Skip to main content Skip to main navigation menu Skip to site footer

Faktor risiko yang mempengaruhi pembesaran volume prostat pada pasien pembesaran prostat jinak yang dilakukan reseksi prostat transuretra

Abstract

Pendahuluan:

Pembesaran prostat jinak atau benign prostatic hyperplasia (BPH) adalah penyakit degeneratif pria yang sering dijumpai. Banyak faktor yang diduga berperan dalam proliferasi jinak kelenjar prostat. Penelitian yang telah ada sebelumnya belum menyatakan faktor risiko mana yang paling berperan terhadap terjadinya BPH. Penulis mencoba mencari tahu faktor risiko mana di antara usia, infeksi saluran kemih, diabetes melitus (DM tipe 2), obesitas, dislipidemia, kadar testosteron, kadar PSA, serta kadar TNF-α dan kadar TGF-β jaringan prostat yang paling berperan dalam volume prostat.

Bahan dan Metode:
Penelitian ini menggunakan rancangan analitik kohort retrospektif dengan data diambil dari rekam medis, dengan melibatkan 83 subjek penelitian yaitu pasien BPH berusia 50-80 tahun yang dilakukan reseksi prostat transuretra di Bali dengan hasil pemeriksaan histopatologi jinak. Tidak didapatkan perbedaan yang bermakna pada karakteristik subjek penelitian. Analisis bivariat (uji Spearman) untuk mencari hubungan antara faktor risiko dengan volume prostat.

Hasil:

Terdapat korelasi positif antara kadar PSA dengan volume prostat (p<0,001) dan kadar testosteron dengan volume prostat (p=0,059, moderate signifikan). Analisis multivariat (regresi linier) didapatkan faktor risiko yang berpengaruh terhadap volume prostat adalah kadar PSA dan testosteron. Setiap peningkatan 1 ng/ml PSA serum akan meningkatkan volume prostat sebesar 1,4 ml (p<0,001) dan setiap peningkatan 1 ng/ml hormon testosteron akan meningkatkan volume prostat sebesar 0,024 ml (p=0,005). Kadar PSA dan kadar testosteron merupakan faktor risiko yang paling berpengaruh terhadap volume prostat.


Introduction:
Benign Prostatic Hyperplasia (BPH) is a common degenerative disease. Many contributing factors that affect benign prostatic proliferation. Many previous studies have not concluded which factors most affecting BPH. This study is aimed at figuring out whether aging, urinary tract infection, diabetes mellitus (DM), obesity, dyslipidemia, testosterone level, PSA level, TNF-α and TGF-β level in prostatic tissue is the most affecting factor to prostatic volume.

Method:
We conducted an analytical retrospective cohort study with data collected from the medical record. We enrolled 83 BPH Balinese patients who underwent TURP with benign histopathologic results. The baseline data were not significantly different. Bivariate analysis (Spearman’s test) were used to find the correlation between risk factors and prostatic volume.

Result:

There was a positive correlation between PSA level and prostatic volume (p<0.001) and between testosterone level and prostatic volume (p=0.059, significantly moderate). Multivariate analysis (linear regression) concluded that PSA level and testosterone level affect the prostatic volume. For every 1 ng/ml raise in PSA value, there will be 1.4 ml prostatic volume enlargement (p<0.001) and for every 1 ng/ml raise in testosterone level, there will be 0.024 ml prostatic volume enlargement (p=0.005). We concluded that PSA level and testosterone level are the most affecting factors to the prostatic volume.

