Search

Objective: To compare the incidence of bacteruria, bacteremia, and Systemic Inflammatory Response Syndrome (SIRS) after Transrectal Ultrasound (TRUS) of prostate biopsy for the patients whom given intrarectal povidone iodine, enema, prophylactic antibiotic with given enema and prophylactic antibiotic. Material & Methods: A Randomised, experimental study, 20 samples of men with suspicious of prostate cancer were divided into two groups, first group (control) were given enema (dulcolax supp 10 mg) and prophylactic antibiotic (ciprofloxacin 1000 mg), second group (treatment) were given enema (dulcolax supp 10 mg) prophylactic antibiotic (ciprofloxacin 1000 mg), and intrarectal povidone iodine befotre TRUS of prostate biopsy. Urine and rectal swab culture examination were performed before biopsy then urine, blood culture, and blood leucocyte 2 days after biopsy. To assess any bacterial translocation from rectum to urinary tract, we match the post biopsy urine culture antibiogram and rectal swab culture antibiogram before biopsy. Complications and serious adverse effects were also monitored. Outcomes were assessed using Unpaired T Test and Mann Whitney depends on the data distribution and homogeneity. Results: There was no significant difference bacteriuria between groups (p=0.26). Bacteremia and SIRS were not found within two groups 2 days after prostate biopsy. Post biopsy bacteriuria positive patients antibiogram were compared with pre biopsy swab rectal culture antibiogram, there was no significant difference between two groups. But, significant correlation of pre biopsy rectal swab culture with post biopsy urine culture (p=0.04) were noted. Conclusion: Intrarectal povidone iodine before TRUS of prostate biopsy were not needed as part of rectal preparation, since enema and prophylactic antibiotic was proven to decrease the incidence of bacteriuria, bacteremia, and SIRS after TRUS of prostate biopsy. The occurrance of bacteriuria were caused by bacterial translocation from rectum to urinary tract.

Objective: The aim of this study was to determine the characteristics of the testicular cancer that were managed in Soetomo Hospital. Materials & Methods: This was a retrospective descriptive study. We reviewed the medical records of patient with testicular tumor admitted in Soetomo Teaching Hospital Surabaya, from January 2008 until December 2013. The data regarding demographic characteristics, clinical presentation, grading and staging based on pathological examination result, and the management of the cancer. Data was presented in tabular and narrative in order to know the number and percentage of testicular cancer in Surabaya. Results: There were 46 patients with testicular cancer with mean age of 27.1 ± 7.9 years. Peak incidence was 15–35 years old (54%). Testicular mass was the most frequent clinical presentation in 42 patients (91%), abdominal mass and other complaints in 4 patients (9%). Most of the patients live outside Surabaya in 34 patients (72%). Location of the tumor was more frequently in scrotum, which occured in 42 patients (91%). A total of 4 patients (9%) were found to have a history of UDT. Based on the TNM staging, patients with stage pT3 were as many as 20 patients (43%), pT4 11 patients (24%), pT2 7 patients (15%) and pT1 4 patients (9%). In regional lymph nodes staging (N) N3 were as many as 26 patients (57%), N0 9 patients (20%), N2 5 patients (11%) and N1 2 patients (4%). Metastase staging (M) M0 was found in 27 patients (58%) and M1 tumor was found 42%. The major pathological finding was seminoma in 37 patients (80%), Yolk sac tumor in 4 patients (9%), Embryonal Ca in 1 patient (2%), Teratoma in 1 patient (2%) and mixed germ cell tumor in 3 patients (7%). The most widely theraphy was underwent orchidectomy followed by PEB chemotheraphy in 29 patients (64%), 3 patients (6%) underwent EBRT and PEB chemotheraphy, 5 patients (11%) underwent PEB chemotheraphy, There were 9 patients (19%) underwent orchidectomy alone. Group of seminoma tumor show normal limit of tumor marker α-FP and β-HCG and increased in non seminoma. Conclusion: Testicular cancer mostly appears in younger males. Most of testicular cancer was seminoma, diagnosed in advanced stage with metastase 42% of the patient. Most of the patients received orchidectomy followed by PEB chemotheraphy.

