Purpose:Anxiety can worsen prostate cancer patients’ decision making and quality of life. Early identification of anxiety disorders is thus very important for excellent prostate cancer treatment. This study aimed to determine the levels of anxiety in patients with early-stage prostate cancer compared with advanced-stage disease.Methods:This cross-sectional study was performed at the Department of Urology, ‘Cipto Mangunkusumo’ Hospital, Faculty of Medicine, University of Indonesia. The subjects were early-stage prostate cancer patients and advanced-stage prostate cancer patients with bone metastatic lesions proved by bone scan. Comparative analysis was done to analyze anxiety scores assessed by use of an 11-item modified Memorial Anxiety Scale for Prostate Cancer (MAX-PC) questionnaire. We also assessed the relationship of the MAX-PC score with age, prostate-specific antigen (PSA) value, number of bone metastases, and pain. Data were analyzed by using SPSS ver. 17 (SPSS Inc.).Results:There were 34 subjects with early-stage prostate cancer and 34 subjects with advanced-stage prostate cancer. We found that the mean anxiety score was significantly lower (P=0.0001) in the early-stage prostate cancer group (8.32±3.65) than in the advanced-stage prostate cancer group (12.61±4.56). Nine subjects had a pathological MAX-PC score (≥16), of whom 1 subject had early-stage disease and 8 subjects had advanced-stage disease. Furthermore, there were significant positive correlations (P<0.001) between MAX-PC score and visual analogue scale pain score (r=0.633), PSA value (r=0.263), and number of bone metastatic lesions (r=0.464). However, the correlation between age and anxiety score was not significant (P=0.170).Conclusions:The MAX-PC anxiety score was significantly associated with the stage of prostate cancer. Furthermore, visual analogue scale pain score, PSA value, and number of bone metastatic lesions can also affect the MAX-PC anxiety score.

Objective: This study aims to validate the Indonesian version of International Prostate Symptom Score (IPSS)to ensure similar purpose and quality as the original version. Material & method: Validation and reliability of IPSS-Ina was performed on 174 subjects divided into 87 benign prostate hyperplasia(BPH) patients and 87 non-BPH subjects as a control group. A total of 33 patients in the BPH group then underwent TURP. Validation was assessed by correlating the IPSS score-Ina with a quality of life score (QoL). Reliability was tested by internal consistency with Cronbach α and test-retest trials. Sensitivity to changes in IPSS-Ina post-therapy was tested by comparing the mean IPSS before and after transurethral resection of the prostate (TURP) therapy. Results: Correlation between IPSS-Ina score with quality of life (QoL) was 0.85 (p <0.001),showing strong correlation.Results of Cronbach's α 0.93; while test-retest trials with the intraclass correlation coefficient (ICC) 0.99; which indicates a very good reliability. The mean initial IPSS-Ina (20.97 ± 4.4) with post-TURP (4.82 ± 1.77) differed significantly (p <0.001). Conclusion: IPSS-Ina proved excellent validation and reliability and was sensitive to symptomatic changeafter therapy. IPSS-Ina have the same goals and the quality of the original version.Keywords: International prostate symptom score, Indonesia, validation, reliability.

Lower urinary tract symptoms (LUTS) due to benign prostatic hyperplasia (BPH) are common in elderly men. In addition to LUTS, patients with BPH also often experience erectile dysfunction (ED). According to the data obtained from 30 BPH patients with symptoms of LUTS using the international prostate symptoms score (IPSS), 53.3% had symptoms of LUTS with a severe degree, and based on the international index of erectile function (IIEF), BPH patients with LUTS symptoms and ED were found to have erectile function (EF) as much as 26.7% with a mild and severe degree, orgasmic function (OF) as much as 40% with a severe degree, sexual intercourse function (SI) as much as 46.7% with a mild-to-moderate degree, sexual satisfaction (SS) as much as 33.3% with a severe degree and overall satisfaction (OS) as much as 43.3% with a mild degree. In this study, the investigators wanted to examine the relationship between the IPSS with the IIEF scores in BPH patients with symptoms of LUTS in the outpatient surgery department of Prof. Dr R. D. Kandou General Hospital Manado. Based on the results of the spearman correlation test, relationship between the IPSS with the IIEF score yielded EF (R: 0.372), OF (R: 389), SI (R: 0.129), SS (R: 0.351), OS (R: 0, 84). These results suggest the presence of a relationship between IPSS and IIEF scores.Keywords: IPSS, IIEF, LUTS, BPHAbstrak: Lower urinary tract symptoms (LUTS) yang disebabkan oleh benign prostatic hyperplasia (BPH) merupakan suatu kondisi yang sering terjadi pada pria usia lanjut. Selain gejala LUTS, pasien BPH sering juga disertai dengan disfungsi ereksi (DE). Menurut data yang diperoleh dari 30 pasien BPH dengan gejala LUTS dengan menggunakan International prostate symptoms score (IPSS) didapatkan 53,3% mengalami gejala LUTS dengan derajat berat dan pasien BPH dengan gejala LUTS yang mengalami DE dengan menggunakan skor international index of erectile function (IIEF) ditemukan fungsi ereksi (FE) sebanyak 26,7% dengan derajat ringan dan berat, fungsi orgasme (FO) sebanyak 40% dengan derajat berat, hubungan seksual (HS) sebanyak 46,7% dengan derajat Ringan-sedang, kepuasan seksual (KS) sebanyak 33,3% dengan derajat berat dan kepuasan menyeluruh (KM) sebanyak 43,3% dengan derajat ringan. Dengan melakukan penelitian ini, peneliti ingin mengetahui hubungan antara skor IPSS dengan skor IIEF pada pasien BPH dengan gejala LUTS di poli Bedah RSUP Prof. Dr. R. D. Kandou Manado. Berdasarkan hasil uji kolerasi menggunakan spearman untuk mengetahui hubungan antara skor IPSS dengan skor IIEF didapatkan FE (R:0,372), FO (R: 389), HS (R:0,129), KS (R: 0,351), KM (R: 0,84). Dari hasil tersebut dapat dilihat adanya hubungan antara skor IPSS dan skor IIEF.Kata kunci: IPSS, IIEF, LUTS, BPH

