Uropathogens in many Asian countries had high resistance to broad-spectrum antibiotics. Knowledge of regional and local resistance data and prudent use of antibiotics are important for proper management of UTI in Asian countries.

Purpose:Racial differences exist in the incidence of prostate cancer (PCa). Although many studies have looked at the performance of prostate-specific antigen (PSA) and PSA density (PSAD) in the detection of PCa, only a few have looked at it in relation to Indonesian men. The objective of this study is to find out better PSA and PSAD cutoff point in the detection of PCa in Indonesian men.Methods:A total of 404 consecutive Indonesian men underwent prostate biopsy for suspicion of PCa from 2008 to 2011. The biopsy criteria include one or more of the following: serum PSA more than 10 ng/mL, PSAD more than 0.15 if PSA 4–10 ng/mL, hypoechoic lesion during transrectal sonography and/or abnormal digital rectal examination.Results:Forty five out of 404 (11.1%) had positive biopsies. The mean age, prostate volume, PSA and PSAD were respectively 64.06 years, 43.03 mL, 45.59 ng/mL and 1.15. Of the 404, 131 cases (32.4%) were confirmed to be urinary retention. Positive urine culture found in 182 cases (45%). The cutoff point to detect PCa as estimated by the receiver operating characteristics was 6.95 ng/mL for PSA (sensitivity 97.8%, specificity 19.6%) and 0.7072 for PSAD (sensitivity 62.2%, specificity 78.7%). Positive predictive value for this PSA and PSAD cutoff point were 11.6% and 27.5% respectively (P=0.004 and P=0.000). There was a significant correlation between hypoechoic lesion and positive biopsy results (P =0.000). Urinary retention elevates PSA cutoff point to 14.55 (sensitivity 90.9%, specificity 50%), while positive urine culture alters almost no PSA cutoff elevation.Conclusions:PSA and PSAD cutoff point for Indonesian men in this series is relatively different from international consensus. Furthermore, these data show that PSA and PSAD cutoff point must be adjusted to racial variation to discriminate between malignant and benign disease. Urinary retention is a significant factor for PSA cutoff increase.

Pre-determined parameters of LOC, ICI, and ROC during US provide objective and measurable data on EUS function. US showed the total disappearance of EUS bursting in the VD group as compared to the C group. These results indicate that ultrasound testing may become a valuable non-invasive tool in future translational studies to investigate SUI/urethral function in rat models.

This paper describes two consecutive studies: a volume study and an efficacy study. The volume study determined the appropriated volume of Medical Grade Silicone Rubber (MSR) needed to achieve complete occlusion of the vas deferens. This was done by in-vitro testing of 130 human vas specimens containing plugs of MSR formed in vivo. The volume of MSR needed to occlude the vas was 0.1531 +/- 0.0059 ml injected by five to six turns of the applicator handwheel. There was a correlation between MSR volume, weight, and the number of turns of the applicator handwheel. An influence of body height upon the volume and weight of the MSR was also observed. An oval shaped clamp (15 mm long) was more effective in producing secure vas occlusion than was a round clamp (10 mm long). The mean outer diameter of the vas specimens was 1.80 +/0 0.15 mm, and the mean maximum dilated inner diameter was 0.93 +/- 0.11 mm. The efficacy study was a clinical trial to compare MSR was occlusion (using an oval 15 mm clamp and the appropriate volume derived from the volume study, n = 58) with no-scalpel vasectomy as the standard procedure (n = 64). The azoospermia rate following MSR vas occlusion was not significantly different from that following no-scalpel vasectomy, and was achieved in 3-6 months.

This open-label, dose-escalation study investigated the ef®cacy and safety of alprostadil (PGE 1 , prostaglandin E 1 ) Sterile Powder (S.Po.) (Caverject # ) for treatment of erectile dysfunction (ED) in 84 men with ED of various etiologies lasting ! 4 months. Doses started with 2.5 mg, then 5 mg, 10, 15, 20, 30, up to a 40 mg maximum. Eligible patients received single alprostadil injections in the physician's of®ce until an erection occurred. Ten minutes after injection, the patient's erection was clinically evaluated. Optimal response was de®ned as erection suf®cient to permit vaginal penetration and lasting 30±60 min. The patient also reported his own evaluation of response and any side effects. Patients were 24±65 y old (mean: 43.7 y), had ED of psychogenic, vascular, or neurogenic origin lasting 4 months±30 y (mean: 3.75 y). Of 84 patients enrolled, 82 completed the study. In the 82 patients who completed the study 78 (92.9%) achieved an optimal response; 18/78 patients (23.1%) had an optimal response at 2.5 mg, 9/78 (11.5%) at 5 mg, 21/78 (26.9%) at 10 mg, 12/ 78 (15.4%) at 15 mg, and 11/78 (14.1%) at 20 mg. Only 5/78 (6.4%) at 30 mg and 2/78 (2.6%) at 40 mg achieved an optimal response. Mean optimal alprostadil dose was 11.9 mg, and the mean minimal effective dose was 9.9 mg. Mean onset of erection was 11.2 min; mean duration of erection was 50.5 min. Penile pain in ®ve patients (6%) was the only reported side effect.