Purpose: Assess the efficacy of combined α1-adrenergic blocker (tamsulosin 0,4 mg) and PDE5 inhibitor (tadalafil 5 mg) therapy compared to tadalafil or tamsulosin alone in treating patient BPH with LUTS and ED. Material and methods: A randomised, double blind experimental study assessed 36 sexually active men with ED and LUTS suggestive of BPH. All patients were randomized to 3 groups: tamsulosin 0,4 mg (n=12), tadalafil 5mg (n=12), and combination of tamsulosin 0,4 mg and tadalafil 5 mg (n= 12), once daily for 6 weeks. Changed in IPSS scores and QoL index, IIEF-5 scores, Qmax, PVR and blood pressure were assessed and compared to baseline. Complication and serious adverse event were also monitored. Outcomes were assessed using ranked analysis of variance (ANOVA) and Kruskall-Wallis depends on data distribution and homogenity. Results: Tamsulosin 0,4 mg once daily for 6 weeks were significantly improved IPSS score and QoL index and Qmax from baseline. Tadalafil 5 mg once daily for 6 weeks were significantly improved IPSS score, QoL index and IIEF-5 index from baseline. Combined tamsulosin and tadalafil therapy were significantly improved IPSS score, QoL index, IIEF-5 index and Qmax from baseline. Significantly better improvement on IIEF-5 dan Qmax from baseline were observed on the combination of tamsulosin and tadalafil compared to monotherapy with tamsulosin or tadalafil after 6 weeks in patients BPH with LUTS and erectile dysfunction. There was no significant decreased in systolic and diastolic blood pressure from combined treatment compared to single treatment. Conclusions: Combined tamsulosin and tadalafil therapy was significantly better in improving IIEF a Objective : Assess the efficacy of combined α1-adrenergic blocker (tamsulosin 0.4 mg) and PDE5 inhibitor (tadalafil 5 mg) therapy compared to tadalafil or tamsulosin alone in treating patient Benign Prostate Hyperplasia (BPH) with lower urinary tract symptom (LUTS) and erectile dysfunction (ED). Material & methods: A randomised, double blind experimental study assessed 36 sexually active men with ED and LUTS suggestive of BPH. All patients were randomized to 3 groups: tamsulosin 0.4 mg (n=12), tadalafil 5mg (n=12), and combination of tamsulosin 0.4 mg and tadalafil 5 mg (n= 12), once daily for 6 weeks. Changed in IPSS scores and QoL index, IIEF-5 scores, Qmax, PVR and blood pressure were assessed and compared to baseline. Complication and serious adverse event were also monitored. Outcomes were assessed using ranked analysis of variance (ANOVA) and Kruskall-Wallis depends on data distribution and homogenity. Results: Tamsulosin 0.4 mg once daily for 6 weeks were significantly improved IPSS score, QoL index and Qmax from baseline. Tadalafil 5 mg once daily for 6 weeks were significantly improved IPSS score, QoL index and IIEF-5 index from baseline. Combined tamsulosin and tadalafil therapy were significantly improved IPSS score, QoL index, IIEF-5 index and Qmax from baseline. Significantly better improvement on IIEF-5 dan Qmax from baseline were observed on the combination of tamsulosin and tadalafil compared to monotherapy with tamsulosin or tadalafil after 6 weeks in patients BPH with LUTS and erectile dysfunction. There was no significant decreased in systolic and diastolic blood pressure from combined treatment compared to single treatment. Conclusion: Combined tamsulosin and tadalafil therapy was significantly better in improving IIEF and Qmax, but not significantly better in improving IPSS and PVR compared to monotherapy with tamsulosin or tadalafil alone. Combined therapy was well tolerated without serious adverse effect. nd Qmax, but not significantly better in improving IPSS and PVR compared to monotherapy with tamsulosin or tadalafil alone. Combined therapy was well tolerated without serious adverse effect.

