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Abstrak :
[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 ]

Abstrak :
Pendahuluan dan tujuan: Obstruksi ureter dikaitkan dengan sejumlah keganasan pelvis, yang umumnya menyumbat ureter distal dengan keterlibatan yang berdekatan atau kompresi ekstrinsik. Percutaneous Nephrostomy (PCN) dan pemasangan Double-J Stent (DJ Stent) secara rutin dilakukan untuk mencegah obstruksi ureter atau mengurangi nyeri pascaoperasi. Pada pasien kanker serviks, stent seringkali gagal memberikan drainase urin yang memadai dan kreatinin serum dapat memprediksi kegagalan pemasangan stent DJ. Kami mengusulkan penggunaan Phenazopyridine untuk membantu identifikasi meatus ureter secara intraoperatif pada pasien dengan kreatinin serum tinggi untuk pemasangan stent DJ. Metode: Kami melakukan penelitian deskriptif analitik dari Januari 2018-Desember 2018. Tiga puluh delapan pasien, didiagnosis kanker serviks dari departemen Obstetri dan Ginekologi ke divisi Urologi, dengan obstruksi ureter yang disebabkan oleh kompresi atau infiltrasi eksternal, ikut serta dalam penelitian ini dengan staging stadium III B dan IV A. Dua tablet Phenazopyridine diberikan 6 jam sebelum pemasangan DJ stent. Kami memeriksa warna urin di meatus ureter secara intraoperatif untuk membantu pemasangan DJ stent. Satu sisi keberhasilan dalam penempatan DJ stent dianggap sebagai keberhasilan dalam penelitian ini. Hasil: Dari 38 pasien, pasien termuda dalam penelitian ini berusia 40 tahun dan tertua berusia 77 tahun. Rerata usia adalah 52,53 ± 7,94 tahun. Keberhasilan pemasangan stent DJ pada 32 pasien (84,2%). Kesimpulan: Dari penelitian kami, pemasangan stent DJ stent penggunaan phenazopyridine berhasil dilakukan pada 32 pasien dengan serum kreatinin yang tinggi. Phenazopyridine adalah pewarna yang murah dan aman untuk membantu menilai meatus ureter pada pemasangan DJ stent. Studi lebih lanjut diperlukan untuk mengeksplorasi pengetahuan kita tentang phenazopyridine dan untuk memahami kegunaannya dalam membantu ahli bedah melakukan penempatan DJ stent. ......Introduction and Objectives: Ureteral obstruction may be associated with a number of pelvic malignancies, generally obstruct the distal ureter by contiguous involvement or extrinsic compression. Percutaneous nephrostomy (PCN) tube and Double-J Stent (DJ Stent) placement are routinely done to prevent ureteral obstruction or to reduce postoperative pain. In cervical cancer patients, stents often failed to provide adequate urinary drainage and serum creatinine could predict the failure of DJ stent insertion. We propose the use of Phenazopyridine to aid the ureter meatus identification intraoperatively in patients with high serum creatinine for DJ stent insertion. Method: We conducted a descriptive analytic study from January 2018-December 2018. Thirty-eight patients, diagnosed as cervical cancer from Obstetric and Gynaecology department to Urology division, with ureteral obstruction caused by external compression or infiltration, were included in the study. Cervical cancer of stage III B and IV A were included in our study. Two tablets of Phenazopyridine wasgiven 6 hours before inserting DJ stent. We examine the color of the urine in ureter meatus intraoperatively to help the insertion of the DJ stent. One side of success in DJ stent placement considered as success in this study Results: From 38 patients, we noted the youngest patient in this study was 40-year-old and oldest was 77-year-old. Mean of age was 52.53 ± 7.94 years old. We noted the success of DJ stent insertion in 32 of the patients (84.2%). Conclusion: From our study, we achieved successful DJ stent placement in 32 of our phenazopyridine-patient having a high serum creatinine. Phenazopyridine is an inexpensive and safe dye to help in assessing ureter meatus in DJ stent insertion. Further studies are needed to explore our knowledge about phenazopyridine and to understand the use in helping surgeon performing DJ stent placement.

Abstrak :
Pendahuluan dan tujuan: Kanker penis merupakan keganasan yang jarang terjadi dan berpotensi mematikan dengan insidensi 0,6-2,1 per 100.000. Karsinoma sel skuamosa (SqCC) adalah keganasan penis yang paling sering ditemukan. PD-L1 adalah penanda tumor yang ikut menstimulasi reseptor PD-1 untuk menekan imunitas antitumor yang dimediasi oleh sel T. Metode: Penelitian ini merupakan studi kohort retrospektif dengan metode pengambilan sampel total. Slide yang diambil dari biopsi tujuh puluh enam pasien pria dari Rumah Sakit Haji Adam Malik yang didiagnosis dengan karsinoma sel skuamosa penis yang telah menjalani biopsi penis diperiksa ulang untuk penelitian ini, dan kadar PD-L1 diukur. Metode statistik digunakan untuk menilai hubungan antara kadar PD-L1 dan stadium SqCC. Hasil: Sebanyak 76 pasien pria menjadi subjek penelitian ini. PD-L1 positif diidentifikasi pada 25 pasien dengan intensitas +1 pada 10 pasien (13,2%), +2 pada 7 pasien (9,2) dan intensitas +3 pada 8 pasien (10,5%). Terdapat 36 pasien (47,4%) yang didiagnosis dengan stadium T3 SqCC, 35 pasien (46,1%) dengan stadium N2 SqCC, dan 10 pasien (13,2%) dengan stadium M1 SqCC. Terdapat korelasi yang signifikan antara ekspresi PD-L1 dan metastasis (p=0,022). Namun, tidak ada korelasi yang signifikan antara ekspresi PD-L1 dan tumor stadium N (p=0,167). Kesimpulan: PD-L1 diekspresikan secara tinggi pada SqCC penis stadium lanjut (32,9%), yang dikaitkan dengan fitur klinikopatologis berisiko tinggi dan hasil klinis yang buruk. Temuan ini menunjukkan potensi penggunaan imunoterapi dalam pengobatan SqCC penis stadium lanjut. ......Introduction: Penile cancer is a rare malignancy and potentially lethal disease with an incidence of 0,6-2,1 per 100.000. Squamous cell carcinoma (SqCC) is the most commonly found penile malignancy. PD-L1 is a tumor marker that co-stimulates the receptor PD-1 to suppress T-cell- mediated antitumor immunity. Methods: This study is a retrospective cohort study with a total sampling method. The slides taken from the biopsies of seventy-six male patients from Haji Adam Malik Hospital diagnosed with penile squamous cell carcinoma who have already undergone penile biopsy were re-examined for this study, and PD-L1 levels were measured accordingly. Statistical methods were used to assess the association between PD-L1 levels and with SqCC stage. Results: A total of 76 male patients are the subjects of this study. PD-L1 positivity is identified in 25 patients with +1 intensity in 10 patients (13,2%), +2 in 7 patients (9,2) and +3 intensity in 8 patients (10,5%). There are 36 patients (47,4%) diagnosed with stage T3 SqCC, 35 patients (46,1%) with stage N2 SqCC, and 10 patients (13,2%) with stage M1 SqCC. There is significant correlation between PD-L1 expression and metastasis (p=0,022). However, there is no significant correlation between PD-L1 expression and stage N tumor (p=0,167). Conclusion: PD-L1 highly expressed in advanced stage penile SqCC (32.9%), which is associated with the high-risk clinicopathologic features and poor clinical outcomes. These findings showed a potential usage of immunotherapy in advanced penile SqCC treatment.