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"[Tujuan: untuk menggambarkan jenis kuman dan sensitifitas kuman terhadap anti mikroba pada pasien yang terpasang DJ stent di RSUP DR. Sardjito.Metode dan cara: penelitian dilakukan secara prospektif dimana seluruh pasien yang dilakukan pelepasan DJ stent dan dilakukan pemeriksaan kultur sensitifitas terhadap potongan DJ stent tersebut di RSUP DR. Sardjito setelah lebih kurang 1 bulan pemasangan DJ stent diambil preparat DJ stent dengan melakukan pemotongan pada DJ stent lebih kurang 2 cm. Potongan tersebut selanjutnya dikirim ke instalasi patologi klinik untuk dilakukan pemeriksaan kultur sensitivitas untuk mengetahui jenis kuman dan sensitifitas kuman terhadap anti mikroba. Data yang didapatkan diinterpretasikan dalam bentuk tabel dan grafikHasil: Rata rata usia pasien adalah 53,13 ± 14,2 tahun. Dimana jenis kelamin laki- laki 20 pasien dan perempuan 10 pasien. Kultur kuman terbanyak adalah Acinetobacter Baumanii (32%) dengan hasil uji sensitifitas, paling sensitive meropenem 21 pasien (84%), ertapenem 20 pasien (80%) dan amikasin 16 pasien (64%) pada penelitian ini memperlihatkan anti mikroba lain memiliki sensitifitasnya paling rendah.Kesimpulan: Pemakaian DJ stent akan menyebabkan tumbuhnya kuman pada permukaan DJ stent dan masih banyak antibiotic yang dapat dipergunakan berdasarkan kultur sensitifitasnya., Objective: To describe any kind of bacteria and their sensitivity to anti micro organism in patients with DJ stent in Sardjito HospitalMethods: This prospective research is done in which all DJ stent from patients were cut 2cm and sent to clinical pathology department to check microorganism culture and sensitivity. All the patients used DJ stent at least 1 month before removal. The data were presented in tables and graphs.Results: The age of patients were 53,13 ± 14,2 year old, consist of 20 men and 10 women. The most common microorganism culture was Acinobacter Baumanii (32%). Anti microorganism which most sensitive was meropenem in 21 patients (84%), ertapenem in 20 patients (80%) and amikacin in 16 patients (64%). The other anti microorganism had lower sensitivity.Conclusion: DJ stent will cause microorganism growth on its surface and there are many antibiotics that can be used based on their antimicroorganism sensitivity.]"

"[Hipospadia merupakan salah satu kelainan congenital pada penis yang paling sering terjadi, dengan angka kejadian 0.2-0.8% kasus di dunia. Prinsip dasar tehnik pembedahan hipospadia masih tetap sama dari tahun ke tahun, padahal terdapat banyak tehnik yang dapat digunakan namun belum ada penelitian yang membandingkan antara satu tehnik operasi dengan tehnik operasi lainnya. Untuk itu, kami mengumpulkan data dari para urolog di Indonesia untuk mengetahui hal tersebut, memberikan gambaran tehnik operasi hipospadia apa saja yang digunakan, dan bisa menjadi bahan pertimbangan urolog lainnya untuk mencoba tehnik operasi lainnya.MetodeDilakukan survey kepada ahli bedah urologi di seminar-seminar dan konferensi yang dilakukan di Indonesia dari tahun 2012-2013 dengan membagikan kuesioner mengenai tatalaksana operatif pada hipospadia distal dan proksimal. HasilTotal sebanyak 87 partisipan menyelesaikan kuesioner yang diberikan. Sebagian besar partisipan (61%) telah menjadi urolog selam kurang dari 5 tahun, dan kebanyakan bekerja di rumah sakit pemerintahan. Jumlah pasien hipospadia yang ditangani per tahunnya rata-rata 1-5 pasien (34.5%) dan usia tersering adalah 3-6 tahun (56.3%) dengan varian tersering yakni tipe midshaft penile (57.5%).Tehnik operasi pada tahap pembebasan kordae yang paling sering digunakan adalah dorsal placation (48.3%) dan dilakukan percobaan ereksi artificial dan turniket intraoperasi (79.3% dan 66%). Pada hipospadia distal, tehnik TIP merupakan yang paling sering digunakan (66.7%-88.5%) sementara sisanya memilih MAGPI, matthew atau onlay island flap. Untuk yang proksimal, beberapa urolog menggunakan TIP (16.1%-39.1%) sementara yang lainnya memilih onlay island flap, koyanagi, transverse preputial island flap, operasi dua tahap, dan cangkok bukal.Penggunaan kateter foley pada stenting daerah distal dan proksimal masih dilakukan oleh sebagian besar urolog setelah prosedur operasi selesai, seperempat responden melakukan sistostomi simultan dengan kateter foley. KesimpulanTren yang terkini dalam penatalaksanaan