Objective: We studied the efficacy and safety of lubricating jelly instillation before ureterolithotripsy for prevention of retropulsion and improvement in stone-free rate. Material & methods: We enrolled 22 subjects with ureteral stone in this prospective, randomized, single-blind and controlled clinical trial. Each subject was randomly assigned to the lubricating jelly instillation group (n=11) and control group (n=11). Ureteroscopy and lithotripsy was performed according the standard protocol, using 9.8 F semirigid ureteroscope and pneumatic lithotripter. A 6 F ureteral catheter was advanced beyond the stone, and lubricating jelly was instilled through the catheter lumen. Retropulsion and the presence of residual fragments were evaluated with plain kidneys, ureters and bladder x-ray and ultrasonography, or Non Contrast-enhanced Computed Tomography. Any complication was reported and graded using the Modified Clavien Classification System.Results: The 2 groups had comparable preoperative characteristics. There were no statistically significant difference between the lubricating jelly instillation group and control group regarding the retropulsion rate (54.5% vs 72.7%, ρ=0.375), the stone-free rate (54.5% vs 36.4%, ρ=0.392), and the complication rate (45.5% vs 54.5%, ρ=0.670). Conclusion: Lubricating jelly instillation during ureterolithotripsy has limited value for prevention of retropulsion and improvement in stone-free rate.

Objective: To compare the accuracy of B-Mode US and color Doppler twinkling artifact for detecting residual stone after Percutaneous Nephrolithotomy (PCNL) with Non-contrast CT (NCCT) as the standard diagnostic. Material & methods: In this prospective study, 30 patients who underwent Percutaneous Nephrolithotomy (PCNL) were examined with US and NCCT. In US, echogenicity and posterior-shadow (PS) parameters were evaluated and compared with color-Doppler ultrasonography (CDUS) twinkling artifact and NCCT signs. The results then analyzed statistically with Kappa and McNemar tests. Results: More positive residual stone results with color Doppler twinkling artifact in 14 patients than B-Mode US in 11. NCCT detected 17 residual stone with the most location in inferior calyx. (n=10, 58.8%). The sensitivity, specificity and difference positive-negative likehood ratio of B-Mode US were 64.7%, 92.3% and 8.02, both Kappa test was significant (p=0.125) and McNemar tests was significant (p=0.002). The color Doppler twinkling artifact has 82.3%, 92.3%, and 10.5 for sensitivity, specificity and difference positive-negative likehood ratio, the Kappa test was significant (p=0.00), McNemar test was not significant (p=1.00). Conclusion: Color Doppler twinkling artifact was valid, highly sensitive and accuracy better than B-mode US in detecting residual stone after PCNL procedure. 1024x768 Normal 0 false false false EN-US X-NONE X-NONE /* Style Definitions */ table.MsoNormalTable {mso-style-name:"Table Normal"; mso-tstyle-rowband-size:0; mso-tstyle-colband-size:0; mso-style-noshow:yes; mso-style-priority:99; mso-style-qformat:yes; mso-style-parent:""; mso-padding-alt:0cm 5.4pt 0cm 5.4pt; mso-para-margin:0cm; mso-para-margin-bottom:.0001pt; mso-pagination:widow-orphan; font-size:11.0pt; font-family:"Calibri","sans-serif"; mso-ascii-font-family:Calibri; mso-ascii-theme-font:minor-latin; mso-fareast-font-family:"Times New Roman"; mso-fareast-theme-font:minor-fareast; mso-hansi-font-family:Calibri; mso-hansi-theme-font:minor-latin; mso-bidi-font-family:"Times New Roman"; mso-bidi-theme-font:minor-bidi;}