Penile augmentation is an individual effort to enlarge one’s penile size for his sexual satisfaction and his mate without functional alteration. This study was aimed to obtain the profile of motivation, sexual satisfaction, mental distortion, and complications in patients with penile augmentation. This was a descriptive categorical study with a retrospective approach. This study was conducted at Prof. Dr. R. D. Kandou Hospital and its link hospitals for 10 months involving 23 patients; most of them (34.78%) were 26-35 years old. Most patients (61%) had internal motivation based on NSSS scale >30. Based on ulcer free period, 3 patients had free period of ulcer I; no patient had free period of ulcer II. Based on pain scale, 14 patients (60.87%) had pain scale of <5 and 9 patients (39.13%) had pain scale of >5. Most complications were in the form of ulcers located in preputium (56.52%). The relationships between motivation and NSSS scale before and after penile augmentation were analyzed using Fisher exact test which obtained P = 0.000 for relationship between motivation and NSSS scale (sexual satisfaction) before and after penile augmentation and P = 0.360 between post augmentation (with its complications) and sexual satisfaction. Conclusion: Patients with penile augmentation were internally and externally motivated without any mental distortion. There was a significant relationship between internal motivation and penile augmentation as well as between motivation and sexual satisfaction. Albeit, there was no significant relationship bewteen complications of penile augmentation and sexual satisfaction. Most patients suffered complications.Keywords: penile augmentation, NSSSAbstrak: Augmentasi penis merupakan usaha individu untuk membesarkan ukuran penis demi memenuhi hasrat seksual dan pasangannya tanpa perubahan fungsi. Penelitian ini bertujuan untuk mendapatkan gambaran motivasi, kepuasan seksual, adanya gangguan jiwa, dan komplikasi pada pasien yang melakukan augmentasi penis. Jenis penelitian ialah deskriptif kategorik dengan pendekatan retrospektif. Penelitian ini dilakukan di RSUP Prof. Dr. R. D. Kandou dan RS jejaring selama 10 bulan yang melibatkan 23 pasien. Rentang usia pasien 16-59 tahun, terbanyak pada usia 26-35 tahun (34,78%). Sebagian besar pasien (61%) dengan motivasi secara internal berdasarkan skala NSSS>30. Berdasarkan periode bebas ulkus didapatkan 3 pasien dengan periode bebas ulkus I; tidak didapatkan pasien dengan periode bebas ulkus II. Berdasarkan skala nyeri didapatkan 14 pasien (60,87%) dengan skala nyeri <5 dan 9 pasien (39,13%) dengan skala nyeri >5. Lokasi komplikasi terbanyak berupa ulkus di preputium (56,52%). Analisis menggunakan Fisher exact terhadap hubungan motivasi dan skala NSSS sebelum dan sesudah augmentasi penis memper-lihatkan hubungan antara motivasi dan kepuasan seksual dengan nilai P = 0,000 (<0,05) serta hubungan antara pasca augmentasi (beserta komplikasi) dan kepuasaan seksual dengan nilai P = 0,360 (>0,05). Simpulan: Pasien yang melakukan augmentasi penis termotivasi secara internal dan eksternal tanpa adanya distorsi gangguan psikiatrik. Terdapat hubungan bermakna antara motivasi internal dan augmentasi penis serta antara motivasi melakukan augmentasi penis dan kepuasan seksual. Tidak terdapat hubungan bermakna antara komplikasi augmentasi penis dan kepuasaan seksual. Hampir seluruh pasien disertai komplikasi.Kata kunci: augmentasi penis, NSSS