Urinary Tract Stones Risk Factors in Patients with Benign Prostatic Hyperplasia in West Java, Indonesia

Background: Urinary tract stones are common in patients with benign prostatic hyperplasia (BPH); therefore, an imaging test is needed for patients who have risk factors for the formation of urinary tract stones. The purpose of this study was to explore the factors associated with the presence of urinary tract stones in patients with BPH as information to conduct imaging tests.Methods: A cross-sectional quantitative analytic study was conducted on medical records of patients with BPH, both with and without urinary tract stones, or patients with urinary tract stones registered at the Department of Urology, Dr. Hasan Sadikin General Hospital, Indonesia, from 2015 to 2018. Data on age, body mass index, hypertension, use of antihypertensive drugs, diabetes mellitus, and hyperuricemia were collected and analyzed using the Mann-Whitney, Chi-square, Fisher exact test, and multivariate logistic regression statistical test to compare variables between BPH with and without urinary tract stones.Results: In total, 235 BPH patients were registered, of whom 74 (31.5%) had urinary tract stones. The median age was 64 years old. There was a relationship between age (p=0.030), diabetes mellitus (p=0.043), and the occurrence of urinary tract stones in patients with BPH. The most dominant risk factor was diabetes mellitus (OR=3.000, 95%CI 1.03-8.69).Conclusions: Age and diabetes mellitus are the risk factors for urinary tract stones in patients with BPH. BPH patients with diabetes mellitus are at a 3-fold risk for urinary tract stones. Diabetes mellitus in BPH patients is an indication to conduct imaging tests

COMPARISON OF PAIN DEGREES USING VISUAL ANALOG SCALE (VAS) IN VARICOCELE PATIENT AFTER MICROSURGERY VARICOLECTOMY COMPARED TO NON MICROSURGERY VARICOCELECTOMY PROCEDURE AT HASAN SADIKIN HOSPITAL BANDUNG IN 2014 – 2015

Objective: This study aimed to report the demographic, presentation, and compare the pain degree after varicocelectomy procedure at Hasan Sadikin Hospital Bandung from 2014 until 2015. Material & Methods: We study the demographic, presentation, and outcome of varicocelectomy to pain degree in patient who came to Hasan Sadikin Hospital Bandung from 2014 until 2015. Results: The mean age of patients was 29.43  years old. Patient consist of 2 (2.89%) patients with varicocele grade I,  32 (46.37 %) patients with varicocele grade II, 33 (47.82%) patients with varicocele grade III, and 2 (2.89 %) with varicocele grade IV. We found incidences of varicocele at the right side in 1 (1.44 %) patient, at the left side in 34 (49.27%) patients, and at bilateral in 34 (49.27%) patients. Thirty eight patients (55%) patients underwent non-microsurgical varicocelectomy and 31 (45%) patients underwent microsurgical varicocelectomy. 22 (57.89%) patients still had pain after non microsurgical varicocelectomy and 30 (96.77%) patients had no pain after microsurgical varicocelectomy. Only one (4.34%) patient experienced scrotal pain after microsurgical varicocelectomy but the pain relieves after 6 months postoperative. Conclusion: Microsurgical varicocelectomy is an effective treatment of varicocele. Our comparative study among open surgical and microsurgical varicocelectomy has confirmed microsurgical varicocelectomy has a better postoperative outcome

THE INDONESIAN LINGUISTIC VALIDATION OF THE URETERAL STENT SYMPTOMS QUESTIONNAIRE

Objective: To validate the Indonesian version of the ureteral stent symptoms questionnaire (USSQ) for patients with indwelling ureteral stents. Material & Methods: The Indonesian version of the USSQ was developed following a well-established multistep process by two urologists and two independent translators. A total of 38 patients with indwelling temporary unilateral ureteral stents completed the Indonesian USSQ. Patients completed questionnaires at 1 week after stent insertion and 1 week after stent removal. The reliability of the Indonesian version was evaluated for internal consistency using Cronbach’s alpha test. Domain structures were examined by interdomain (section) associations using Spearman’s correlation coefficient (r). Sensitivity to change of each domain was assessed using Wilcoxon test. Results: Urinary, pain, general health, work performance and additional problem showed good internal consistency whereas sexual problem and global quality of life displayed low consistency. There were strong correlations of urinary symptoms with body pain (r=0.633) and general health (r=0.686), moderate correlation with work performance. In addition there was also strong correlation between body pain and general health (r=0.723). Sensitivity to change were significant to all domain except sexual matters domain. (p<0.001). Conclusion: The Indonesian USSQ is reliable and can be utilize as a tool to investigate symptoms and to assess quality of life related issues due to ureteral stents in Indonesian patient

Consensus and diversity in the management of varicocele for male infertility: Results of a global practice survey and comparison with guidelines and recommendations

Purpose: Varicocele is a common problem among infertile men. Varicocele repair (VR) is frequently performed to improve semen parameters and the chances of pregnancy. However, there is a lack of consensus about the diagnosis, indications for VR and its outcomes. The aim of this study was to explore global practice patterns on the management of varicocele in the context of male infertility. Materials and Methods: Sixty practicing urologists/andrologists from 23 countries contributed 382 multiple-choice-questions pertaining to varicocele management. These were condensed into an online questionnaire that was forwarded to clinicians involved in male infertility management through direct invitation. The results were analyzed for disagreement and agreement in practice patterns and, compared with the latest guidelines of international professional societies (American Urological Association [AUA], American Society for Reproductive Medicine [ASRM], and European Association of Urology [EAU]), and with evidence emerging from recent systematic reviews and meta-analyses. Additionally, an expert opinion on each topic was provided based on the consensus of 16 experts in the field. Results: The questionnaire was answered by 574 clinicians from 59 countries. The majority of respondents were urologists/uro-andrologists. A wide diversity of opinion was seen in every aspect of varicocele diagnosis, indications for repair, choice of technique, management of sub-clinical varicocele and the role of VR in azoospermia. A significant proportion of the responses were at odds with the recommendations of AUA, ASRM, and EAU. A large number of clinical situations were identified where no guidelines are available. Conclusions: This study is the largest global survey performed to date on the clinical management of varicocele for male infertility. It demonstrates: 1) a wide disagreement in the approach to varicocele management, 2) large gaps in the clinical practice guidelines from professional societies, and 3) the need for further studies on several aspects of varicocele management in infertile men