Objective: To define the relationship between intravesical prostatic protrusion (IPP), prostate specific antigen (PSA), and prostate volume (PV), and to determine which one is the best predictor of bladder outlet obstruction (BOO) due to benign prostatic enlargement. Material & method: 95 male patients > 40 years old presenting with LUTS and BPH, between January until July 2012. They were evaluated with digital rectal examination (DRE), International Prostate Symptoms Score (IPSS), total PSA serum, uroflowmetry, post-void residual urine measurement, IPP and PV using transabdominal ultrasound. Statistical analysis included Chi-square and Spearman’s Rank correlation test.Receiver Operator Characteristic (ROC) curves were used to evaluate the correlation of PSA, PV, and IPP with BOO. Results: Mean PSA was significantly higher in obstructed patients (8.6 ng/mL; 0.76-130) compared to non-obstructed patients (6.44 ng/mL; 1.0-40.6). Mean PV was significantly larger in obstructed patients (50.33 mL ± 24.34) compared to non-obstructed patients (45.39 mL ± 23.43). Mean IPP was significantly greater in obstructed patients (7.29 ± 2.78) compared to non-obstructed patients (6.59 ± 2.93). The Spearman rho correlation coefficients were 0.617, 0.721, and 0.797, for PSA, PV, and IPP, respectively. Using ROC curves, the areas under the curve for PSA, PV, and IPP were 0.509, 0.562 and 0.602, respectively. The positive predictive values of PV, PSA, and IPP were 59.7%, 55.6% and 60.2% respectively. Conclusion: PSA, PV, and IPP measured through transabdominal ultrasonography are noninvasive and accessible method that significantly correlates with BOO in BPH patients. IPP is a better predictor for BOO than PSA or PV.Keywords: Bladder outlet obstruction, intravesical prostatic protrusion, prostate specific antigen, prostate volume, transabdominal ultrasound, benign prostate hyperplasia.
The decision that declared COVID-19 as a pandemic in March 2020 had become a medical emergency that also effects kidney transplantation program and care. Kidney transplantation has been a definitive treatment for end-stage renal disease (ESRD) patients since it improves patient’s quality of life. However great the beneficence is, kidney transplant procedure still carries high risk of COVID-19 infection especially for recipients who are obliged to take immunosuppression agents after transplantation. Purpose: This study aimed to evaluate kidney transplant procedure in Dr. Sardjito General Hospital within before and during pandemic based on recipients’ and donors’ characteristics and laboratory findings such as creatinine and urine time. Patients and methods: This study is designed as a cross-sectional analytic research to evaluate 30 patients that underwent kidney transplant in Dr. Sardjito General Hospital within before (April 2019-2020) and during (April 2020-2021) COVID-19 era. Data analyses were carried out using SPSS version 25.0 and were served with simple charts and tables. Results: There is a decrement of kidney transplant procedure within before (n=16) and during (n=14) COVID-19. Age group of recipients that underwent the most of transplantation before pandemic are 20-29 years old while during pandemic are 40-49 years old. There is no significant difference in length-of-stay within before (12.0±4.17 days) and during (9.29±3.73 days) COVID-19 (p=0,077). Laboratory findings such as creatinine of pre-transplantation (9.47±4.05; 7.81±6.00) and 3 months’ post-transplantation (1,55±0,78; 1,15±0,67) also did not show significant changes (p=0,153) as well as urine time (245.60±225.55; 428.38±657.70; p=0.321). Conclusion: There is a decrement of kidney transplant procedure in Dr. Sardjito General Hospital within before and during COVID-19 era. There are no significant differences found within length-of-stay, creatinine pre and 3 months’ post-transplantation and urine time. On the whole, transplant outcomes have remained similar within pre and during COVID-19 era.
BACKGROUND Glucose transporters (GLUTs) and oxidant metabolism are associated with the mechanism of infertility. This study evaluated the impact of hyperglycemia on glucose and oxidant metabolisms of Sertoli cells (SCs). METHODS This study was an animal study to investigate the expression of messenger RNA monocarboxylate transporter 4 (MCT4), GLUT1, GLUT3, nuclear factor erythroid 2-related factor 2 (Nrf2), glutathione peroxidase, catalase (CAT), and lactate dehydrogenase A (LDHA) of Wistar rats testes that were induced hyperglycemia. Reverse transcription polymerase chain reaction analysis was used. Hyperglycemic state in the Wistar rats was induced by streptozotocin. 24 rats were divided into 3 groups: non-hyperglycemia (control), 2-week, and 4-week hyperglycemic state. All data were collected and analyzed using SPSS version 15.0 (IBM Corp., USA). RESULTS The expression of glucose transporter (GLUT1 and GLUT3), lactate transporter (MCT4), and cellular defense protein against oxidant (Nrf2 and CAT) was significantly increased in the 2-week and 4-week hyperglycemic state groups with p<0.01, respectively. CONCLUSIONS Hyperglycemic state affects the metabolism of SCs. Alteration of GLUTs and oxidative metabolism may indicate metabolic alterations by a prolonged exposure to hyperglycemia that may be responsible for diabetes-related male infertility.
Objective: This study aims to investigate the characteristics of androgen receptors (AR), estrogen receptor 1 (ER1) and estrogen receptor 2 (ER2) expression in dartos tissue of patients with congenital hypospadias, compared to normal penis. Material & Methods: We harvested 63 dartos tissue consisting of 53 congenital hypospadias that underwent urethroplasty (20 distal and 33 proximal) and 10 normal penis that underwent circumcision as controls from September 2017 to September 2018. The expressions of AR, ER1, and ER2 were measured using Quantitative Real-Time PCR (qPCR). All data were analyzed by Prism 7, and one-way ANOVA tests were used to compare gene expressions between the groups. Results: The mean age was 68.99 (± 45.5) and 65.6 (± 25.8) months in boys with and without hypospadias, respectively. The expression of mRNA AR was decreased in proximal (6.26 ± 2.30) and distal hypospadias (6.43 ± 2.22) compared to controls (9.69 ± 1.10), which were statistically significant (p=0.0001 and p<0.0001, respectively). We found a statistically significant difference of ER1 expression compared to controls (p=0.0064). The expression of ER2 was significantly increased in distal (21.03 ± 5.00) and proximal hypospadias (25.21 ± 8.06) groups compared to controls (11.80 ± 2.49) (p<0.0001). There was no statistically significant mean difference in mRNA ER1 expression (p=0.65). Conclusion: The repressed AR and elevated ER mRNA as shown in our study may suggest that defects in those receptors’ interaction and/or balance may contribute to hypospadias and penile curvature condition. Further studies are needed to evaluate any gene-related problems in hypospadias. Keywords: Hypospadias, androgen receptor, estrogen receptor, dartos tissue.
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