Objective: This study was conducted to determine the correlation between Presume Circle Area Ratio (PCAR) and IPSS score, Qmax, and post voiding residual urine (PVR) and to find PCAR cut-off value in determining the presence Bladder Outlet Obstruction (BOO) in Benign prostatic hyperplasia (BPH) Lower Urinary Tract Symptoms (LUTS). Materials & Methods: This study was observational analytic study with 30 BPH LUTS patients as subjects during the period September 2015 to January 2016. The determined variables were PCAR, IPSS score, Qmax, post voiding residual urine (PVR) and analyzed using the SPSS program v21. Results: There were 30 patients who met the inclusion and exclusion criteria with the mean age of 67.47 years. In the correlation test, there was insignificant correlation between PCAR with IPSS (r=0.138, p=0.467), a significant correlation between PCAR with Qmax (r=0.468, p=0.009), PCAR with PVR (r=0.399, p=0.029), PCAR with BOO (r=0.491, p=0.006) PCAR cutoff value is 0.65 with sensitivity of 69% and specificity of 71%. Conclusion: PCAR has a significant correlation with PVR, Qmax and BOO but no significant with IPSS score. PCAR value >0.65 indicating BOO in BPH LUTS. PCAR can be used as an alternative non-invasive examination in determining the existence of BOO.

Objective: To investigate free-stone rate after Percutaneous Nephrolithotomy (PNL) using S.T.O.N.E nephrolitometry scoring system, with regards of stone size (S), skin-to-stone distance (T), obstruction degree (O), number of calyx involved (N), and stone density (E) in Non Contrast CT Scan (NCCT). Material & methods: This is an analytic observational study on patients with renal stones undergoing PNL. All patients underwent NCCT before and after PNL; each variables was measured and counted for a total score. Post-operative evaluation was done using NCCT. Results: Thirty patients met inclusion criteria, 19 (63.3%) were stone-free, and 11 (36.7%) were with residual stone. Among the five variables, stone size (p=0.005), number of calyx involved (p=0.002) affected the outcome of surgery, while skin-to-stone distance, obstruction degree, and stone density did not. The overall total score of S.T.O.N.E nephrolithometry is correlated with the outcome of PNL (p=0.001). Conclusion: S.T.O.N.E nephrolithometry is a simple scoring system, while it is also easy to use, and can be used to predict the free-stone rate after PNL.

Objective: To identified outcomes and complications of percutaneous nephrolithotomy (PCNL) in patients of various body mass indices (BMI) to determine the safety of this procedure in patients with elevated BMI.Material & methods: The analytic observational prospective study of patients who underwent PCNL between February to July 2015 in the operating room Soetomo General Hospital Surabaya. Specifically, BMI, stone-free rates, difficulties duringsurgery, complications, and Clavien score were assessed. We evaluate the independent contribution of BMI as a predictor of outcomes. Results: There were 35 selected patients with kidney stone and planned to PCNL, 20 patients were included and 15 patients were excluded from this study. The patients consisted of 10 men (50%) and 10 women (50%). Mean age was 47.55 years (range 33-75). There were 4 patients with diabetes (20%), and 10 patients with hypertension (50%). Mean stone size was 23.30 mm. Stone location was 11 patients (55%) in the right kidney, and 9 patients (45%) in the left. There were 12 patients (60%) with a single stone, and 8 patients (40%) with multiple stones. BMI values were distributed as follows,underweight 1 patient (5%), normoweight 7 patients (35%), overweight 6 patients (30%), obesity 6 patients (30%). Mean skin to stone distance (SSD) was 87.56 mm. Stone free rate was 55%, and difficulties during surgery only seen in 1 patient (5%) bleeding profusely and open surgery was performed. Clavien score in these patients were grade I in 11 patients (55%), grade II in 7 patients (35%), and grade IIIB in 2 patients (10%). The BMI had no significant effect with Intra operative and postoperative difficulties (0.390. p

