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"Pendahuluan dan tujuan: Studi ini bertujuan untuk mengusulkan istilah baru terkait batu kandung kemih berukuran besar pada populasi pasien anak berdasarkan stone burden, kapasitas kandung kemih, dan gangguan ginjal yang berhubungan dengan batu kandung kemih.Metode: Tiga puluh empat anak dengan batu kandung kemih di Rumah Sakit kami antara Januari 2014 hingga Agustus 2019 dimasukkan ke dalam penelitian. Data mengenai usia pasien, gejala klinis, riwayat diet, status sosial ekonomi, pemeriksaan laboratorium termasuk pemeriksaan darah lengkap, urinalisis dan kultur urin, adanya hidronefrosis, ukuran batu, status gizi, dan jenis operasi dikumpulkan. Estimasi Volume Batu (EVB) diukur dengan menggunakan rumus Ackermann, sedangkan Estimasi Kapasitas Kandung Kemih (EKKK) dihitung dengan menggunakan rumus Koff. Kurva Receiver Operating Characteristic (ROC) digunakan untuk menentukan nilai cut-off terbaik untuk menentukan nilai rasio EVB terhadap EKKK di mana batu kandung kemih menyebabkan hidronefrosis.Hasil: Hidronefrosis tercatat pada 12 pasien. Terdapat perbedaan hasil yang signifikan pada rerata EVB dan rasio EVB terhadap EKKK ditemukan pada kedua kelompok (masing-masing p <0,001 dan 0,006). Kurva ROC digunakan untuk menilai akurasi rasio EVB terhadap EKKK sebagai prediktor kejadian hidronefrosis dengan luas area di bawah kurva 0,768 (95% CI 0,624 hingga 0,949). Nilai cut-off rasio EVB terhadap EKKK adalah 0,0286 dengan sensitivitas 94,40%, spesifisitas 62,50%, nilai prediksi positif 73,91%, dan nilai prediksi negatif 90,90%.Kesimpulan: Kami mengusulkan untuk menggunakan istilah giant pada kasus batu buli pasien anak dengan menggunakan rasio EVB terhadap EKKK di atas 0,028. Kami berharap penelitian kami akan mendorong peneliti lain untuk secara prospektif mengevaluasi implikasi terapeutik dari terminologi baru.

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Introduction: This current study aims to propose a new term related to giant bladder stones in pediatric patient populations concerning the stone burden, bladder capacity, and renal impairment related to the bladder stone.

Methods: Thirty-four children with bladder stones in our center between January 2014 to August 2019 were admitted to the study. Data regarding patient's age, clinical symptoms, dietary history, socioeconomic status, laboratory investigations include complete blood examination, urinalysis and urine culture, presence of hydronephrosis, stone size, nutritional status, and type of procedure were collected. Estimated stone volume (ESV) was measured using Ackermann's formula, while estimated bladder capacity (EBC) was calculated using Koff formulas. Receiver operating characteristic (ROC) curve was constructed to determine the best cut-off value for determining what ESV to EBC ratio value at which a bladder stone cause hydronephrosis.

Results: Hydronephrosis was noted in 12 patients. A significant difference in the mean ESV and ESV to EBC ratio was found between those two groups (p < 0.001 and 0.006 respectively). ROC curve was used to assess the accuracy of the ESV to EBC ratio as a predictor of hydronephrosis incidence with the area under the curve 0.768 (95% CI 0.624 to 0.949). Cut-off value of this ESV to EBC ratio is 0.0286 with a sensitivity 94.40%, specificity 62.50%, positive predictive value 73.91%, and negative predictive value 90.90%.

Conclusion: We propose to use the term giant in pediatric cases using the EBV to EBC ratio above 0.028. We hope that our work will stimulate other researchers to prospectively evaluate the therapeutic implications of the new terminology."

