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Abstrak :
TUJUAN: Menilai perubahan pancaran urin maksimal (Amax) pada penderita striktur uretra setelah uretrotomi interna dan hubungannya dengan letak dan panjang striktur uretra. BAHAN DAN CARA: Penelitian ini dilakukan secara deskriptif korelatif ( cross-sectional study ). Penelitian ini dilakukan dengan pemeriksaan Q max pada penderita striktur uretra setelah kateter uretra dilepas dan tiga minggu pasca uretrotomi intema di poliklinik bagian bedah urologi RSVP Dr. Hasan Sadikin Bandung selama periode Desember 2001-November 2002. Dilakukan analisa statistik dengan uji Mann-Whitney. HASIL PENELITIAN: Didapatkan 61 penderita striktur uretra pasca uretrotomi intema dengan 41 penderita (67,2%) panjang striktur uretra ≤ 2 cm dan 47 penderita (77%) striktur uretra anterior. Q max Setelah Kateter Uretra Dilepas Q max Tiga Minggu Setelah Uretrotomi Interna Panjang Striktur < 10 ml/s ≥10 ml/s < l0 ml/s ≥10 ml/s < 2cm 12,2 % 87,8 % 48,7 % 51,3 % > 2cm 35% 65% 75% 25% Letak Striktur Anterior 19,1 % 80,9 % 55,6 % 44,4 % Posterior 21,4 % 78,6 % 71,4 % 28,6 % Pada analisa statistik dengan uji Mann-Whitney didapatkan hubungan yang bermakna antara panjang striktur uretra dengan pancaran urin maksimal { p = 0,012 ) dan hubungan yang tak bermakna antara letak striktur uretra dengan pancaran urin maksimal. KESIMPULAN: Perubahan Q max pasca uretrotomi interna dipengaruhi oleh panjang striktur uretra dan tidak dipengaruhi oleh letak striktur uretra. ...... OBJECTIVES: The aim of this study is to assess the changes in Q max of patients with urethral stricture after internal urethrotomy regarding the correlation with the location and the length of the stricture. METHODS: A prospective cross-sectional observation was conducted to evaluate the correlation between Q max and the length as well as the location of stricture. The Q max obtained after urethral catheter removal were compared to the Q max three weeks after the procedures. The length and the locations of the stricture were evaluated using retrograde as well as antegrade uretrography. The study was conducted in OPD of Hasan Sadikin Hospital Bandung between December 2001 - November 2002. Statistical analysis used was Mann-Whitney test. RESULTS: Fourty-one patients (67.2%) out of 61 patients with urethral stricture underwent internal urethrotomy have a stricture ≤ 2 cm in length while 47 patients (77%) have a stricture in the anterior part of the urethra. Q max After urethral Catheter Removal Removal Q max Three Weeks After Interna Length of stricture < 10 ml/s ≥10 ml/s < l0 ml/s ≥10 ml/s ≤ 2crn 12,2 % 87,8 % 48,7 % 51,3 % > 2cm 35% 65% 75% 25% Location of Stricture Anterior 19,1 % 80,9 % 55,6 % 44,4 % Posterior 21,4 % 78,6 % 71,4 % 28,6 % There is a significant correlation between the length of the stricture and Q max ( p = 0.012 ) but the correlation between the location of the stricture and Q max is not significant. CONCLUSIONS: The changes of Q max after internal urethrotomy are influenced by the length of the stricture but not by the location of the stricture.