References

  1. Mochtar, C.A., Umbas, R., Soebadi, D.M., dkk. 2015. Panduan Penatalaksanaan Klinis Pembesaran Prostat Jinak (Benign Prostatic Hyperplasia/BPH). 2nd Ed. Jakarta: Ikatan Ahli Urologi Indonesia. p. 1-27.
  2. Duarsa, G.W.K., Lesmana, R., Mahadewa, T.G.B. 2016. High Serum Prostate Specific Antigen as A Risk Factor for Moderate-Severe Prostate Inflammation in Patient with Benign Prostatic Hyperplasia. Bali Med J., 4(3): 148-151.
  3. De Nunzio C., Kramer, G., Marbeger, M., dkk. 2011. The Controversial Relationship between Benign Prostatic Hyperplasia and Prostate Cancer: The Role of Inflammation. Eur. Urol., 60(1): 106-117.
  4. Cooperberg, M.R., Presti, Jr, J.C., Shinohara, K. Carroll, P.R. 2013. Neoplasm of the Prostate Gland. In: McAninch, J.W., Lue, T.F., editors. Smith and Tanagho’s General Urology. 18th Ed. New York: The McGraw-Hill Companies. p. 350-379
  5. Duarsa, G.W.K., Oka, A.A.G., Maliawan, S., dkk. 2018. Elevated Tumor Necrosis Factor-α and Transforming Growth Factor-β in Prostatic Tissue are Risk Factors for Lower Urinary Tract Symptoms after Transurethral Resection of the Prostate in Benign Prostatic Hyperplasia Patients with Urinary Retention. The Open Urology & Nephrology Journal, 11: 46-53.
  6. Carroll, P., dkk. 2013. PSA Testing for the Pre-treatment Staging and Post-treatment Management of Prostate Cancer: Revision of Best Practice Statement. American Urological Association.
  7. Putra, I.B.O.W., Hamid, A.R.A.H., Mochtar, C.A., Umbas, R. 2016. Relationship of age, prostate-specific antigen, and prostate volume in Indonesian men with benign prostatic hyperplasia. Prostate Int., 42: 43-48.
  8. Roehrborn, C.G. 2012. Benign Prostatic Hyperplasia: Etiology, Pathophysiology, Epidemiology, and Natural History. In: Wein, A.J., Kavoussio, R.L., Novick, A.C., Partin, A.W., Peters, C.A., editors. Campbell-Walsh Urology. 10th Ed. USA: Elsevier. p. 2570-2610.
  9. Chughtai, B., Lee, R., Te, A., Kaplan, S. 2011. Role of Inflammation in Benign Prostatic Hyperplasia. Rev. Urol., 13(3): 147-150.
  10. Deori R., Das B., Rahman M.A. 2017. A Study of Relationship of Prostate Volume, Prostate Specific Antigen, and Age in Benign Prostatic Hyperplasia. International Journal of Contemporary Medical Research, 4(7): 1582-1586.
  11. Briganti, A., Capitanio, U., Suardi, N., Gallina, A., dkk. 2009. Benign Prostatic Hyperplasia and Its Aetiologies. European Urology Supplements, 8: 865-871.
  12. Kim, J.M., Song, P.H., Kim, H.T., Moon, K.H. 2011. Effect of Obesity on Prostate-Specific Antigen, Prostate Volume, and International Prostate Symptom Score in Patients with Benign Prostatic Hyperplasia. Korean J. Urol., 52: 401-405.
  13. Mohammed, M.M., Abdulridha, M.K., Al-Mulahummadi, YM.K. 2013. Body Mass Index (BMI), Lipid Profile, Leptin Level and Their Correlation with Prostate Specific Antigen (PSA) in Iraqi Patients with Benign Prostatic Hyperplasia (BPH). Karbala Journal of Pharmaceutical Science, 4: 18-31.
  14. Chen, Z., Miao, L., Gao, X., Wang, G, Xu, Y. 2015. Effect of Obesity and Hyperglycemia on Benign Prostatic Hyperplasia in Elderly Patients with Newly Diagnosed Type 2 Diabetes. Int. J. Clin. Exp. Med., 8(7): 11289-11294.
  15. Werny, D.M., Saraiya, M., Gregg, E.W., Prostate-Specific Antigen Values in Diabetic and Nondiabetic US Men, 2001-2002. 2006. Am J Epidemiol., 164(10):978-83.
  16. Al-Asadi, J.N., Al-Naama L.M., Abdul-Kareem, M.M., dkk. 2017. Serum Level of Prostate-Specific Antigen in Diabetic Patients in Basrah, Iraq. Niger Postgrad Med J., 24(4):240-244.
  17. Miller, E.A., Pinsky, P.F., Pierre-Victor, D. 2018. The Relationship between Diabetes, Prostate-Specific Antigen screening test, and Prostate Cancer. Cancer Cause Control, 29(10):907-914.

How to Cite

Sari, Y. A., Duarsa, G. W. K., & Mahadewa, T. G. B. (2019). Faktor risiko yang mempengaruhi pembesaran volume prostat pada pasien pembesaran prostat jinak yang dilakukan reseksi prostat transuretra. Medicina, 50(2). https://doi.org/10.15562/medicina.v50i2.702

HTML
568

Total
206

Share

Search Panel

Yudit Anastasia Sari
Google Scholar
Pubmed
Medicina Journal


Gede Wirya Kusuma Duarsa
Google Scholar
Pubmed
Medicina Journal


Tjokorda Gde Bagus Mahadewa
Google Scholar
Pubmed
Medicina Journal