hipospadia di Indonesia masih bervariasi bergantung pada kebiasaan urolog. Hasil menunjukkan pendekatan yang berbeda- beda pada tehnik operasi hipospadia distal maupun proksimal, dan tidak sesuai juga dengan literature yang ada. Hal ini mungkin disebabkan karena faktor sosioekonomi, lingkungan, dan pengalaman pribadi.;Hypospadia is one of the most common congenital anomaly of the penis, ranging from to be 0,2 to 8.2% worldwide.The principles of hypospadia surgery remains the same throughout the years and there are many techniques of surgery which could be chosen but current practice in Indonesia have not yet been studied. With this in mind, we obtained data from urologist in Indonesia to provide an insight and hopefully be a source of discussions that may lead to a change of personal practice.MethodsA survey was conducted in seminars and conferences in Indonesia from 2012 to 2013 with a questionairre regarding repair of distal and proximal hypospadia Results A total of 87 participants completed the questionairre. Most of the participants (61%) had been a urologist for less than 5 years, and most worked in goverment university hospital.The number of patient encountered most was 1-5 patient per year (34,5%) and the age majority was 3-6 years old (56,3%) with the highest variant seen was midshaft penile (57,5%).Regarding technique of the operation, for chordee release most used dorsal plication (48,3%) and also performed artificial erection and tourniquet intra- operatively (79,3% and 66%). For distal repair, the tubularized incised plate (TIP) was the preferred technique (66,7% - 88,5%) while the remainder preferred MAGPI, matthew or onlay island flap. For proximal repair, some still preferred TIP (16,1% - 39,1%) while the remainder relied on onlay island flap, koyanagi, transverse preputial island flap, two-staged repair and buccal graft.The use of foley catheter for distal and proximal stenting post repair remains majority in the case of hypospadia, with less than a quarter performed also cystostomy simultaneously. ConclusionsThe current trend in the management of hypospadias in Indonesia still varies based on personal preferrence. The result also shows different approach for proximal and distal hypospadia even compared to the literature. This might be caused by socioeconomic, environmental or personal experience., Hypospadia is one of the most common congenital anomaly of the penis, ranging from to be 0,2 to 8.2% worldwide.The principles of hypospadia surgery remains the same throughout the years and there are many techniques of surgery which could be chosen but current practice in Indonesia have not yet been studied. With this in mind, we obtained data from urologist in Indonesia to provide an insight and hopefully be a source of discussions that may lead to a change of personal practice.MethodsA survey was conducted in seminars and conferences in Indonesia from 2012 to 2013 with a questionairre regarding repair of distal and proximal hypospadia Results A total of 87 participants completed the questionairre. Most of the participants (61%) had been a urologist for less than 5 years, and most worked in goverment university hospital.The number of patient encountered most was 1-5 patient per year (34,5%) and the age majority was 3-6 years old (56,3%) with the highest variant seen was midshaft penile (57,5%).Regarding technique of the operation, for chordee release most used dorsal plication (48,3%) and also performed artificial erection and tourniquet intra- operatively (79,3% and 66%). For distal repair, the tubularized incised plate (TIP) was the preferred technique (66,7% - 88,5%) while the remainder preferred MAGPI, matthew or onlay island flap. For proximal repair, some still preferred TIP (16,1% - 39,1%) while the remainder relied on onlay island flap, koyanagi, transverse preputial island flap, two-staged repair and buccal graft.The use of foley catheter for distal and proximal stenting post repair remains majority in the case of hypospadia, with less than a quarter performed also cystostomy simultaneously. ConclusionsThe current trend in the management of hypospadias in Indonesia still varies based on personal preferrence. The result also shows different approach for proximal and distal hypospadia even compared to the literature. This might be caused by socioeconomic, environmental or personal experience.]"

