Hasil Pencarian  ::  Simpan CSV :: Kembali

"Pendahuluan dan tujuan: Penyakit virus corona (COVID-19) telah mempengaruhi praktik sehari-hari dalam pelayanan kesehatan. Penelitian ini bertujuan untuk mengetahui dampak COVID-19 terhadap praktik urologi di Indonesia.Metode: Penelitian ini merupakan studi potong-lintang menggunakan kuisioner berbasis web (Survey Monkey) yang didistribusikan dan dikumpulkan dalam waktu tiga minggu. Seluruh dokter urologi yang berpraktik di Indonesia dikirimkan sebuah tautan kuisioner elektronik melalui E-mail, aplikasi Whatsapp Messenger, dan/atau layanan pesan singkat, dan kepala residen dalam setiap pusat urologi mendistribusikan kuisioner elektronik kepada residen urologi.Hasil: Rerata respon adalah 369/485 (76%) pada dokter urologi dan 220/220 (100%) pada residen urologi. Sejumlah kurang dari 10 persen respon [ada setiap bagian didapatkan tidak lengkap. Terdapat 35/369 (9.5%) dokter urologi dan 59/220 (26.8%) residen urologi yang pernah dinyatakan pasien suspek COVID-19, dan tujuh diantaranya dinyatakan positif terkonfirmasi COVID-19. Mayoritas dokter urologi (66%) lebih menyukai melanjutkan konsultasi tatap muka dengan jumlah pasien yang terbatas, dan lebih dari 60% dokter urologi lebih menyukai menunda mayoritas (66%) atau seluruh operasi elektif. Sebagian besar dokter urologi juga memiliki untuk menunda operasi elektif pada pasien dengan gejala terkait COVID-19 da pasien yang membutuhkan perawatan pasca-operasi ICU. Dokter dan residen urologi melaporkan tingginya rerata menggunakan apat pelindung diri, selain gaun medis dan masker N95, yang mana persediaannya terbatas. Beberapa dokter ahli bedah onkologi urologi dipertimbangkan menjadi prioritas utama untuk dokter urologi Indonesia selama masa epidemic COVID-19.Kesimpulan: Pandemi COVID-19 telah menyebabkan penurunan pelayanan urologi baik pada klinik rawat jalan dan pelayanan pembedahan dengan prosedur uro-onkologi sebagai prioritas untuk dilakukan.

---

Introduction and objectives: Coronavirus disease 2019 (COVID-19) has affected daily practices in health care services. This study aimed to investigate the impact of COVID-19 on urology practice in Indonesia.

Methods: This was a cross-sectional study using web-based questionnaire (Survey Monkey), which was distributed and collected within a period of three weeks. All practicing urologists in Indonesia were sent an e-questionnaire link via E-mail, WhatsApp Messenger application, and/or short message service, and the chief of residents in each urology centre distributed the e-questionnaire to urology residents.

Results: The response rate was 369/485 (76%) among urologists and 220/220 (100%) among urology residents. Less than 10 percent of the responses in each section were incomplete. There are 35/369 (9.5%) of urologists and 59/220 (26.8%) of urology residents had been suspected as COVID-19 patients, of whom seven of them were confirmed to be COVID-19 positive. The majority of urologists (66%) preferred to continue face-to-face consultations with a limited number of patients, and more than 60% of urologists preferred to postpone the majority (66%) or all elective surgery. Most urologists also chose to postpone elective surgery in patient with COVID-19-related symptoms and patient who required post-operative ICU-care. Urologist and urology residents reported high rates of using personal protective equipment, except for medical gowns and N95 masks, which were in short supply. Several uro-oncology surgeries were considered to be the top priority for Indonesian urologist during COVID-19 epidemic period.

Conclusion: The COVID-19 pandemic has caused a decline in urology service in both outpatient clinic and surgery services with uro-oncological procedure as a priority to conduct."

"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.

---

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."

