Wrap up sk3 urin

8/17/2019 Wrap up sk3 urin

1/31

Blok Ginjal dan Saluran Kemih

Wrap Up Skenario 3

Tidak Bisa Buang Air Kecil

Kelompok B-05

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*ora Saputri ""0#0"("+,

*ur $ahmadina ""0#0"(#00

amor .ai/al Ghani ""0#0"(#0)

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!o i So%iah ""0#0"33"(

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TELP. 62.21.4244574 FAX. 62.21.4244574

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+.2 E #(*(3# &'#3'a P!(" a H#/&!/*a"#a PH+.+ E/# & #(*(3# &'#3'a P!(" a H#/&!/*a"#a PH

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1


3/31

Skenario 3

Tidak Bisa Buang Air Kecil

La%# ; *a%#, 65 a:)' a a'3 &!( a %& P(*#%*#'#% & a: &'3a' %&*):a' # a% #"a %&'9#'3

"& a% 1 :a!# a'3 *a*), &"%#/)' &!a"a "a'3a #'3#' %&'9#'3. S& &*) ' a !#-a a LUTS Lower Urinary Tract Syndrome "&/&! # :&"#" &'"#, '(% )!#a, )!3&'"#, f!&%)&'"#,terminal dribbling "&!#'3 #!a"a%a' "& &*) ' a. IPSS International Prostate Symptom Score < +0

a' S%(! %)a*# a" :# )/ =(L < 5. Pa a /& &!#%"aa' f#"#% # a/a %a' !&3#(' ")/!a /) #% )*3#'3 a' /a a /& &!#%"aa' 9(*(% ) )! # a/a %a' /!(" a & &"a!. O*&: (% &! a'3

& &!#%"a' a #a' )!%a' )' )% #/a"a'3 %a & &! )!#' a' #*a%)%a' /& &!#%"aa' NO;I>P.

2


4/31

Kata Sulit

1. LUTS ? ")a ) "#' !( a'3 &'3&'a# "a*)!a' %& #: a3#a' a-a:a'3 &!%a# a' &'3a' #"f)'3"# M. & !)"(! a'3 &!:) )'3a'&'3a' /!("&" /&')aa'.

2. H&"#" &'"# ? %&a aa' # a'a "&"&(!a'3 &')'33) *a a )' )% &!%& #:.+. N(% )!#a ? &!%& #: &!*& #:a' # a*a :a!#.4. U!3&'"# ? /&!a"aa' #'3#' #%"# &!*& #: a'3 # a% #"a # a:a'.5. Terminal dribbling ? "& &*a: #%"# a"#: &!a"a a a "#"a )!#'& # a*a @&"#9a

)!#'a!#a &'3a' a"#: %&*)a! & &"a'; & &"a' )!#'&.6. IPSS ? "%(!#'3 &!)/a /&! a' aa' a'3 &! #!# a!# 7 /&! a' aa' a'3

&!'#*a# 0;5 a'3 #3)'a%a' )' )% &'#*a# a' & a' a) /a"#&' PH.

7. =(L ? "%(!#'3 &!)/a /&! a' aa' a'3 &! #!# a!# 1 /&! a' aa' a'3 &!'#*a# 0;7 a'3 #3)'a%a' )' )% &'#*a# a' & a' a)

/a"#&' PH.8. )*3#'3 ? /& &'3%a%a' a'3 &!a"a /a a "aa /a*/a"#.9. NO;I>P ? /& &!#%"aa' "&9a!a !a #(3!af# a!# !a% )" )!#'a!#)" &'3a'

&'33)'a%a' a:a' %(' !a" /("# #f a'3 #")' #%a' &*a*)#I> )' )% &*#:a a'a ( # a' f#"#(*(3# !a% )" )!#'a!#)".