"Pendahuluan dan tujuan: Penelitian ini bertujuan untuk mendeskripsikan alasan pasien di balik penolakan radikal sistektomi pada kanker kandung kemihMetode: Penelitian ini dilakukan di Rumah Sakit Umum Adam Malik dalam rentang periode Juli 2014 hingga Agustus 2020. Family meeting ataupun wawancara dilakukan untuk menjelaskan risiko dan manfaat dari operasi dan mendapatkan persetujuan atau penolakan (dan alasan penolakan) dari prosedur tersebut. Analisis bivariat menilai signifikansi semua variabel dependen sebagai prediktor penolakan radikal sistektomi. Variabel yang signifikan akan dimasukkan dalam analisis regresi multivariat.Hasil: Sebanyak 51 pasien kanker kandung kemih yang baru terdiagnosis dan dindikasikan untuk radikal sistektomi diikutsertakan dalam penelitian ini, dengan rata- rata usia 51,73±8,73 tahun; 34 (66,67%) diantaranya berusia <55 tahun. Ada 42 pasien laki-laki (82,4%) dalam penelitian ini. 15 (29,4%) pasien menolak radikal sistektomi. 81,25% pasien stadium awal setuju untuk menjalani radikal sistektomi. Rasio prevalensi pasien stadium III-IV yang menolak menjalani radikal sistektomi adalah 1,544 (95% CI, 0,977-2,440). Hanya enam pasien (35,3%) berusia ≥55 tahun yang menyetujui prosedur, dengan rasio prevalensi pasien berusia ≥55 tahun yang menolak prosedur sebesar 2.500 (95% CI, 1.298–4.814).Kesimpulan: Usia ≥55 tahun, tingkat pendidikan rendah, dan stadium III-IV menjadi faktor penentu penolakan radikal sistektomi. Odds rasio penolakan adalah 2.500 (95% CI, 1.298–4.814), 3.588 (95% CI, 1.708–7.537), dan 1.544 (95% CI, 0.977–2.440) masing-masing untuk usia ≥55 tahun, tingkat pendidikan rendah, dan tahap III-IV.

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Introduction: This study aimed to describe the reasons behind patient’s radical cystectomy refusal for bladder cancer

Methods: This study was conducted at Adam Malik General Hospital between July 2014 and August 2020 were recruited in this study. A family conference or interview was taken to explain the risk and benefit of the surgery and get the approval or rejection (and refusal reason) of the procedure. The bivariate analysis assessed all dependent variables’significance as a predictor of radical cystectomy refusal. Significant variables will be included in the multivariate regression analysis.

Results: A total of 51 newly diagnosed bladder cancer patients indicated for radical cystectomy were included in this study, with an average of 51.73±8.73 years old; 34 (66.67%) of those were aged <55 years old. There were 42 male patients (82.4%) in this study. 15 (29.4%) patients refused the radical cystectomy. 81.25% of early-stage patients agreed to undergo radical cystectomy. The prevalence ratio of stage III–IV patients refused to undergo radical cystectomy was 1.544 (95% CI, 0.977–2.440). Only six patients (35.3%) aged ≥55 years agreed to the procedure, with a prevalence ratio of patients ≥55 years of age to refuse to the procedure of 2.500 (95% CI, 1.298–4.814). Conclusion: Age ≥55 years, low education level, and stage III-IV were the determining factors in the rejection of radical cystectomy. The odds ratios for refusal were 2.500 (95% CI, 1.298–4.814), 3.588 (95% CI, 1.708–7.537), and 1.544 (95% CI, 0.977–2.440) for ages ≥55 years, low education level, and stages III-IV, respectively."

"ABSTRAKPasien stroke biasanya mengalami disfungsi, termasuk gangguan eliminasi karenaneurogenic bladder. Residu urin digunakan untuk melihat kemampuan dalampengosongan kandung kemih. Penelitian ini bertujuan membandingkan residu urinantara bladder training yang waktu dimulainya/inisiasi sejak pasien stroke pasca faseakut dengan yang dimulai satu hari sebelum kateter dilepas. Desain penelitianmenggunakan Quasy experiment post-test-only design with a comparison group danpengambilan sampel menggunakan metode purposive random sampling. Residu urindiukur dengan alat bladder scan dan dicatat dalam lembar observasi. Pengaruh bladdertraining pada kelompok treatment dan kelompok kontrol terhadap volume residu urindiuji dengan uji t independen. Rata-rata residu urin pada kelompok treatment lebih kecil(54,00 ml dengan SD= 144,22 ml) dibandingkan rata-rata volume residu urin kelompokkontrol (101,71 ml dengan SD= 42,55 ml). Hasil uji t independen menunjukkan tidakada perbedaan volume urin residu pada kelompok treatment dan kelompok kontrol(p=0,84). Dengan demikian institusi pelayanan perlu mempertimbangakanmengembangkan sistem dan membuat prosedur tetap untuk tindakan bladder trainingdan perawat perlu melakukan bladder training sebelum kateter urin dilepaskan.