"Batu saluran kemih (BSK) didefinisikan sebagai pembentukan batu pada ginjal, ureter, atau kandung kemih. Beberapa penelitan menunjukkan bahwa ketidaknormalan parameter metabolik merupakan hal yang umum pada pasien BSK. Tujuan penelitian ini adalah untuk melihat hubungan antara indeks massa tubuh (IMT), asam urat serum, glukosa serum, dan tekanan darah dengan opasitas batu pada pasien BSK. Penelitian ini dilakukan secara retrospektif dengan melihat data rekam medis dari pasien BSK yang menjalani prosedur ESWL pada Januari 2008-Desember 2013 di Departemen Urologi RS Cipto Mangunkusumo. Data yang yang diambil adalah indeks masa tubuh (IMT), kadar asam urat serum, glukosa serum, tekanan darah, dan opasitas BSK. Hubungan antara IMT, kadar asam urat serum, glukosa serum, dan tekanan darah, dengan opasitas batu dianalisis menggunakan uji chi-square. Terdapat 2.889 pasien yang menjalani prosedur ESWL pada Januari 2008-Desember 2013. Analisis dilakukan terhadap 242 pasien yang memiliki rekam medis lengkap. Rerata usia adalah 48,02±12,78 tahun. Rasio laki-laki terhadap perempuan adalah 2,27:1. Rerata IMT adalah 29,91±3,78 kg/m2. IMT berisiko didapatkan pada 66,52% pasien. Proporsi batu radioopak adalah 77,69% (188 pasien). Dua puluh dua pasien (9,1%) memiliki tekanan darah normal. Pasien dengan kadar serum asam urat tinggi sebanyak 34,30% (83 pasien). Secara statistik didapatkan hubungan yang bermakna antara kadar serum glukosa sewaktu dengan opasitas batu (p < 0,05). Terdapat hubungan yang bermakna antara kadar serum glukosa sewaktu dengan opasitas batu pada pasien BSK. Pasien hiperglikemia cenderung memiliki batu radiolusen. Sementara pasien normoglikemia cenderung memiliki batu radioopak.

---

Urolithiasis refers to formation of stone in the kidney, ureter, or bladder. Several studies showed metabolic abnormalities were common in urolithiasis patients. The aim of this study was to describe the association between body-mass-index (BMI), serum uric acid, serum glucose, and blood pressure toward stone opacity in urinary tract stone patients. This study was done retrospectively by reviewing registry data of urinary tract stone patients that had undergone ESWL on January 2008-December 2013 in Department of Urology Cipto Mangunkusumo Hospital. Data concerning body mass index, serum uric acid, serum glucose, blood pressure, and urinary tract stone opacity were recorded. Associations between body mass index, serum uric acid, serum glucose and blood pressure with urinary tract stone opacity were using chi-square test. There were 2,889 patients who underwent ESWL on January 2008-December 2013. We analyzed 242 subjects with complete data. Mean age was 48.02 (± 12.78 years). Male-to-female ratio was 2.27:1. Mean BMI was 29.91 (± 3.78) kg/m2. High risk BMIs were found in 161 patients (66.52%). The proportion of radioopaque stone was 77.69% (188 patients). Twenty two patients (9.1%) had normal blood pressure. Patients with high serum uric acid were 34.30 % (83 patients). We found a significant association between random serum glucose level and stone opacity (p < 0.05). There is significant association between random serum glucose level and stone opacity in urolithiasis patients. Hyperglycemia patients tend to have radiolucent stone, whereas normoglycemia patients tend to have radioopaque stone."

"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.

---

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."