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3


5/31

1. A/a :) )'3a' )"#a &'3a' # a% #"a )a'3 a#! %&9#*B2. M&'3a/a /a"#&' # a% #"a )a'3 a#! %&9#* "& a% 1 :a!# a'3 *a*)B+. A/a :) )'3a' !#-a a LUTS &'3a' # a% #"a )a'3 a#! %&9#*B4. M&'3a/a #"a &! a # :&"#" &'"#B5. &!a/a '#*a# '(! a* IPSS a' =(LB

6. M&'3a/a a a /& &"a!a' /a a !&3#(' ")/!a/) #%B7. M&'3a/a /a a /& &!#%"aa' 9(*(% ) )! # a/a %a' /!(" a a'3 & &"a!B

. M&'3a/a #a' )!%a' )' )% /& a"a'3a' %a & &! )!#'& a' #*a%)%a' /& &!#%"aa'NO;I>PB

8. A/a #a3'("#" /a"#&' &!"& ) B10. A/a /& &!#%"aa' *a#' "&*a#' NO;I>PB11. a3a# a'a /& &!#%"aa' "a*)!a' %& #: *a-a' &'#" &')!) /a' a'3a' #"*a B

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6/31

1. Pa a )"#a < 60 a:)' a%a' &! a # /&'#'3%a a' )%)!a' /!(" a "&")a# &'3a' /&'#'3%a a' ) )! a' 9&' &!)'3 a%a' &' a # PH a'3 #"& a %a' (*&: &!%)!a'3' a :(! ('& &" (" &!('.

2. Ka!&'a a a' a /&' & /# a' )!& :!a /a!" /!(" a #9a a'3 #"& a %a' (*&: /& &"a!a' /!(" a a' %&3a3a*a' M. & !)"(! )' )% &!%(' !a%"# 9)%)/ %)a a' a a) 9)%)/ *a a"&:#'33a %(' !a%"# &!/) )";/) )".

+. S& a%#' )!)% !#-a a LUTS a%a "& a%#' )!)% M. & !)"(! )' )% &'3%( /&'"a"# "&:#'33a )!#' ")*# )' )% #%&*)a!%a'.

4. Ka!&'a &! a # :#/&! !(/# M. & !)"(! "&:#'33a # a% a/a &'3%( /&'"a"# /&' & /# a' )!& :!a a'3 #"& a %a' (*&: /& &"a!a' /!(" a a'3 a%:#!' a

&' & a %a' @&"#9a )!#'a!#a & &"a! a' &! &%a'.5. IPSS ? R#'3a' ? "%(! 0;7

S& a'3 ? "%(! ;18&!a ? "%(! 20;+5

=(L ? "%(! 0;76. Ka!&'a &! a # :#/&! !(/# M. & !)"(! "&:#'33a # a% a/a &'3%( /&'"a"#

/&' & /# a' )!& :!a a'3 #"& a %a' (*&: /& &"a!a' /!(" a a'3 a%:#!' a&' & a %a' @&"#9a )!#'a!#a & &"a! a' &! &%a'.

7. Ka!&'a /a a )"#a *a' ) a# ) )"#a < 60 a:)' &! a # /&'#'3%a a' )%)!a' /!(" a a'3&!3a' )'3 /a a /( &'"# DHT. Pa a )"#a *a' ) :(! ('& &" (" &!(' &')!)' a'

:(! ('& &" !(3&' & a/ a a) &'#'3%a . Da*a %&*&' a! /!(" a , 5 a*fa !& )% a"& #/&2 &!) a: &" (" &!('& &' a # DHT a'3 &%&! a *(9a* a' &' & a %a': /&!/*a"#a /!(" a "&:#'33a )!#'& &' a # &!:a a . U!#'& # @&"#9a )!#'a!#a %&*)a!

& a/# "&*a*) &!"#"a "&:#'33a &! a # :#/&!"&'"# #@# a" M. & !)"(! a'3 &' & a %a'

&! a a:' a f!&%)&'"# #%"# %a!&'a M. & !)"(! %(' !a%"# -a*a)/)' &*) /&'):.H#/&!"&'"# #@# a" &' & a %a' M. & !)"(! :#/&! !(/# a' @&"#9a )!#'a!#a & &"a!.#*a # a% # a'3a'# "&3&!a a/a &! a # %( /*#%a"# "&/&! # :# !()!& &! a'