Objective: The main objective of this study was to determine renal function in patients with Benign Prostat e Hyperplasia ( BPH ) in acute urinary retention period and two weeks after catheter insertion using creatinine serum and u rinary Neutrophil Gelatinase-Associated Lipocalin ( NGAL ) biomarker parameters. Materials & Method : This is an observational co - hort study conducted in patients with BPH with acute urinary retention who came to Soetomo General Hospital , Surabaya . All the patients underwent laboratory investigation that were urinary NGAL and creatinine serum, marker of renal function. Result: The mean creatinine serum of 31 samples when retention phase was 1 . 6 ± 0 . 9 mg/dL an d it decreased after 2 weeks of urinary catheter insertion (1 . 46 ± 0 . 89 mg/dL). Mean urinary NGAL level when retention phase was 308 . 1 ± 244 . 8 ng/dL, and after 2 weeks after urinary catheter insertion it decreased to 158 . 5 ± 123 . 3 ng/dL. There was significant decreasing creatinine serum and urinary NGAL levels in patients with BPH and acute urinary retention in the retention phase 2 weeks after urinary catheter insertion, with p value 0 . 05). Conclusion: There was a significant decreasing creatinine serum and urinary NGAL levels in patients with BPH and acute urinary retention in retention phase and two weeks after urinary catheter insertion. There was no significant correlation between the urinary NGAL and creatinine serum and the duration of retention and urinary retention volume. Normal 0 false false false EN-US X-NONE X-NONE /* Style Definitions */ table.MsoNormalTable {mso-style-name:"Table Normal"; mso-tstyle-rowband-size:0; mso-tstyle-colband-size:0; mso-style-noshow:yes; mso-style-priority:99; mso-style-qformat:yes; mso-style-parent:""; mso-padding-alt:0cm 5.4pt 0cm 5.4pt; mso-para-margin-top:0cm; mso-para-margin-right:0cm; mso-para-margin-bottom:10.0pt; mso-para-margin-left:18.0pt; text-align:justify; line-height:115%; mso-pagination:widow-orphan; font-size:11.0pt; font-family:"Calibri","sans-serif"; mso-ascii-font-family:Calibri; mso-ascii-theme-font:minor-latin; mso-fareast-font-family:"Times New Roman"; mso-fareast-theme-font:minor-fareast; mso-hansi-font-family:Calibri; mso-hansi-theme-font:minor-latin;}

Objective: To compare clinical therapeutic effects (frequency, dysuria, and pyuria), microbiology, pharmacokinetics index Cmax/MIC Fosfomycin Trometamol 3 gr single dose with Ciprofloxacin 2 x 500 mg/12 hours for 5 days in the treatment of uncomplicated UTI in women due to Escherichia coli (E.Coli). Materials & Methods: Experimental observational design from February until July 2013. Twenty two women with uncomplicated UTI due to E.Coli performed clinical and microbiological examination. Pharmacokinetics index (Cmax/MIC) is looked for. Patients are divided 2 group, Ciprofloxacin 500 mg/12 hours 5 days and Fosfomycin Trometamol single dose. Repeat clinical and microbiological evaluation is performed in 7 days after therapy. Statistic analysis use Chi Square test, Paired T test, and Independent T test. Results: In the treatment of uncomplicated UTI in women, Fosfomycin Trometamol single dose therapy provides clinical cure (dysuria 81.2%, p = 0.338, frequency 90.9%, p = 0.004, pyuria 90.9%, p = 0.009) much better than Ciprofloxacin 500 mg/12 hours 5 days. Fosfomycin Trometamol single dose therapy also provides bacteriological eradication (100%) better than Ciprofloxacin 500 mg/12 hours 5 days (p = 0.035). Fosfomycin Trometamol single dose had a higher pharmacokinetics index (Cmax/MIC) compared to Ciprofloxacin 500 mg/12 hours (p = 0.035). Conclusion: Fosfomycin Trometamol single dose therapy is superior to Ciprofloxacin 500 mg/12 hours 5 days in the treatment of uncomplicated UTI in women. Keywords: Therapeutic effect, fosfomycin trometamol, ciprofloxacin, uncomplicated UTI, Escherichia coli.