"Pengantar: Batu saluran kencing adalah salah satu penyebab yang paling sering dari nyeri kolik yang muncul pada layanan kesehatan primer. Penanganan dari kasus batu saluran kemih dibagi menjadi beberapa kelompok yaitu operatif dan juga konservatif. Cystone adalah salah satu terapi tambahan yang dapat ditambahkan pada regimen penanganan konservatif untuk ukuran batu dan memudahkan pengeluaran batu saluran kemih. Penelitian ini bertujuan untuk melihat keamanan dan efektivitas dari pemberian Cystone ini pasca tindakan ESWL. Metodologi : Penelitian ini dilakukan antara bulan Mei 2014-November 2015, jumlah sampel yang berpartisipasi dalam penelitian ini adalah 81 sampel, 42 berada pada grup cystone dan 39 dalam grup placebo. Setelah dilakukan ESWL, satu grup diberikan tablet cystone 2 x 2 setiap hari selama 4 minggu, grup lain diberikan placebo. Penanganan lanjutan seperti KUB radiografi, CT urografi dan juga pemeriksaan USG dilakukan setelah mengkonsumsi obat-obatan ini.Hasil: Dari 84 sampel yang berpartisipasi dalam penelitian ini, karkteristik demografik dan baseline antara grup tatalaksana dan grup placebo mirip satu sama lain. Tidak ada perbedaan statistic yang signifikan antara besar batu sebelum dan sesudah konsumsi cystone baik pada grup cystone ataupun placebo. Satu kejadian efek samping yang serius dilaporkan pada grup cystone, tidak ada kejadian efek samping yang berat terlihat pada grup placebo. Diskusi: Penelitian sebelumnya memperlihatkan bahwa cystone ini secara signifikan dapat memperkecil besar batu ginjal dan mengubah komposisi batu ginjal. Hasil yang berbeda ini kemungkinan disebabkan oleh perbedaan besar batu ginjal baik pada riset ini maupun literature-literatur sebelumnya. Berdasarkan penelitian ini, kami tidak merekomendasikan penggunaan cystone sebagai terapi adjunctive- management conservative dari batu ginjal ini.

---

Introduction: Urinary stone is one of the most common cause of colicky pain in primary care. Management of urinary stone is divided into operative management and conservative management. Cystone is one of the traditional adjunctive therapy that may added to conservative management regiment to reduce kidney stone size and speed-up the stone passing. This study aims to see the efficacy and safety of Cystone after Extracorporeal Shock Wave Lithotripsy. Methods : This clinical trial was conducted from May 2014-November 2015, the total sample for this research are 81 samples, 42 in cystone group and 39 in placebo group. After undergoing ESWL procedure, one group were given 2 x 2 cystone tables daily for 4 weeks, and the other were given placebo. Further examination such as KUB radiography, CT urography, USG examination were conducted after consumption of the drugs. Results : Among 84 subjects that participated in this research, demographic charcteristics and baseline disease were comparable. No statistically significant changes on the stone size in both cystone and placebo group. One serious adverse event appeared in cystone group compared to none in the placebo group. Discussion: Previous research showed that cystone made significant changes on the renal stone size and composition. This differing results may be caused by different stone sizes in both this research and previous literature. Based on this research’s result we do not recommend using cystone as an adjunctive conservative management of renal stone"

"

Batu saluran kemih (BSK) didefinisikan sebagai pembentukan batu pada ginjal, ureter, atau kandung kemih. Beberapa penelitan menunjukkan bahwa ketidaknormalan parameter metabolik merupakan hal yang umum pada pasien BSK. Tujuan penelitian ini adalah untuk melihat hubungan antara indeks massa tubuh (IMT), asam urat serum, glukosa serum, dan tekanan darah dengan opasitas batu pada pasien BSK. Penelitian ini dilakukan secara retrospektif dengan melihat data rekam medis dari pasien BSK yang menjalani prosedur ESWL pada Januari 2008 – Desember 2013 di Departemen Urologi RS Cipto Mangunkusumo. Data yang yang diambil adalah indeks masa tubuh (IMT), kadar asam urat serum, glukosa serum, tekanan darah, dan opasitas BSK. Hubungan antara IMT, kadar asam urat serum, glukosa serum, dan tekanan darah, dengan opasitas batu dianalisis menggunakan uji chi-square. Terdapat 2.889 pasien yang menjalani prosedur ESWL pada Januari 2008 – Desember 2013. Analisis dilakukan terhadap 242 pasien yang memiliki rekam medis lengkap. Rerata usia adalah 48,02±12,78 tahun.  Rasio laki-laki terhadap perempuan adalah 2,27:1. Rerata IMT adalah 29,91±3,78 kg/m². IMT berisiko didapatkan pada 66,52% pasien.  Proporsi batu radioopak adalah 77,69% (188 pasien). Dua puluh dua pasien (9,1%) memiliki tekanan darah normal. Pasien dengan kadar serum asam urat tinggi sebanyak 34,30% (83 pasien). Secara statistik didapatkan hubungan yang bermakna antara kadar serum glukosa sewaktu dengan opasitas batu (p < 0,05). Terdapat hubungan yang bermakna antara kadar serum glukosa sewaktu dengan opasitas batu pada pasien BSK. Pasien hiperglikemia cenderung memiliki batu radiolusen. Sementara pasien normoglikemia cenderung memiliki batu radioopak.