"[Ureteropelvic junction obstruction (UPJO) merupakan salah satu kelainan kongenital traktus urinarius dengan insidensi 5/100.000 per tahun. Tindakan bedah yang minimal invasif dapat memberikan waktu operasi yang lebih singkat, morbiditas minimal, penurunan kebutuhan analgesia pascaoperasi, waktu rawat yang lebih singkat, dan penyembuhan yang lebih cepat daripada operasi terbuka. Meskipun demikian, tatalaksana optimal ureteropelvic junction obstruction masih dalam perdebatan. Banyak studi yang membandingkan endopielotomi dan pieloplasti per laparoskopi. Angka kesuksesan endopielotomi dan pieloplasti dilaporkan bervariasi dalam berbagai studi.TujuanUntuk mengidentifikasi tatalaksana optimal dari ureteropelvic junction obstruction.MetodeMeta-analisis dari studi kohor yang dipublikasi sebelum Februari 2014 dilakukan dengan menggunakan data Medline. Kriteria inklusi adalah tatalaksana ureteropelvic junction obstruction dengan endopielolitotomi (antegrad dan atau retrograd) dan pieloplasti per laparoskopi (transperitoneal atau retroperitoneal). Kriteria eksklusi adalah perbaikan UPJO sekunder dan fungsi ginjal yang buruk. Kriteria sukses didefinisikan sebagai tidak adanya gejala klinis dan dikombinasikan dengan penurunan hidronefrosis secara signifikan yang ditunjukkan dengan diuretic IVU atau ultrasonografi dan tidak ada tanda obstruksi pada diuretic IVU atau renografi diuretik atau tes Whitaker. Random-effect model dengan metode DerSirmonian-Laird digunakan untuk menghitung risk ratio (RR) dan 95% interval kepercayaan (IK) gabungan. Heterogenitas dinilai dengan menggunakan statistik I2. Semua analisis dilakukan dengan menggunakan Stata statistical software, versi 12.0 (StataCorp).HasilKami menganalisa 4 studi kohor. Angka kesuksesan dari 479 pasien (233 pieloplasti per laparoskopi, 246 endopielotomi), 21 bulan pascaoperasi, adalah 92.3% (215/233) setelah pieloplasti per laparoskopi, 63.8% (157/246) setelah endopielotomi. Berdasarkan angka keberhasilan tatalaksana UPJO, pieloplasti lebih baik daripada endopielotomi (risk ratio keseluruhan adalah 1.35 (95% CI 0.97 hingga 1.88); p<0.0001 dan I2=90.6 %).KesimpulanPieloplasti per laparoskopi memiliki angka keberhasilan yang lebih tinggi daripada endopielotomi. Metaanalisis ini dapat membantu ahli urologi sebelum memulai tindakan terapi UPJO., The ureteropelvic junction obstruction (UPJO) is one of the most common congenital abnormalities of the urinary tract with a reported incidence of 5/100,000 annually. Minimal invasive surgeries have emerged giving short operative time, minimal morbidity, decreased postoperative analgesic requirements, shorter hospitalization, and early recovery and convalescence compared to open surgery. Yet, the optimal management of ureteropelvic junction obstruction is still in debate. Many studies have been conducted comparing endopyelotomy and laparoscopic pyeloplasty. The success rates of endopyelotomy and pyeloplasty are reported in various success rate in many studies.ObjectiveTo identify the optimal management of ureteropelvic junction obstruction .MethodA meta-analysis of cohort study published before February 2014 was performed using Medline databases. Management of ureteropelvic junction obstruction treatment using endopyelolitotomy (anterograde and or retrograde) and laparoscopic pyeloplasty (transperitoneal or retroperitoneal) were included. Publication using secondary UPJO repair, poor functioning kidney were excluded. Success was defined as absence of any clinical symptoms and combined with significant reduction of hydronephrosis showed with on diuretic IVU or ultrasonography result, and no sign of obstruction on diuretic IVU or diuretic renography or Whitaker test. A random-effects model with DerSirmonian-Laird method was used to calculate the pooled Risk Ratio (RRs) and 95% Confidence Interval (CI). We assessed the heterogeneity by calculating the I2 statistic. All analyses were performed with Stata statistical software, version 12.0 (StataCorp).Result We analized 4 cohort studies. The success rate from 479 patients (233 laparoscopic pyeloplasty, 246 endopyelotomy), 21 months postoperatively, was 92.3% (215/233) after laparoscopic pyeloplasty, 63.8% (157/246) after endopyelotomy. Based on success rate in ureteropelvic junction obstruction management, laparoscopic pyeloplasty is better than endopyelotomy (overall risk ratio was 1.35 (95% CI 0.97 to 1.88); p<0.0001 and I2=90.6 %).]"

