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Abstrak :
ABSTRAK
Peningkatan PSA dapat ditemukan pada semua kelainan terkait prostat, baik keganasan kanker prostat maupun non-keganasan prostatitis . Terdapat hipotesis bahwa pemberian antibiotik diperkirakan dapat menurunkan kadar PSA. Penelitian ini bertujuan melihat pengaruh pemberian antibiotik terhadap penurunan kadar PSA pada pasien yang menderita LUTS yang memiliki kadar PSA tinggi. Penelitian ini menggunakan metode randomisasi-terkontrol yang dibagi menjadi 2 kelompok, kelompok yang mendapat terapi antibiotik dan kelompok yang mendapat plasebo diberikan selama 2 minggu. Nilai PSA diperiksa saat awal dan saat selesai obat. Biopsi prostat dilakukan pada saat selesai konsumsi obat. Tidak terdapat pengaruh yang signifikan antara penggunaan antibiotik dengan penurunan kadar PSA pada penderita LUTS

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ABSTRACT
To see the effect of antibiotic administrations on PSA level reduction in patients with LUTS who have high PSA level, subjects were collected from urology outpatient clinic of Cipto Mangunkusumo National Hospital using consecutive sampling. Patients who have LUTS went through a selection process using inclusion and exclusion criteria. Selected patients were randomized into two different groups control who receive antibiotics and placebo group. Both groups were then given two weeks length of therapy, assessments for PSA levels before and after drug administrations, and a prostate biopsy at the end of drug administrations.There is no significant association between antibiotic and PSA level reduction in LUTS patients.

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[ABSTRAK
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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ABSTRACT
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 ;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 ;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 , 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 ]

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Material dan Metode: Kami mendapatkan 50 pasien terpasang DJ stent perendoskopi dan dibagi menjadi kelompok kontrol terdiri dari 25 pasien dan kelompok yang mendapat obat antimuskarinik terdiri dari 25 pasien. Kedua kelompok tersebut kami bandingkan keluhan LUTS dan kualitas hidup pasca pemasangan DJ stent yang dinilai pada saat satu hari setelah lepas kateter dan dua minggu pasca pemasangan DJ stent. Penilaian LUTS pasien dilakukan dengan total skor IPSS dan kualitas hidup pasien dengan pertanyaan QoL. Hasil: Satu hari pasca lepas kateter antara kelompok kontrol dengan kelompok yang mendapat obat antimuskarinik, tidak didapatkan perbedaan yang bermakna secara statistik pada total skor IPSS, skor IPSS komponen storage symptoms dan voiding symptoms, dan nilai QoL. Dua minggu pasca pemasangan DJ stent pada kedua kelompok didapatkan perbedaan yang bermakna total skor IPSS, skor IPSS komponen storage symptoms dan voiding symptoms, dan nilai QoL, yaitu lebih rendah pada kelompok pasien yang mendapat obat antimuskarinik. Perbandingan antara satu hari setelah lepas kateter dengan dua minggu pasca pemasangan DJ stent pada kelompok obat antimuskarinik, terdapat penurunan dengan perbedaan bermakna pada total skor IPSS, skor IPSS komponen storage symptoms dan voiding symptoms, dan nilai QoL. Kesimpulan: Pemberian obat antimuskarinik selama jangka waktu tertentu, memberikan perbaikan gejala LUTS, baik voiding symptoms maupun storage symptoms, dan peningkatan kualitas hidup pada pasien-pasien yang terpasang DJ stent.

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Objective: To analyze the effect of antimuscarinic drug on LUTS and Quality of Life (QOL) in patients with DJ stent. Materials and Methods: We analyzed 50 patients who have DJ stent inserted endoscopically and divided the subjects into two groups, 25 patients had anti- muscarinic and 25 patients as the control group. LUTS and QoL were compared in both groups one day after catheter released and at the second week after DJ stent insertion. The severity of LUTS was examined based on total IPSS score and quality of life based on QoL questionnaire. Results: In day 1 after the catheter released, there were no statistically significant differences on the total IPSS score, storage and voiding symptoms score on IPSS, and QoL score between two groups. Two weeks after DJ stent insertion, there were significant differences on total IPSS score, storage and voiding symptoms score on IPSS, and QoL score between two groups, where the group with anti- muscarinic had lower score than the control group. Group with antimuscarinic drug showed significant decrease of total IPSS score, storage and voiding symptoms score on IPSS and QoL score at the second week after DJ stent insertion compared to the first day. Conclusion: Antimuscarinic administration for a period of time, improved LUTS symptoms and increased quality of life in patients with DJ stent.