---

Urolithiasis refers to formation of stone in the kidney, ureter, or bladder. Several studies showed metabolic abnormalities were common in urolithiasis patients. The aim of this study was to describe the association between body-mass-index (BMI), serum uric acid, serum glucose, and blood pressure toward stone opacity in urinary tract stone patients. This study was done retrospectively by reviewing registry data of urinary tract stone patients that had undergone ESWL on January 2008 – December 2013 in Department of Urology Cipto Mangunkusumo Hospital. Data concerning body mass index, serum uric acid, serum glucose, blood pressure, and urinary tract stone opacity were recorded. Associations between body mass index, serum uric acid, serum glucose and blood pressure with urinary tract stone opacity were using chi-square test. There were 2,889 patients who underwent ESWL on January 2008 – December 2013. We analyzed 242 subjects with complete data. Mean age was 48.02 (± 12.78 years). Male-to-female ratio was 2.27:1. Mean BMI was 29.91 (± 3.78) kg/m². High risk BMIs were found in 161 patients (66.52%). The proportion of radioopaque stone was 77.69% (188 patients). Twenty two patients (9.1%) had normal blood pressure. Patients with high serum uric acid were 34.30 % (83 patients). We found a significant association between random serum glucose level and stone opacity (p < 0.05). There is significant association between random serum glucose level and stone opacity in urolithiasis patients. Hyperglycemia patients tend to have radiolucent stone, whereas normoglycemia patients tend to have radioopaque stone.

"

"[ABSTRAK LatarBelakangDelayedgraftfunction(DGF)adalahkomplikasiyangumumdijumpaipadatransplantasidarimayat.Berdasarkanstuditerdahulu,DGFdanfactorresikonyamemilikihasilyangbervariasipadadonornefrektomihidupMetodePenelitimelakukananalisisretrospektifdarirekammedicdonordanresipientransplantasiginjalpada100kasuslaparoskopidonornefrektomihidupdiRumahSakitCiptoMangunkusumodariNovember2011hinggaFebruari2014.KriteriaDGFadalahpasiendidialisispada1minggupostoperasidan/ataukreatininlebihdari2.5mg/dlpadaharike7postoperasi.PasienyangtidakmasukdalamkriteriatersebutdidefinisikanmemilikirenalallograftyangberfungsinormalHasilPrevalensiDGFpadapenelitianiniadalah14%.Indeksmassatubuhresipien,coldischemiatime,waktuanastomosisvaskular,dantotalischemiatimelebihtinggipadagrupDGF,tetapitidakditemukanfaktorresikoDGFyangsignifikansecarastatisticsaatdilakukananalisismultivariatKesimpulanInsidensiDGFpadastudiinimasukdalamrentangyangdiamatipadastudi-­‐studisebelumnya.FaktorresikoyangdilaporkansebagaifaktorresikoDGFpadalaparoskopidonornefrektomihiduptidaksignifikansecarastatistikdenganDGFpadastudikaliini.

