Background: Bladder cancer is still a burden on the world of oncology medicine, which every year affects about 3.4 million people globally with 430,000 new cases per year. It is the fourth most common cancer in men and eighth most common women malignancy in the world. This makes bladder cancer a “silent killer” and it needs appropriate treatment planning. Single immediate instillation of chemotherapy after transurethral resection of the bladder (TURB) is recommended by EAU guideline, but its use remains a controversy. Objective: Study aimed to analyze benefit of intravesical chemotherapy following TURB in terms of recurrency of non-muscle invasive bladder cancer (NMIBC). Methods: Systematic review and meta-analysis of randomized controlled trials comparing the efficacy of a single instillation after TURB with TURB alone in NMIBC (pTa-pT1) patients was conducted. Studies searched throughout Medline, PubMed, Embase, and Cochrane in December 2018. Keywords were intravesical chemotherapy, combination, transurethral resection, bladder cancer. Inclusion criteria were RCT studies, subjects in study were treated single immediate chemotherapy instillation after TURB compared to TURB alone in patient with pTa-pT1 urothelial carcinoma of the bladder. Trials with additional treatment prior to first reccurence were not eligible. Studies using recurrence rate as dependent variable. From 361 studies, in total 11 studies were eligible for this meta-analysis. Results: From those 11 studies, it is shown that intravesical chemotherapy using Epirubicin and Mitomycin-C following TURB showed significant decrease of recurrence rate of bladder cancer even to progression of the disease compared to TURB alone (p<0.05) with pooled Risk Ratio were 0.69 and pooled heterogeneity (I2) were 26.6%. Conclusion: This meta-analysis study showed that combination therapy of intravesical chemotherapy after TURB is superior to TURB alone in showing the recurrence rate of NMIBC.

<p class="EnglishAbstract">Benign prostatic hyperplasia (BPH) is one of the most common diseases affecting the elderly, and Transurethral Resection of the Prostate (TURP) is a gold standard surgical procedure in BPH patients. Although the TURP rate is high, the publication of TURP profile data in Indonesia is still limited. This study aimed at determining the characteristics of BPH patients who underwent TURP at Saiful Anwar General Hospital. This study is a descriptive study by collecting data of 162 BPH patients who underwent TURP from January 2015 to August 2017. TURP is primarily performed in patients aged 61-70 years (39.5%). Recurrent urinary retention was the most common indication for the procedure (54.9%) followed by bladder stone (21%), pharmacological therapy failure (10.5%), inguinal hernia (8%), severe Lower Urinary Tract Symptoms (LUTS) (3.7%), and renal insufficiency (1.9%). As many as 58% of patients who underwent TURP had a prostate volume higher than 50 ml. Urinary retention is the most common complaint among BPH patients who underwent TURP, and recurrent urinary retention is the most common TURP indicator. </p>

Migration of the intrauterine device (IUD) into the bladder has been a rare case. There were reported 31 cases of IUD migration into the bladder until 2006. Although IUD migration is asymptomatic, it should be removed to prevent complications such as pelvic abscess, bladder or intestinal rupture, and adhesion. A 52-year-old woman came to the urology clinic with pyuria since the previous 3 months. She had a history of IUD insertion in 1982; and two months later, she got pregnant. Since 2015, she has suffered from dysuria but has never been treated and has worsened in the past 3 months. On physical examination, tenderness was found in the suprapubic region. The results of urinalysis showed pyuria and hematuria. The ultrasonography findings, there were large bladder stones. An abdominal x-ray revealed the presence of a bladder stone with the IUD tail. Vesicolithotomy was performed and the IUD was found attached to an 11x7 cm bladder stone. The patient had a good postoperative condition without any special complications. The IUD in the bladder is a medium for forming secondary bladder stones. Most cases of IUD migration are caused by a lack of evaluation after the installation procedure. This case suggested that the physician should be more careful in carrying out the installation procedure. It is necessary to evaluate the location of the IUD after installation to prevent further patient complications.

Background: Nocturia is a common urinary system disease. Objective: This study aimed to investigate the causes of nocturia in women Indonesian inhabitants aged≥ 40 years. Methods: A stratified sample strategy was used to conduct a randomized cross-sectional study on 562 residents under the age of 40 in Malang City, East Java, Indonesia. A questionnaire was completed, which included socioeconomic demographics, lifestyle characteristics, and clinical history. Each night, nocturia was defined as at least two voids. The chi-squared test was used to determine proportional differences between age and gender groups. Multivariate logistic regression analysis was used to assess gender-related factors. This was determined that P0.05 was statistically significant. Results: Data on 562 people aged 61.60 + 9.81 years eligible for statistical analysis at the end, comprising 185 (32.92%) men and 377 (67.08%) women. Overall nocturia prevalence was 31.8% (179/562). It rose significantly with age (P<0.001) and reached >48% in those above the age of 70. In both men and women, nocturia was linked with diabetes, hypertension, cardiovascular disease, and the overactive bladder symptom score (OABSS) (P0.05). There was no link discovered between nocturia and education, profession, civil status, BMI, female birth history, or the International Prostate Symptom Score. Conclusion: Nocturia is linked to aging, cardiovascular disease, hypertension, OABSS, and diabetes in Indonesians over the age of 40.

The acute scrotum is a common urological emergency and has a broad differential diagnosis. There is no clear consensus on a particular algorithm to follow in the diagnosis of testicular torsion. Testicular Workup for Ischemia and Suspected Torsion (TWIST) Score, a risk scoring system based on signs and symptoms, can be invaluable in managing patients with the acute scrotum, specifically testicular torsion. This study aimed to evaluate the effectiveness of the TWIST scoring system for differential diagnosis of acute scrotal patients. The study was conducted using secondary data, medical records from 111 male patients diagnosed with acute scrotum in Saiful Anwar General Hospital Malang between January 2015 and December 2018. Data about the onset of pain, first contact, history, physical examination findings, any adjunct test performed, and intra-operative findings were collected. The effectiveness of the TWIST score in diagnosing testicular torsion was determined by calculating the sensitivity, specificity, positive predictive value (PPV), and negative predictive value (NPV). Of the 111 patients, 43 patients (38.7%) had testicular torsion. The mean age was 17.49 (6.69) years. A total of 39 patients were classified as high risk as per the TWIST Score with cut point 5 had 83.7% sensitivity, 95.6% specificity, 92.3% positive predictive value (PPV), and 90.3% negative predictive value (NPV). The area under the curve was 0.93. The use of the TWIST Score in clinical practice can accurately determine high-risk patients who can proceed straight to the operating theatre without the need for an ultrasound.