Objective: To evaluate the diagnostic value of Non Contrast Helical Computed Tomography (NCHCT) scanning as the first choice diagnostic modality for detecting urolithiasis cases in Soetomo General Hospital Surabaya and evaluate the feasibility as alternative to Intravenous Urography (IVU). Material & Methods: Seventeen patients with clinical manifestation of suspected urolithiasis underwent NCHCT and IVU to evaluate suspected urolithiasis. Reformatted three-dimensional CT was performed in all patients. The images were correlated with findings from surgical procedure (ureteroscopy, percutaneous nephrolithotomy, and open surgery). Sensitivity, specificity, positive predictive value, negative predictive value, and diagnostic accuracy were determined for NCHCT and IVU. Results: The diagnosis of urolithiasis was defined as unequivocal evidence of urolithiasis on either NCHCT or IVU. Sixteen of seventeen patients evaluated were diagnosed with urolithiasis. NCHCT established the diagnosis in 16 of 17 patients while IVU was positive in 11 of 17 patients. IVU was negative in 6 of the 17 cases. The sensitivity, specificity and accuracy of NCHCT was 100%, 100%, and 100% respectively (p = 0.05) and the sensitivity, specificity, and accuracy of IVU was 68%, 100% and 70% respectively (p = 0.35). There was no statistically significant difference between IVU and NCHCT using Fisher’s exact test. Conclusions: NCHCT accurately diagnosed urolithiasis in patients with suspected urolithiasis. Considering that NCHCT is more effective and efficient than IVU as diagnostic modality in determining the presence of urolithiasis, it may be considered to replace IVU as the first line diagnostic tool for urolithiasis in Soetomo General Hospital Surabaya. Keywords: Non Contrast Helical CT Scan, Intravenous Urography, Urolithiasis.

Objective: To investigate the effects of allogenic adipose-derived stem cell (ADSC) transplantation on urethral tissue regeneration after vaginal distension in a rat model. Material & Method: 32 female wistar rats underwent vaginal distension (VD) for 4 h. Subsequently, PKH-labeled ADSCs (2 x 10 5 in 200 µl PBS, ADSC group, n = 18) or PBS (200 µl, placebo group, n = 18) were injected into periurethral tissue. Two and four weeks following transplantation (ADSC or PBS), voiding behavior (frequency) and muscle-collagen ratio of urethral tissue were measured to evaluate urethral sphincter regeneration. Data were analysed by paired-t test, one-way ANOVA and post hoc LSD. Results: Mean voiding frequency was significantly differ e nt in the ADSC group at two weeks (p 0 . 05). Conclusion: ADSC transplantation promotes urethral muscle-collagen ratio with development of striated muscle after vaginal distension, so that can improve voiding behavior in a rat model. Keywords: Adipose-derived stem cell, vaginal distension, rat-SUI model, muscle-collagen ratio, voiding stain on paper. Normal 0 false false false EN-US X-NONE X-NONE /* Style Definitions */ table.MsoNormalTable {mso-style-name:"Table Normal"; mso-tstyle-rowband-size:0; mso-tstyle-colband-size:0; mso-style-noshow:yes; mso-style-priority:99; mso-style-qformat:yes; mso-style-parent:""; mso-padding-alt:0cm 5.4pt 0cm 5.4pt; mso-para-margin-top:0cm; mso-para-margin-right:0cm; mso-para-margin-bottom:10.0pt; mso-para-margin-left:0cm; line-height:115%; mso-pagination:widow-orphan; font-size:11.0pt; font-family:"Calibri","sans-serif"; mso-ascii-font-family:Calibri; mso-ascii-theme-font:minor-latin; mso-hansi-font-family:Calibri; mso-hansi-theme-font:minor-latin;}