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ABSTRACTThe stroke patients usually experience with various dysfunction, including disturbancein elimination because of neurogenic bladder. Urine residue can be used to detect thebladder function in contracting and voiding urine. This research was aimed to comparebladder training initiation after stroke patients have passed the acute phase and one daybefore the urine catheter was removal. This research was used Quasy experimentposttest-only design with a comparison group design. The sample in this research takingby purposive random sampling method. Urine residue measuring with bladder scan andrecorded in the observation sheet. The mean of urine residue in the treatment group wassmaller (54,00 ml with SD=144,22 ml) if compared with the urine residue volume incontrol group (101,71 ml with SD=42,55 ml). The influence bladder training in both oftreatment and control groups and the differences of the urine residue volume wasanalyzed with t test independent, there wes no differences between urine residue volumein the groups (p=0,84). Therefore the health institution must consider to develop thesystem and made a procedure in bladder training program’s and the nurse must dobladder training before the urine catheter was removal."

"[ABSTRAK BPH salah satu penyakit yang sering ditemukan di negara-negara berkembang, prevelansi dan insiden BPH banyak terjadi pada lansia pria yang banyak tinggal di daerah perkotaan dan menempati presentase kasus urologi yang paling umum terjadi dimana kasusnya mencapai 75%. Kasus BPH di perkotaan sering ditangani dengan tindakan Transurethral Resection Prostate (TURP). Salah satu hal yang harus diperhatikan perawat dalam melakukan asuhan keperawatan pada klien post op TURP adalah pemantauan cairan irigasi. Penulisan ini memaparkan dan menganalisis asuhan keperawatan post operasi yang menitikberatkan pada implementasi pemantauan irigasi bladder. Hasil analisis menunjukkan ada hal-hal yang harus diperhatikan oleh perawat dalam melakukan pemantauan irigasi bladder antara lain jenis cairan yang digunakan, kecepatan aliran, dan pemantauan tanda-tanda penyumbatan kateter. Pengetahuan perawat tentang irigasi bladder perlu ditingkatkan untuk menghindari komplikasi yang umum terjadi pada pasien post op TURP; ABSTRACT BPH is one of a common disease in developing country, BPH incident and prevalency mostly found in elderly who live in urban area and and be the most common urology case up to 75% cases. Usually BPH in urban area handled with Transurethral Resection of Prostate (TURP). One of nursing consideration on post TURP care is irrigation fluid monitoring. This research describe and analyze post TURP nursing care which focused implementation on irrigation bladder. The analysis result showed that things such as fluid type, flow velocity, and chatether clearance need to be awared. Knowledge about bladder irrigation of the nurse should be increase to avoid complication that commonly happen to post op TURP client.;BPH is one of a common disease in developing country, BPH incident and prevalency mostly found in elderly who live in urban area and and be the most common urology case up to 75% cases. Usually BPH in urban area handled with Transurethral Resection of Prostate (TURP). One of nursing consideration on post TURP care is irrigation fluid monitoring. This research describe and analyze post TURP nursing care which focused implementation on irrigation bladder. The analysis result showed that things such as fluid type, flow velocity, and chatether clearance need to be awared. Knowledge about bladder irrigation of the nurse should be increase to avoid complication that commonly happen to post op TURP client.;BPH is one of a common disease in developing country, BPH incident and prevalency mostly found in elderly who live in urban area and and be the most common urology case up to 75% cases. Usually BPH in urban area handled with Transurethral Resection of Prostate (TURP). One of nursing consideration on post TURP care is irrigation fluid monitoring. This research describe and analyze post TURP nursing care which focused implementation on irrigation bladder. The analysis result showed that things such as fluid type, flow velocity, and chatether clearance need to be awared. Knowledge about bladder irrigation of the nurse should be increase to avoid complication that commonly happen to post op TURP client.;BPH is one of a common disease in developing country, BPH incident and prevalency mostly found in elderly who live in urban area and and be the most common urology case up to 75% cases. Usually BPH in urban area handled with Transurethral Resection of Prostate (TURP). One of nursing consideration on post TURP care is irrigation fluid monitoring. This research describe and analyze post TURP nursing care which focused implementation on irrigation bladder. The analysis result showed that things such as fluid type, flow velocity, and chatether clearance need to be awared. Knowledge about bladder irrigation of the nurse should be increase to avoid complication that commonly happen to post op TURP client., BPH is one of a common disease in developing country, BPH incident and prevalency mostly found in elderly who live in urban area and and be the most common urology case up to 75% cases. Usually BPH in urban area handled with Transurethral Resection of Prostate (TURP). One of nursing consideration on post TURP care is irrigation fluid monitoring. This research describe and analyze post TURP nursing care which focused implementation on irrigation bladder. The analysis result showed that things such as fluid type, flow velocity, and chatether clearance need to be awared. Knowledge about bladder irrigation of the nurse should be increase to avoid complication that commonly happen to post op TURP client.]"