Abstrak :
Background: There is a growing interest In the potential biological effects of electromagnetic fields (EMFS) on human. Mobile phone is currently known as one of the most world wide used tool which emitted, up to certain extent, EMFS. We try to explore the possible adverse effects of mobile phone on the function of the reproductive system, particularly focused on serum testosterone level, as one of the most important parameter of reproductive function. Objective: To evaluate the biological effect of RFEMR of mobile phone on serum testosterone level. Method: As a model, we exposed 9 New Zealand Rabbits to RFEMR of mobile phone, Nokia 8110, 900 MHz, built in antena,with Specific Absorption Rate (SAR) of 0.6 mW/cm2 • Total serum testosterone level was evaluated from 2 ml of rabbit blood collected prior and after the exposure. Group A exposed to 10 calls per day, group B exposed to 20 calls per day,and group C exposed to 30 calls per day ; duration of each call was 120 seconds, within 7 consecutive days. Result: Statistical analysis show a significant correlation was shown between RFEMR of mobile phone and serum total testosterone level (p = 0.0208; a < 0.15) as well as between intensity of radiation and serum total testosterone level (p = 0.0753; a < 0.15 ). Conclusion: RFEMR of mobile phone has an impact on serum total testosterone level.

Abstrak :
Telah diketahui bahwa estrogen dan reseptor estrogen sangat berpengaruh pada sistem reproduksi, perkembangan payudara dan pembentukan kanker pada wanita. Namun efek estrogen pada sistem reproduksi pria serta mekanisme estrogen pada terjadinya kanker pada pria, khususnya kanker prosat masih belum jelas. Dari sekumpulan penelitian didapatkan kemungkinan estrogen dan reseptor estrogen berperan pada terjadinya kanker pada pria, terutama kanker prosat Reseptor estrogen dapat ditemukan pada stroma dan sel epitel prostat. ......It is known that estrogen and estrogen receptors have a great influence on the reproductive system, breast development and the formation of cancer in women. However, the effect of estrogen on the male reproductive system and the mechanism of estrogen in the occurrence of cancer in men, especially prostate cancer, is still unclear. From a set of studies, it is possible that estrogen and estrogen receptors play a role in the occurrence of cancer in men, especially prostate cancer Estrogen receptors can be found in the stroma and epithelial cells of the prostate.

Abstrak :
Tujuan : Menilai variabilitas pengukuran volume total dan zona transisional prostat dengan ultrasonografi transrektal oleh pemeriksa yang sama dan antar pemeriksa yang berbeda. Metoda : Dilakukan dua kali pengukuran volume total dan zona transisional prostat oleh satu pemeriksa yang sama dan oleh dua pemeriksa yang berbeda pada 30 pasien yang berkunjung ke klinik Urologi RS Hasan Sadikin, Bandung Hasil : Rerata pengukuran volume total dan zona transisional prostat pada satu pemeriksa adalah 45,7 ± 19,2 ml dengan kisaran antara 18,1 hingga 89,7 ml (median 44,1) dan 16,9 ± 10,3 ml dengan kisaran antara 3,1 hingga 34,6 ml (median 14,3), sedangkan pada dua pemeriksa adalah 45,9 ± 19,3 ml dengan kisaran antara 18,3 hingga 89,8 ml (median 44,1) dan 16,9 ± 10,2m1 dengan kisaran antara 3,1 hingga 34,6 ml(median 14,5). Beda rerata plus/minus simpang baku pengukuran volume total dan zone transisional prostat pada pemeriksa yang sama adalah -0,2 ± 1,0 dan -0,1 ± 0,1, sedangkan pada pemeriksa yang berbeda adalah -0,6 ± 2,2 dan 0,1 ± 1,7. Interval Kepercayaan (IK) 95% pengukuran volume total dan zone transisional prostat pada pemeriksa yang sama antara -0,52 hingga 0,14 dan antara -0,53 hingga 0,65 sedangkan pada pemeriksa yang berbeda antara -1,35 hingga 0,21 dan antara -0,53 hingga 0,65. Kesimpulan : Didapatkan variasi yang cukup lebar dalam pengukuran volume total dan zona transisional prostat terutama antar pemeriksa yang berbeda dibandingkan dengan pemeriksa yang sama, walaupun demikian pengukuran dengan ultrasonografi transrektal cukup diandalkan dalam menilai volume prostate.