---

ABSTRACTBackgroundDelayed graft function (DGF) is a common complication affecting deceaseddonor renal transplantation. Based on previous studies, DGF and its risk factors inlive donor nephrectomy (LDN) have a various results.MethodsWe retrospectively analyzed the medical records of donor and recipient from ourfirst 100 cases of laparoscopic LDN in Cipto Mangunkusumo Hospital fromNovember 2011 to February 2014. The criteria used to define DGF were therequirement for dialysis in postoperative week 1 and/or serum creatinine greaterthan 2.5 mg/dl at postoperative day 7. Patients who did not match any of thesecriteria were define as having normal renal allograft function.ResultsThe overall prevalence of DGF was 14%. Recipients body mass index, coldischemia time, vascular anastomosis time, and total ischemia time were higheramong the delayed graft function group, but no risk factors for DGF weresignificantly associated after multivariate analysis.ConclusionsThe incidence of DGF in our study was in the range of that observed in previousstudies. The factors that previously reported and believed as risk factors of DGFin laparoscopic LDN were not significantly associated with the development ofDGF in our study.;BackgroundDelayed graft function (DGF) is a common complication affecting deceaseddonor renal transplantation. Based on previous studies, DGF and its risk factors inlive donor nephrectomy (LDN) have a various results.MethodsWe retrospectively analyzed the medical records of donor and recipient from ourfirst 100 cases of laparoscopic LDN in Cipto Mangunkusumo Hospital fromNovember 2011 to February 2014. The criteria used to define DGF were therequirement for dialysis in postoperative week 1 and/or serum creatinine greaterthan 2.5 mg/dl at postoperative day 7. Patients who did not match any of thesecriteria were define as having normal renal allograft function.ResultsThe overall prevalence of DGF was 14%. Recipients body mass index, coldischemia time, vascular anastomosis time, and total ischemia time were higheramong the delayed graft function group, but no risk factors for DGF weresignificantly associated after multivariate analysis.ConclusionsThe incidence of DGF in our study was in the range of that observed in previousstudies. The factors that previously reported and believed as risk factors of DGFin laparoscopic LDN were not significantly associated with the development ofDGF in our study.;BackgroundDelayed graft function (DGF) is a common complication affecting deceaseddonor renal transplantation. Based on previous studies, DGF and its risk factors inlive donor nephrectomy (LDN) have a various results.MethodsWe retrospectively analyzed the medical records of donor and recipient from ourfirst 100 cases of laparoscopic LDN in Cipto Mangunkusumo Hospital fromNovember 2011 to February 2014. The criteria used to define DGF were therequirement for dialysis in postoperative week 1 and/or serum creatinine greaterthan 2.5 mg/dl at postoperative day 7. Patients who did not match any of thesecriteria were define as having normal renal allograft function.ResultsThe overall prevalence of DGF was 14%. Recipients body mass index, coldischemia time, vascular anastomosis time, and total ischemia time were higheramong the delayed graft function group, but no risk factors for DGF weresignificantly associated after multivariate analysis.ConclusionsThe incidence of DGF in our study was in the range of that observed in previousstudies. The factors that previously reported and believed as risk factors of DGFin laparoscopic LDN were not significantly associated with the development ofDGF in our study., BackgroundDelayed graft function (DGF) is a common complication affecting deceaseddonor renal transplantation. Based on previous studies, DGF and its risk factors inlive donor nephrectomy (LDN) have a various results.MethodsWe retrospectively analyzed the medical records of donor and recipient from ourfirst 100 cases of laparoscopic LDN in Cipto Mangunkusumo Hospital fromNovember 2011 to February 2014. The criteria used to define DGF were therequirement for dialysis in postoperative week 1 and/or serum creatinine greaterthan 2.5 mg/dl at postoperative day 7. Patients who did not match any of thesecriteria were define as having normal renal allograft function.ResultsThe overall prevalence of DGF was 14%. Recipients body mass index, coldischemia time, vascular anastomosis time, and total ischemia time were higheramong the delayed graft function group, but no risk factors for DGF weresignificantly associated after multivariate analysis.ConclusionsThe incidence of DGF in our study was in the range of that observed in previousstudies. The factors that previously reported and believed as risk factors of DGFin laparoscopic LDN were not significantly associated with the development ofDGF in our study.]"