"[Tujuan: Mengidentifikasi korelasi dan insiden metastasis tulang pada pasien kanker prostat dengan Gleason Score (GS) dan Prostate Specific Antigen (PSA) yang rendah.Material dan Metode: Studi deskriptif retrospektif pada pasien kanker prostat di Rumah Sakit Cipto Mangunkusumo periode 2006-2011. Ada 478 pasien dengan kanker prostat. Pasien kanker prostat dengan PSA rendah, telah menjalani pemeriksaan histopatologi, dan bone scan diikutsertakan dalam studi, sehingga didapatkan 358 pasien sebagai subjek penelitian.Nilai PSA diukur dengan sandwich electrochemiluminescent immunoassay. Pemeriksaan histopatologi diklasifikasikan menurut sistem grading Gleason dan dibagi menjadi 3 kategori: diferensiasi baik (GS ≤6), diferensiasi sedang (GS 7), dan diferensiasi buruk (GS 8-10). Bone scan dikerjakan dengan dengan agen radiofarmaka (Tc99m methylenendiphosphonate) dan kemudian gambar ditangkap dengan kamera gamma.Hasil: Rerata usia 67.52±7.8 tahun, rerata GS 7.7±1.3, dan median PSA adalah 56.9 (rentang: 0,48-17000 ng/mL). Ada 11 orang pasien (3,0%) dengan bone scan positif dengan PSA <20 ng/mL dan GS<8. Lebih lanjut, ada 2 pasien (0,6%) dengan GS≤6 dan PSA<10 ng/mL memperlihatkan metastasis ke tulang.Kesimpulan: Pada studi ini, ada sebagian kecil pasien mengalami metastasis tulang dengan PSA (PSA<10 mg/mL) dan GS (GS≤6) rendah., Objective This study was aimed to identify correlation and incidence of bone metastases in prostate cancer patient with low Gleason Score GS and Prostate Specific Antigen PSA Materials and Methods A descriptive restrospective study to patients with prostate cancer in Cipto Mangunkusumo Hospital in 2006 2011 There were 478 patient with prostate cancer Patients with prostate cancer who had PSA value histological examination and bone scan were included in the study resulting in 358 eligible patients for the study PSA value was measured using the sandwich electrochemiluminescent immunoassay Histological examination was graded according to Gleason rsquo s grading system and divided into 3 category well differentiated GS le 6 moderately differentiated GS 7 and poorly differentiated GS 8 10 Bone scan was done using radiopharmaceuticals agent Tc 99m methylenen diphosphonate and then the image was captured using gamma camera Results The mean age was 67 52 7 8 mean GS was 7 7 1 3 and median PSA was 56 9 range 0 48 17000 ng mL There were 11 patients 3 0 with positive bone scan with PSA]"

"[Pendahuluan: Sejak tahun 70-an hingga sekarang, skor Gleason merupakan parameter penting pada penatalaksanaan kanker prostat. Biopsi prostat yang umum dipakai untuk membedakan antara kondisi jinak dan ganas semakin menjadikan skor Gleason berperan penting dalam menentukan tatalaksana selanjutnya. Meskipun demikian, terdapat diskrepansi antara skor Gleason yang diambil secara biopsi dan paskaoperasi.Tujuan: Untuk menentukan perbedaan skor Gleason sebelum dan setelah dilakukan prostatektomi radikal, dan untuk mencari faktor-faktor yang berperan dalam peningkatan skor Gleason.Metode: Dilakukan evaluasi laporan patologi dari spesimen prostat yang didapatkan secara biopsi dan paska prostatektomi radikal antara Januari 2004 sampai Desember 2013. Kriteria eksklusi dari studi ini adalah laporan-laporan yang tidak mencantumkan skor Gleason ataupun diagnosis selain adenokarsinoma prostat.Hasil: Studi ini menginklusikan 36 subjek dengan adenokarsinoma prostat yang telah menjalani prostatektomi radikal. Skor Gleason 6 merupakan skor tersering yang dilaporkan pada biopsi, sedangkan skor Gleason 7 merupakan skor tersering yang dilaporkan pada spesimen prostatektomi radikal. Diantara subjek, 58,3% (n=21) memiliki perbedaan antara skor Gleason biopsi dan prostatektomi radikal; 11,1% (n=4) memiliki penurunan dan 47,2% (n=17) mengalami peningkatan. Dengan menggunakan analisis statistik