Objective: This study evaluated the correlation between preoperative urine culture and intraoperative stone cultur e and the impact of stone culture findings on post-operative systemic inflammatory response syndrome. Material & Method: Patients with kidney stones who underwent p ercutaneous nephrolithotomy ( PCNL ) from February to May 2012 were prospectively analyzed. A pre - operative urine culture was obtained in the morning before the operation, fragmented stone collected were cultured in Departement of Microbiology. Patients were monitored closely in the postoperative period for signs of systemic inflammatory response syndrome (SIRS). Results: A total of 33 patients underwent PCNL and examined for urine cultures, stone culture and postoperative SIRS, 15 (45 . 45%) patients with positive urine culture, 18 patients (54 . 54%) with positive stone culture but only 1 patient (3 . 03%) had same pathogen (p = 0 . 629). Ten patients (55 . 6%) with positive stone cultures had evidence of systemic inflammatory respose syndrome postoperatively. The calculated stone culture value for sensitivity, specifi ci ty, positive predictive value and negative predictive value were 100%, 65 . 2%, 55 . 6% , and 100%. Preoper a tive hydronephrosis (p = 0 . 003) and operative time (p = 0 . 001) are identified as the key risk factors for SIRS after PCNL. Conclusion: Positive stone culture are better predictors for SIRS after PCNL. Stone culture examination is an essential in directing the proper antibiotic therapy in patients with SIRS after PCNL. Keywords: Percutaneous nephrolithotomy (PCNL) , urine culture, stone culture, systemic inflammatory response syndrome after PCNL . Normal 0 false false false EN-US X-NONE X-NONE /* Style Definitions */ table.MsoNormalTable {mso-style-name:"Table Normal"; mso-tstyle-rowband-size:0; mso-tstyle-colband-size:0; mso-style-noshow:yes; mso-style-priority:99; mso-style-qformat:yes; mso-style-parent:""; mso-padding-alt:0cm 5.4pt 0cm 5.4pt; mso-para-margin-top:0cm; mso-para-margin-right:0cm; mso-para-margin-bottom:10.0pt; mso-para-margin-left:0cm; line-height:115%; mso-pagination:widow-orphan; font-size:11.0pt; font-family:"Calibri","sans-serif"; mso-ascii-font-family:Calibri; mso-ascii-theme-font:minor-latin; mso-fareast-font-family:"Times New Roman"; mso-fareast-theme-font:minor-fareast; mso-hansi-font-family:Calibri; mso-hansi-theme-font:minor-latin;}

Objective: To compare the efficacy of combination therapy of 4 mg doxazosin + 15 mg meloxicam with 4 mg doxazosin single therapy for benign prostate hyperplasia (BPH) patients with lower urinary tract symptoms (LUTS). Materials & Methods: A prospective, randomized and double blind study with total of 22 BPH patients with LUTS were randomized to receive 4 mg doxazosin + placebo once daily for 6 weeks or a combination of 4 mg doxazosin + 15 mg meloxicam once daily for 6 weeks. Inclusion criteria included IPSS ≥ 8, age > 50 years, prostate blood flow grade II. Therapeutic efficacy was assessed by comparing changes in IPSS, maximal urinary flow (Q-max) and changes in prostate blood flow between baseline and immediately after 6 weeks of therapy. Results: There was no significant difference in IPSS change between the two treatment groups (delta IPSS 4 ± 1.1 versus 3.7 ± 1.5, p = 0.630). There was a significant difference in Q-max changes between the two groups (delta Q-max 4 ± 1.5 versus 2.1 ± 0.7, p < 0.001). In group therapied with 4 mg doxazosin + 15 mg meloxicam prostate blood flow decreased from grade II to grade I in 9 of 11 patients (81%). Whereas, in the treatment group of 4 mg doxazosin + placebo no reduction was found in prostate blood flow. Conclusion: Combination therapy of 4 mg doxazosin + 15 mg meloxicam once daily for 6 weeks is better than 4 mg doxazosin therapy alone in improving Q-max and decreasing prostate blood flow in BPH patients with LUTS. Keywords: Benign prostate hyperplasia, inflammation, COX-2 inhibitors. Normal 0 false false false EN-US X-NONE X-NONE /* Style Definitions */ table.MsoNormalTable {mso-style-name:"Table Normal"; mso-tstyle-rowband-size:0; mso-tstyle-colband-size:0; mso-style-noshow:yes; mso-style-priority:99; mso-style-qformat:yes; mso-style-parent:""; mso-padding-alt:0cm 5.4pt 0cm 5.4pt; mso-para-margin-top:0cm; mso-para-margin-right:0cm; mso-para-margin-bottom:10.0pt; mso-para-margin-left:0cm; line-height:115%; mso-pagination:widow-orphan; font-size:11.0pt; font-family:"Calibri","sans-serif"; mso-ascii-font-family:Calibri; mso-ascii-theme-font:minor-latin; mso-hansi-font-family:Calibri; mso-hansi-theme-font:minor-latin;}