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Objective : To assess the intra-examiner and inter-examiner factor in the measurement of prostate volume using transrectal ultrasound. Method : Total prostate volume and transition zone volume were measured by the first examiner (measurement I), followed by the second examiner (measurement II). Afterward the same measurements were conducted again by the first examiner (measurement III). The whole procedure were done on 30 patients in the TRUS Unit of The Department of Urology, Hasan Sadikin Hospital, Bandung. Result : The mean total prostate volume and transition zone volume measured by the same examiner (Measurement I and Measurement III) were 45.67(±19.2) ml, ranged from 18.05 to 89.68 with a median of 44.18 ml and 16.92(±10.3) ml, ranged from 3.13 to 34.64 with a median of 14.30 ml. The mean total prostate volume and transitional zone volume measured by different examiners (Measurement I and Measurement II) were 45.86(±19.3) ml, ranged from 18.30 to 89.77 with a median of 44.18 ml and 16.8(±10.3) ml, ranged from 3.18 to 34.55 with a median of 14.51 ml. The mean difference between Measurement 1 and Measurement III using a Confidence Interval (CI) of 95 % were -0,20(±0,1),(-0.52-0.14) ml for total prostate volume and -0.07(±0.7) ml), (-0.38-0.16) ml for transitional zone volume. The mean difference between Measurement I and Measurement II using a Confidence Interval (CI) of 95 % were -0.57(±2.2) ml, (-1.35-0.21) ml for total prostate volume and -0.07(±1.7) ml, (-4.01-3.55) ml, for transition volume. Conclusion : A considerable difference between the measurement by total and transitional zone volume of the prostate were shown if performed repeatedly by the same examiner as well as by different examiner. The variation is greater in measurement conducted by different examiner compared to the one conduct by the same examiner.

Abstrak :
Tujuan: Mencari nilai ambang (cut-off value) rasio kadar prostate-specific antigen (PSA) terhadap volume zone transisional prostat (PSA-ZT) yang optimal dalam mendeteksi karsinoma prostat serta membandingkan sensitivitas dan spesifisitas PSA-ZT dan prostate-specific antigen density (PSAD) dalam mendeteksi karsinoma prostat. Metode: Studi cross sectional dengan subjek pasien yang dirujuk ke unit USG prostat, subbagian Urologi, RS Hasan Sadikin, Bandung, untuk deteksi karsinoma prostat atau persiapan operasi prostat, dengan nilai PSA> 4 ng/ ml dan menjalani pemeriksaan USG prostat transrektal menggunakan probe biplanar 7,5 MHz. Konfirmasi kelainan patologi prostat berdasarkan hasil biopsi atau operasi (TUR prostat atau prostatektomi terbuka). Hasil: Didapatkan 223 subjek yang memenuhi kriteria, 39 pasien dengan karsinoma prostat dan 184 pasien tanpa karsinoma prostat. Nilai median dan rentang PSA-ZT pada pasien dengan karsinoma prostat dan tanpa karsinoma prostat masing-masing 1,999 (0,150-56,170) dan 0,353 (0,009-6,290) Berdasarkan analisis dengan kurva receiver operating characteristic (ROC), didapatkan nilai ambang yang optimal untuk PSA-ZT adalah 0,40 dengan sensitivitas 88,5% dan spesifisitas 57,8%, lebih baik dibandingkan PSAD (menggunakan nilai ambang 0,25), yaitu 88,5% dan 53,1%. Nilai prediksi positif PZA-ZT juga lebih tinggi dibandingkan PSAD (77,78% dibandingkan 71,31%). Kesimpulan: Rasio kadar PSA terhadap volume zone transisional prostat (PSA ZT) mempunyai nilai spesifisitas dan nilai prediksi positif yang sedikit lebih baik dibandingkan PSAD. PSA-ZT berpotensi digunakan dalam mendeteksi karsinoma prostat.