dijumpai bahwa rendahnya densitas PSA (PSAD) memiliki korelasi dengan likelihood peningkatan (r=0,658, p=0,006).Kesimpulan: Sebagian besar pasien memiliki perbedaan antara skor Gleason hasil biopsi dan paskaoperasi dimana terlihat kecenderungan peningkatan dibandingkan dengan penurunan skor. PSAD merupakan faktor yang berkorelasi dengan peningkatan skor Gleason., Introduction: Since its introduction in mid 70 until now, Gleason Score is an important parameter in the treatment of prostate cancer. The common practice of prostate biopsy to differentiate between malignant and benign condition of the prostate, hence makes Gleason score plays important role in determine the next step of treatment. Still there is a discrepancy between Gleason score taken from biopsy and postoperatively.Aim: To determine the Gleason score difference before and after radical prostatectomy, and to find factors that has a role in the upgrading of Gleason score.Methods: We evaluated pathology reports of prostate specimens obtained from biopsy and after radical prostatectomy between January 2004 until December 2013. Exclusion criteria of this study were reports that failed to mentioned Gleason score or a diagnosis apart from adenocarcinoma of the prostate.Results: This study enrolled 36 subjects with adenocarcinoma of the prostate who underwent radical prostatectomy. Gleason score 6 was the most reported score in initial biopsy while Gleason score 7 was the most reported in radical prostatectomy specimen. Among the subjects 58.3% (n=21) had diferrences of Gleason score between biopsy and radical proistatectomy; 11.1% (n=4) had a downgrading and 47.2% (n=17) had an upgrading. Using statistical analysis we found out that low prostate specific antigen densities (PSAD) had correlation with upgrading likelihood (r 0.658, p = 0.006)Conclusion: More than half of our patient had differences between biopsy Gleason score and postoperative scores with majority showed a likelihood of upgrading rather than downgrading, PSAD was the factors that correlates with upgrading in Gleason score.]"

"[Tujuan: Untuk mengetahui pengaruh kepribadian tipe A terhadap kejadian kanker prostatMetode: Penelitian ini merupakan penelitian case control dengan subjek pasien kanker prostat dan kontrol. Dilakukan penelitian menggunakan kuisioner menggunakan Howard Glazer Personality Questionnaire (HGPQ) and Social Readjustment Rating Scale (SRRS). SRRS dibagi dalam kejadian 2 tahun, 5 tahun, dan 10 tahun. Data dievaluasi dengan analisa stastistik Chi Quadrat dan Mann Whitney UHasil: Tidak terdapat hasil yang signifikan dalam hasil SRRS 2 tahun (P= 0,94), 5 tahun (p = 0,73) dan 10 tahun (p=0,47) antara pasien kanker prostat dan kontrol. Terdapat hasil yang signifikan dalam hasil HGPQ antara pasien kanker buli dan kontrol (p=0,007)Kesimpulan: Kepribadian tipe A sebagai kepribadian pemicu stres memberikan korelasi positif terhadap kejadian kanker prostat., Objective:To investigate the effect of type A personality as a stress personality type on prostate cancer incidence.Method:This was case control study with prostate cancer patient and control as subject of the study. Subject were asked some questionnaires about their personality using Social Readjustment Rating Scale (SRRS) and Howard Glazer Personality Questionnaire (HGPQ). Events in SRSS scale devided in 2 years ago, 5 years ago and 10 years ago. Data was evaluate with chi Quadrat and Mann Whitney U.Result:There were no significant difference in SRRS score between prostate cancer patien and control in 2 years events (p=0,94), 5 years events (p= 0,73) and 10 years (p=0,47). There were significant difference in HGPQ score between bladder cancer and control (p=0,007).Conclusion:Type A personality as a stress personality have a positive correlation in incidence of prostate cancer]"