Objective: To evaluate some parameters as the predictors of urine retention incident in Benign Prostate Hyperplasia (BPH) patients. Materials & Methods: From May to August 2012, a total of 24 BPH patients aged 47-69 years with lower urinary tract symptomps (LUTS) including 12 patients with urine retention were participated in the study. Prostate specific antigen (PSA) examination was performed on all patients. For urine retention patients, PSA was performed 2 weeks after catheterization as the procedure may affect PSA levels. Transrectal ultrasonography (TRUS) was examined to assess total prostate volume (VTP), transitional zone volume (VZT), transitional zone index (IZT = VZT / VTP), and resistive index of prostate capsulary arteries. Statistic was utilized using simple and multiple logistic regression. Receiver operating characteristic (ROC) was calculated to assess the usefulness of parameters as a predictor of urine retention. Results: There was no significant difference in age between LUTS and BPH patients with urine retention (p = 0,487). There was no relationship between PSA and transitional zone index to incidence of urine retention in BPH patients (PSA; p = 0,173 and TZI; p = 0,192). Multiple logistic regression analysis showed only resistive index of prostate capsulary arteries which correlates with urine retention incidence (p = 0,014), with area under ROC 0,865 (95% CI 0,721 to 1,008) and cut-off value of > 0,675 as a predictor of urine retention incidence. Conclusion: Resistive index of prostate capsulary arteries by transrectal ultrasonography (TRUS) is a predictor of urine retention incidence in BPH patients. Key words : prostate specific antigen, transitional zone index, resistive index of prostate capsulary arteries, benign prostate hyperplasia, lower urinary tract symptoms, urine retention. Normal 0 false false false EN-US X-NONE X-NONE /* Style Definitions */ table.MsoNormalTable {mso-style-name:"Table Normal"; mso-tstyle-rowband-size:0; mso-tstyle-colband-size:0; mso-style-noshow:yes; mso-style-priority:99; mso-style-qformat:yes; mso-style-parent:""; mso-padding-alt:0cm 5.4pt 0cm 5.4pt; mso-para-margin:0cm; mso-para-margin-bottom:.0001pt; mso-pagination:widow-orphan; font-size:11.0pt; font-family:"Calibri","sans-serif"; mso-ascii-font-family:Calibri; mso-ascii-theme-font:minor-latin; mso-fareast-font-family:Calibri; mso-fareast-theme-font:minor-latin; mso-hansi-font-family:Calibri; mso-hansi-theme-font:minor-latin; mso-bidi-font-family:"Times New Roman"; mso-bidi-theme-font:minor-bidi; mso-ansi-language:IN;}

Objective: In attempt to explain effects of orchiectomy and detorsion in contralateral testis immune response after unilateral testicular torsion. Materials and methods: Forty eight rattus norwegicus strain wistar white rats testes underwent 720º unilateral left testicular torsion. The experimental animals were divided into 6 group: 2 had sham operation which served as control, 2 groups had ligation left testicular torsion with subsequent orchiectomy at 4 and 24 hours, 2 groups had ligation left testicular torsion followed by detorsion at 4 and 24 hours. Contralateral testes were analyzed 7 days later for examination percentage of IL-4 producing lymphocyte and immunoglobulin G producing plasma cells in contralateral testis by means of immunohistochemical method. Results: Multivariate analysis result revealed that in unilateral left testicular torsion followed by detorsion at 24 hours group we found IL-4 and IgG had entered intratubules and were different from orchiectomy and control group (p=0,0001 and p=0,0001). This indicated damage of germinal epithelium in contralateral testes caused by imunologic response stimulated by detorsion. In left testicular torsion and orchiectomy or detorsion at 4 hours did not show both IL-4 and IgG in intratubules and no significant different both IL-4 and IgG in extratubules among orchiectomy, detorsion and control group (p=0,326 and p=0,064). This indicated that in 4 hours immune response were not significantly different between those groups and germinal epithelium were still intact. Conclusion: Detorsion in 24 hours testicular torsion had stimulated immune response which caused damage of germinal epithelium in contralateral testis. In 4 hours testicular torsion immune response happened not significantly different between detorsion, orchiectomy and control.