Abstrak :
Strktur uretra adalah kelainan berupa penyempitan lumen uretra akibat terbentuknya jaringan parut (scar) yang melibatkan epitel dan jaringan erektil korpus spongiosum. Proses patofisiologi terjadinya kelainan ini belum sepenuhnya diketahui. Di antara berbagai faktor yang terlibat, diferensiasi miofibroblas merupakan salah satu faktor kunci.Tujuan penelitian ini adalah untuk mengetahui diferensiasi miofibroblas pada proses terjadinya striktur uretra di tingkat selular dan melihat hubungan antara growth factor dan komposisi kolagen dengan diferensiasi miofibroblas. Penelitian ini adalah studi eksperimental pada kelinci New Zealand jantan dewasa yang dibagi menjadi dua kelompok, yaitu kelompok model penyembuhan uretra normal dan model striktur uretra.Dua kelinci pada masing-masing kelompok dilakukan eutanasia pada hari ke-2, 7, 14, 21, 30, 60, dan 90. Dilakukan pemeriksaan adanya sumbatan uretra dengan sondase bougie 8 F, pemeriksaan CRP serum darah, pemeriksaan hematoksilin-eosin, trichrome Masson, picrosirius red, TUNEL, dan RT PCR untuk melihat ekspresi gen α-SMA, TGF β, dan b-FGF. Dari hasil penelitian dijumpai adanya perbedaan dalam apoptosis miofibroblas, komposisi kolagen I/total, kadar TGF β dan b-FGF antara kedua kelompok. Terdapat korelasi positif sedang antara apoptosis miofibroblas dengan ekspresi gen TGF β dan korelasi positif lemah antara apoptosis miofibroblas dan komposisi kolagen tipe I/ kolagen total. ......Urethral stricture is a narrowing urethral lumen due to scar formation involving epithel and corpus spongiosum erectile tissue. Pathophysiology process of this abnormality is not fully understood. Among various factors involved, myofibroblast differentiation is a key factor. The purpose of this study is to investigate the process of myofibroblast differentiation on urethral stricture formation process at cellular level and observe the correlation between growth factors and collagen composition with myofibroblast. The study was an experimental study in adult male New Zealand rabbits, divided into two groups, namely the normal urethral healing model and urethral stricture model. Euthanasia was performed in two rabbits of each group on days 2, 7, 14, 30, 60, and 90. Urethral stricture was confirmed by bougie. Several laboratory examination were done, including CRP blood serum, haematoxylin eosin, trichrome Masson, picrosirius red, TUNEL and RT PCR to look at gene expression of α- SMA, TGF β, b-FGF, dan EGF. The study found a difference in apoptosis myofibroblast, composition of collagen type I/total, TGF β and b-FGF levels between the two groups. There was also a positive moderate correlation between TGF β gene expression and myofibroblast apoptosis proportion and a positive weak correlation collagen type I/ total composition and myofibroblast apoptosis proportion.;Urethral stricture is a narrowing urethral lumen due to scar formation involving epithel and corpus spongiosum erectile tissue. Pathophysiology process of this abnormality is not fully understood. Among various factors involved, myofibroblast differentiation is a key factor. The purpose of this study is to investigate the process of myofibroblast differentiation on urethral stricture formation process at cellular level and observe the correlation between growth factors and collagen composition with myofibroblast. The study was an experimental study in adult male New Zealand rabbits, divided into two groups, namely the normal urethral healing model and urethral stricture model. Euthanasia was performed in two rabbits of each group on days 2, 7, 14, 30, 60, and 90. Urethral stricture was confirmed by bougie. Several laboratory examination were done, including CRP blood serum, haematoxylin eosin, trichrome Masson, picrosirius red, TUNEL and RT PCR to look at gene expression of α- SMA, TGF β, b-FGF, dan EGF. The study found a difference in apoptosis myofibroblast, composition of collagen type I/total, TGF β and b-FGF levels between the two groups. There was also a positive moderate correlation between TGF β gene expression and myofibroblast apoptosis proportion and a positive weak correlation collagen type I/ total composition and myofibroblast apoptosis proportion.