:# !('&f!("#".. P& a"a'3a' %a & &! #*a%)%a' )' )% & a' ) /a"#&' &!%& #: a' /& &!#%"aa'

NO;I>P #*a%)%a' )' )% &'3& a:)# /& &"a!a' %&*&' a! /!(" a a'3 &! a #.8. PH &'#3'a /!(" a :#/&!/*a"#a .10. PSA, P& &!#%"aa' )!( #'a #%, )!(f*(- & ! , US !&% a*, "#" ("%(/#, )!#'a*#"#",

f)'3"# 3#' a*, CT;"9a', :& a (*(3#9.11. (*&:, %a!&'a a!)!a )' )% &'(*('3 /a"#&'.

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5


7/31

S!#'3 &! a a:' a )"#a %a a! :(! ('& &!" (" &!(' &')!)' a' %a a! :(! ('& &" !(3&'& a/ a*a ) )'3. P&!) a:a' %a a! :(! ('& #'# &' & a %a' : /&!/*a"#a a'3 a/a #*a

&!*a' ) a%a' &! a # /& &'3%a%a' /!(" a . & a*a a'3 # &!# a a a*a: LUTS. Pa a /& &!#%"aa' a'a '&"#" # a/a %a' IPSS R#'3a'? "%(! 0;7, S& a'3 ? "%(! ;18, &!a ? "%(!

20;+5, =(L ? "%(! 0;7. Pa a /& &!#%"aa' f#"#% # a/a %a' ")/!a/) #9 )*3#'3 a' 9(*(% ) )! # a/a %a' /& &"a!a' /!(" a . P& &!#%"aa' /&')' a'3 *a#' a a*a: PSA, P& &!#%"aa')!( #'a #%, )!(f*(- & ! , US !&% a*, "#" ("%(/#, )!#'a*#"#", f)'3"# 3#' a*, CT;"9a',:& a (*(3#9. D#a3'("#" a'3 # a/a a a*a: PH &'#3'a /!(" a :#/&!/*a"#a . Ta a*a%"a'a

a'3 #*a%)%a' a a*a: /& a"a'3a' %a & &!. #*a # a% # a'3a'# "&3&!a a/a &! a #%( /*#%a"# "&/&! # :# !()!& &! a' :# !('&f!("#".

Sasaran Belajar

6


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1.1 Ma%!("%(/#% A'a ( # P!(" a

1.2 M#%!("%(/#% A'a ( # P!(" a

479# 2emahami dan 2enjelaskan %isiologi rostat

4793 2emahami dan 2enjelaskan Benigna rostat :iperplasia ;B :<

+.1 D&f#'#"# &'#3'a P!(" a H#/&!/*a"#a PH

+.2 E #(*(3# &'#3'a P!(" a H#/&!/*a"#a PH

+.+ E/# & #(*(3# &'#3'a P!(" a H#/&!/*a"#a PH

+.4 K*a"#f#%a"# &'#3'a P!(" a H#/&!/*a"#a PH

+.5 Pa (f#"#(*(3# &'#3'a P!(" a H#/&!/*a"#a PH

+.6 Ma'#f&" a"# K*#'#" &'#3'a P!(" a H#/&!/*a"#a PH

+.7 D#a3'("#" a' D#a3'("#" a' #'3 &'#3'a P!(" a H#/&!/*a"#a PH

+. Ta a*a%"a'a &'#3'a P!(" a H#/&!/*a"#a PH

+.8 K( /*#%a"# &'#3'a P!(" a H#/&!/*a"#a PH

+.10 P&'9&3a:a' &'#3'a P!(" a H#/&!/*a"#a PH+.11 P!(3'("#" &'#3'a P!(" a H#/&!/*a"#a PH

479( 2emahami dan 2enjelaskan andangan 7slam 2engenai emeriksaan 4a1an=enis


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/a a "# /a#. S !( a' a )3a f# !(&*a" #% a' &'3a' )'3 "& ) *a: &!%a" "&!a ( ( .A*@&(*# a' ) )*# %&*&' a! "a'3a # a% &!a )! a' "a'3a &!a3a &' )% a' )%)!a'' a.A*@&(*# a' ) )*# &!9a a'3 &!%a*#;%a*#, %& )a' a & #*#%# *) &' a'3 *& a!. La #'a

a"a* %)!a'3 &*a" a' &/# &* "a'3a &!*#/a ;*#/a . J&'#" &/# &*' a "&*a/#" a a) &! #'3%a a' &!@a!#a"# a!# "#*#' !#" "a /a# %) #" !&' a:, &!3a' )'3 /a a " a )" &' (%!#' a' %&3#a a'%&*&' a!. S# (/*a" a a' a% &'3a' )'3 ) #! "&%!& a' ) #! *#/# . Sa*)!a' %&*)a!