"ABSTRAKSalah satu komplikasi tersering PCNL adalah perdarahan. Penelitian ini bertujuan mengidentifikasi faktor prediktor jumlah total perdarahan PCNL, dan mengevaluasi pola transfusi darah. PCNL dilakukan acak oleh dua konsultan endourologi dan dianalisa prospektif. Pasien dewasa dengan batu ginjal pielum > 20 mm, kaliks inferior >10 mm, atau staghorn dijadikan sampel. Pasien dengan koagulopati, pengobatan antikoagulan, atau dilakukan konversi operasi terbuka dieksklusi. Pemeriksaan darah lengkap dilakukan pada awal dan 12, 24, 36, 72 jam paska-operasi. Faktor-faktor seperti stone burden, jenis kelamin, luas permukaan tubuh, perubahan kadar hematokrit dan jumlah transfusi darah dianalisa regresi untuk mendapatkan prediktor total blood loss (TBL). Didapatkan rerata TBL 560,92±428,43 ml dari total 85 pasien. Stone burden merupakan faktor paling berpengaruh terhadap TBL (p=0.037). Kebutuhan transfusi darah diprediksi dengan menghitung TBL (ml) = -153,379 + 0,229 stone burden (mm2) + 0,203 baseline serum hematokrit (%). Sebanyak 87,1% pasien tidak menerima transfusi peri-operatif, 3,5% menerima transfusi intra-operatif, 7,1% menerima transfusi post-operatif, 2,3% menerima transfusi intra dan post-operatif; sehingga menghasilkan cross-matched transfusion ratio 7,72. Rerata tranfusi darah peri-operatif 356,00±145,88 ml. Stone burden menjadi faktor prediktif paling berpengaruh terhadap jumlah perdarahan. Jumlah darah yang ditransfusikan dan dilakukan cross-matched ditemukan tinggi. Formula yang kami usulkan dapat mengurangi kejadian transfusi yang tidak dibutuhkan.

---

ABSTRACTThe most common complication of PCNL is bleeding. We aimed to identify predictive factors of PCNL blood loss and evaluate transfusion practice. A prospective study was randomly performed by two consultants of endo-urology. Adults with kidney stones in pelvic >20mm, inferior calyx >10mm or staghorn were included; those with coagulopathy, under anti-coagulant treatment or open conversion were excluded. Full blood count was taken at baseline and during 12, 24, 36, 72-hours post-operatively. Factors such as stone burden, sex, body surface area, hematocrit level shifting and amount of blood transfused were analyzed statistically using regression to identify predictive factors of total blood loss (TBL). Mean TBL was 560.92±428.43 ml from 85 patients enrolled. Our results revealed that TBL (ml): -153.379 + 0.229xstone burden (mm2) + 0.203xbaseline serum hematocrit (%); considerably predicted the need for blood transfusion. Amount of 87.1% patients did not receive perioperative transfusion, 3.5% received intra-operative transfusion, 7.1% post-operative, 2.3% both intra and post-operative, giving a cross-matched transfusion ratio 7.72. Mean peri-operative blood transfused was 356.00±145.88 ml. Stone burden was the most influential PCNL blood loss predictive factor. Amount of blood transfused and cross-matched was relatively high. An appropriate blood order using our equation would reduce any unnecessary transfusions.;;;;"

"ABSTRAKTujuan penelitian ini adalah untuk menentukan nilai Efficacy Quotient EQ?? dari tindakan ESWL Extracorporeal Shockwave Lithotripsy menggunakan mesin Piezolith Richard Wolf 3000 pada batu ureter. Desain penelitian adalah metode survei yang bersifat deskriptif dan analisis multivariat. Terdapat 113 95 dari 119 pasien yang dinyatakan bebas batu setelah tindakan ESWL pertama. Didapatkan nilai EQ 0,89. Hanya ukuran batu yang mempengaruhi angka bebas batu dalam penelitian ini P < 0,05 . Disimpulkan bahwa prosedur ESWL menggunakan mesin Richard Wolf Piezolith 3000 memiliki nilai efficacy quotient dan angka bebas batu yang lebih baik daripada mesin-mesin sebelumnya dan yang sejenis.Kata KunciBatu ureter, ESWL, efficacy quotient, angka bebas bat.

