60%, a positive likelihood ratio of 2,76 , and a negative likelihood ratio of0,42. Diagnostic value of UBC ELISA test with cut-off 12 ug/L had a sensitivity of 38,5% and a specificity of 91,7%, a positive predictive value of 83,3% and a negative predicitive value of 57,9%, a positive likelihood ratio of 4,63 and a negative llikelihood ratio of 0,67. If the cystitis case was excluded, it had a sensitivity of 38,5%, and a specificity of 87,5%, a positive predictive value of 83,3%, and a negative predicitive value of 46,7%, a positive likelihood ratio of 3,08 , and a negative likelihood ratio of0,70.Diagnostic value of combined NMP-22 ELISA test with UBC ELISA test had a sensitivity of 76,9% and a specificity of 75%, a positive predictive value of 76,9% and a negative predicitive value of 75%, a positive likelihood ratio of 3,08 and a negative llikelihood ratio of0,31. If the cystitis case was excluded, it had a sensitivity of 78,5%, and a specificity of 71,4%, a positive predictive value of 84,6%, and a negative predicitive value of 62,5%, a positive likelihood ratio of 2,74 , and a negative likelihood ratio of0,30.The conclusion was that the combined NMP-22 ELISA test with UBC test had the highest sensitivity, thus itwould not miss any primary or recurrent tumour in the bladder, although this neededto be confirmed by cystoscopy."

"ABSTRAKLatar belakang: Selama beberapa hari setelah persalinan, retensio urin dengan distensi kandung kemih adalah fenomena yang umum terjadi. Jika pasien tidak dapat berkemih spontan dalam waktu 4 jam setelah bersalin, besar kemungkinan bahwa dia mengalami Retensio Urin Post Partum RUPP . Di beberapa tempat pengukuran residu urin dilakukan 4 jam post partum, sementara di tempat lain dilakukan 6 jam post partum. Ketidakseragaman waktu pengukuran ini akan mempengaruhi diagnosis, tata laksana, serta prognosis. Waktu pengukuran yang lebih lama akan menyebabkan kandung kemih akan terisi lebih banyak urin, sehingga akan terdistensi dalam waktu yang lebih lama, sehingga waktu pemulihan akan lebih lama.Objektif: Diketahuinya lama pemulihan dan volume residu urin pada kelompok pasien dengan retensio urin pasca persalinan dengan beda waktu pengukuran,Desain penelitian dan metode: Penelitian ini menggunakan desai uji klinis acak di RSUPN Cipto Mangunkusumo dan RSUD Karawang bulan Maret-Desember 2017. Perermpuan pasca salin dengan risiko retensio urin pasca persalinan, bersedia mengikuti penelitian, dan terdiagnosis retensio urin dibagi menjadi dua kelompok. Kelompok pertama diukur residu urinnya dalam 4 jam, kelompok kedua dalam 6 jam. Pasien lalu diberikan tatalaksana retensio urin sesuai protokol RSUPNCM dan dicatat waktu pulihnya.Hasil: Karakteristik pasien pada kedua kelompok dianggap setara. Median lama pemulihan pasien retensio urin yang diukur residu urin 4 jam adalah 30 jam, berbeda 21 jam dengan pasien yang diukur resiudnya 6 jam, yaitu 51 jam p

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ABSTRACTIntroduction Few days after delivery, urinary retention with bladder distention commonly happens. If patient unable to void spontaneously 4 hours after delivery, most likely she will develops post partum urinary retention PPUR . In some hospitals, the urinary residual volume was measured at 4th hour, other measures at 6th hour post delivery. This will affects the diagnosis, management, and prognosis. The longer the measurement will make the bladder filled with much more urine volume, thus the bladde will be distended in longer period, so the recovery time will be prolonged.Objective To know the differrence of recovery time and the urinary residual volume between group of patient with different time of urinary residual collecting.Study design and methode A randomized controlled trial was held at Cipto Mangunkusumo central general hospital and central Karawang hospital between March and Desember 2017. Post partum women with urinary retention risks, willing to contribute to the trial, and diagnosed as post partum urinary retention were divided into 2 groups. Urinary residual volume was meassured in 4th hour and 6th hour in each group. Patient then treated according to RSCM guideline, and the time of recovery was documented.Result Both group have similar characteristic. The median length of recovery in the group which the urinary residual was measured in 4th hour was 30 hours, 21 hours shorter than 6th hour group, 51 hours p 0.001 . The median of urinary residual volume of the 4th hour group was 600 ml, 400 ml lesser than the 6th hour group, 1000 ml p 0.001 Conclussion time of recovery are shorter in the 4th hour group and the urinary residual volume are less in the 4th hour group compared to the 6th hour group.Keywords post partum urinary retention, urine residual, urinary residual collecting time"