Abstrak :
Disfungsi ereksi (DE) merupakan disfungsi seksual pada laki-laki yang paling sering ditemukan dan prevalensinya mencapai 76% pada pasien LUTS. Penyebab DE dihubungkan dengan kelemahan otot dasar panggul. Salah satu terapi yang dapat diberikan adalah latihan otot dasar panggul, yang bertujuan untuk meningkatkan aktivitas otot ischiocavernosus dan bulbocavernosus. Biofeedback otot dasar panggul dapat memberikan informasi visual dan auditorik sehingga otot dapat melakukan kontraksi dengan tepat. Penelitian bertujuan untuk mengetahui pengaruh pemberian biofeedback otot dasar panggul terhadap perbaikan fungsi ereksi pada pasien dengan lower urinary tract symptoms (LUTS). Perbaikan fungsi ereksi dinilai dengan skor IIEF (International Index of Erectile Function), EHS (Erectile Hardness Score), dan kekuatan otot dasar panggul. Perbaikan gejala LUTS juga dinilai dengan skor IPSS (International Index of Prostat Symptoms). Penelitian ini merupakan studi randomized controlled trial pada pasien rawat jalan di RSUPN Cipto Mangunkusumo. Subjek pada penelitian ini dibagi menjadi 2 kelompok, pada kelompok perlakuan mendapatkan biofeedback otot dasar panggul sebanyak 10 sesi, 2 kali seminggu dan latihan otot dasar panggul dirumah. Kelompok kontrol hanya mendapatkan latihan otot dasar panggul dirumah. Terdapat 21 pasien LUTS yang mengalami disfungsi ereksi (DE). Sebanyak 10 subjek (50%) termasuk dalam kategori DE ringan, 4 subjek (20%) termasuk dalam kategori DE sedang, dan 6 subjek (30%) termasuk dalam kategori DE berat. Dari hasil penelitian didapatkan perbaikan skor IIEF, IPSS, EHS, slow twitch dan fast twitch pada kelompok perlakuan (p-value <0,05), sedangkan pada kelompok kontrol hanya didapatkan perbaikan pada skor IIEF dan IPSS (p-value <0,05). Kesimpulan penelitian ini adalah terdapat perbaikan fungsi ereksi (peningkatan skor IIEF, skor EHS, penurunan skor IPSS dan peningkatan kekuatan otot dasar panggul) setelah pemberian biofeedback otot dasar panggul pada pasien DE dengan LUTS selama 10 sesi. ......Erectile dysfunction (ED) is the most common male sexual dysfunction, and its prevalence reaches 76% in LUTS patients. The cause of ED is associated with weakness of the pelvic floor muscles. One of the therapies that can be given is pelvic floor muscle exercises, which aim to increase the activity of the ischiocavernosus and bulbocavernosus muscles. Pelvic floor muscle biofeedback can provide visual and auditory information so that the muscles can contract properly. This research aims to determine the effect of pelvic floor muscle biofeedback on improving erectile function in patients with lower urinary tract symptoms (LUTS). Improvement in erectile function was assessed by scores of IIEF (International Index of Erectile Function), EHS (Erectile Hardness Score), and pelvic floor muscle strength. Improvement in LUTS symptoms was also assessed by an IPSS (International Index of Prostate Symptoms) score. This research was a randomized controlled trial study on outpatients at Cipto Mangunkusumo General Hospital. Subjects in this study were divided into 2 groups, the treatment group received 10 sessions of pelvic floor muscle biofeedback, 2 times a week and pelvic floor muscle exercises at home. The control group only got pelvic floor muscle exercises at home. There were 21 LUTS patients who experienced erectile dysfunction (ED). A total of 10 subjects (50%) were included in the mild ED category, 4 subjects (20%) were included in the moderate ED category, and 6 subjects (30%) were included in the severe ED category. From the results of the study, it was found that the scores for IIEF, IPSS, EHS, slow twitch and fast twitch were improved in the treatment group (p-value <0.05), whereas in the control group there were only improved in IIEF and IPSS scores (p-value <0.05 ). The conclusion of this study was that there was an improvement in erectile function (increased IIEF score, EHS score, decreased IPSS score and increased pelvic floor muscle strength) after administering pelvic floor muscle biofeedback to patients ED with LUTS for 10 sessions.

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Tujuan: Penelitian ini akan mencari korelasi antara pemeriksaan dengan sistim skoring (IPSS) dan hasil pemeriksaan uroflowmetri (Qmax) serta hasil pemeriksaan urodinamik ( BOOI ). Diharapkan akan diketahui sejauh mana data subyektif pasien berkorelasi dengan data obyektif. Bahan dan Cara: Data dikumpulkan dari pasien yang dilakukan pemeriksaan di Poliklinik Khusus Urologi sejak bulan Oktober 2005 sampai dengan Mei 2006 dengan kriteria inklusi dan eksklusi. HasiI Penelitian: Terdapat 89 pasien yang memenuhi kriteria inklusi. Umur rata-rata 65,56 ±7,2 tahun. IPSS rata-rata 20,57+7,0. Pancaran kencing maksimal (Qmax) rata-rata 5,94 ±3,5 ml/detik. BOOI kategori obstruksi sebanyak 56 (65,1%) pasien, ekuivokal 20 (23,3%) dan tidak obstruksi sebanyak 10 (11,6%). Koefisien korelasi antara IPSS dan Qmax adalah r = - 0,32 (sangat lemah) signifikansi p = 0,002. Koefisien korelasi antara IPSS dengan BOOI adalah r = 0,28 p = 0,008. Koefisien korelasi antara Qmax dan BOOI adalah r = - 0,45 p = 0,00. Hasil uji Anova didapatkan adanya perbedaaan Qmax yang bermakna p=0,041 (p<0,05) diantara derajat LUTS. Pada penelitian ini tidak ada perbedaan BOOT yang bermakna (p=0,093) diantara derajat LOTS. Tidak ada perbedaan Qmax yang bermakna (p = 0,12 ) diantara BOOT. Kesimpulan: Keluhan LUTS yang diukur dengan IPSS mempunyai korelasi sangat lemah tetapi signifikan dengan pemeriksaan obyektif yang diukur dengan uroflowmetri dan urodinamik. Pemeriksaan uroflowmetri mempunyai korelasi sangat lemah tetapi signifikan dengan pemeriksaan urodinamik.