---

ABSTRACT

The study aim was to determine the Efficacy Quotient EQ of ESWL using Piezolith Richard Wolf 3000 machine for ureteral stone. Design of study was both descriptive statistical and multivariate analytical study. From 113 95 of 119 patients were stated stone free after the first ESWL. EQ value was 0.89. Stone size was the only factor that correlated significantly with stone free rate P 0.05 . It is concluded that ESWL procedure using Richard Wolf Piezolith 3000 machine patients had better efficacy quotient and better stone free rate than previous reports using similar machines. Key WordsUreteral stone, ESWL, efficacy quotient, stone free rate."

"LATAR BELAKANG : Percutaneous nephrolithotomy (PCNL) adalah salah satu terapi batu ginjal dan batu ureter yang minimal-invasif. Di Rumah Sakit Cipto Mangunkusumo anestesia spinal merupakan pilihan anestesia utama untuk PCNL, namun regimen anestesia spinal yang digunakan masih bervariasi, dan kejadian hipotensi masih cukup besar. Penelitian ini membandingkan angka kejadian hipotensi pada PCNL dengan anestesia spinal antara dua regimen, yaitu bupivakain 0,5% hiperbarik 12,5 mg ditambah fentanil 25 mcg dan bupivakain 0,5% hiperbarik 15 mg ditambah fentanil 25 mcg. METODOLOGI: Dua puluh dua pasien PCNL dewasa, ASA I-III, tanpa kelainan kardiovaskuler, dirandomisasi menjadi kelompok I yang mendapat bupivakain 0,5% hiperbarik 12,5 mg ditambah fentanil 25 mcg dan kelompok II yang mendapat bupivakain 0,5% hiperbarik 15 mg ditambah fentanil 25 mcg. Anestesia spinal dilakukan dalam posisi duduk, pungsi di L3-4/L4-5, kemudian pasien telentang lalu derajat blok sensorik dan motorik dinilai. Sebelum pasien pasien diposisikan prone, derajat blok sensorik dan motorik dinilai lagi. Tekanan darah diperiksa pada menit ke-3, 6, 9, 12, 15, 20, 30, 40, 50, dan 60 setelah injeksi obat spinal. HASIL: Angka kejadian hipotensi pada kelompok I adalah 33% sedangkan pada kelompok II 60% (p=0,391). Tidak terdapat perbedaan profil blok sensorik dan motorik pada kedua kelompok. Satu pasien di kelompok II memerlukan tambahan fentanil intravena 100 mcg pada menit ke-70. SIMPULAN : Angka kejadian hipotensi pada kedua kelompok subyek penelitian tidak berbeda bermakna.

---

BACKGROUND: Percutaneous nephrolithotomy (PCNL) is a minimally-invasive therapy for treatment of upper ureteral and renal stones. In Cipto Mangunkusumo Hospital, spinal anesthesia is the major option of anesthesia for PCNL, but spinal anesthesia regimens used are still varied, and the incidence of hypotension is still quite large. This study compared the incidence of hypotension in the PCNL with spinal anesthesia between the two regimens, 0.5% hyperbaric bupivacaine 12.5 mg plus fentanyl 25 mcg versus 0.5% hyperbaric bupivacaine 15 mg plus fentanyl 25 mcg.

METHODOLOGY: Twenty-two adult PCNL patients, ASA I-III, without cardiovascular abnormalities, were randomized into group I, which received 0.5% hyperbaric bupivacaine 12.5 mg plus fentanyl 25 mcg and group II received 0.5% hyperbaric bupivacaine 15 mg plus fentanyl 25 mcg. Spinal anesthesia performed in sitting position, puncture in L3-4/L4-5, then the patient were positioned supine and the degree of sensory and motor block were assessed. Before the patient were positioned prone, the degree of sensory and motor block were assessed again. Blood pressure checked at minute 3, 6, 9, 12, 15, 20, 30, 40, 50, and 60 after injection of spinal regiments.

RESULTS: The incidence of hypotension in group I was 33% and in group II was 60% (p = 0.391). There were no differences in sensory and motor block profiles in both groups. One patient in group II requires additional intravenous fentanyl 100 mcg in the 70th minute.

CONCLUSION: The incidence of hypotension in both groups of study subjects did not differ significantly."