& /)' a# *) &' a'3 # a% &!a )! a' #!#/ ) )*# "&%!& (!#" a'3 %&9#*.

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a"# (f#*#%. S&!#'3%a*# &'3a' )'3 a a'; a a' )*a a a) )*a &*)! #"& ) %('%!& &' /!(" a %(!/(!a a #*a"&a a'3 &!)/a%a' %(' &'"a"# "&%!& a'3 )'3%#' &'3a*a # /&!%a/)!a'.

T&*a: # & )%a' *# a a&!a: ('a &! &' ) a'3 &! & a "&9a!a :#" (*(3# a)/)' #(*(3#, a# )?

1. ('a A' &!#(! a a) >&' !a* S&")a# &'3a' *( )" a' &!#(!, # a% /)' a %&*&' a!, &! #!#a a" " !( a f# !( )"%)*a!. ('a #'# &*#/) # "&/&! #3a %&*&' a! /!(" a .

2. ('a P&!#f&! S&")a# &'3a' *( )" *a &!a* a' /(" &!#(!, &*#/) # 70 a""a %&*&' a! /!(" a . ('a #'# !&' a' &!:a a/ #'f*a a"# a' &!)/a%a' & /a a"a* %a!"#'( a

&! a' a%.

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H#'33a "&%a!a'3 a"#: &*) #%& a:)# "&9a!a /a" # /&' & a &! a #' a :#/&!/*a"#a

/!(" a , & a/# & &!a/a :#/( &"#" &' & ) %a' a:-a :#/&!/*a"#a /!(" a &!a %a# a'' a

&'3a' /&'#'3%a a' %a a! &:# !( &" (" &!(' DHT a' /!("&" a3#'3 &' a # )a .

& &!a/a &(!# a a) :#/( &"#" a'3 # )3a "& a3a# /&' & a # )*' a : /&!/*a"#a /!(" a

a a*a:?

"9 Teori :ormonal

S&*a#' a' !(3&' &" (" &!(' DHT , &" !(3&' )3a &!/&!a' )' )% &! a #' a PH.

D&'3a' &! a a:' a )"#a a%a' &! a # /&!) a:a' %&" a'3a' :(! ('a*, a# ) a' a!a

:(! (' &" (" &!(' a' :(! (' &" !(3&', %a!&'a /!( )%"# &" (" &!(' &')!)' a' &! a #

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&' # a!( a a"&, # a'a "#fa &" !(3&' #'# a%a' &!a'3"a'3 &! a #' a :#/&!/*a"#a /a a

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/!(*#f&!a"# "&* & a/# %& ) #a' &" !(3&'*a: a'3 &!/&!a' )' )% /&!%& a'3a' " !( a. Da!#

&! a3a# /&!9( aa' a' /&'& )a' %*#'#" a/a #/&!(*&: %&"# /)*a', a:-a a*a %&a aa'

'(! a* :(! (' 3('a ( !(/#' :#/(f#"& a%a' &' & a %a' /!( )%"# :(! (' a' !(3&' &" #"

a'3 a%a' &'3(' !(* /&! ) ):a' /!(" a . D&'3a' a%#' &! a a:' a )"#a, a%a' &! a #

/&')!)'a' a!# f)'3"# &" #%)*&! "/&! a (3&'&"#" a'3 a%a' &' & a %a' /&')!)'a' a'3

/!(3!&"#f a!# "&%!&"# a' !(3&'. Ha* #'# &'3a%# a %a' :(! (' 3('a ( !(/#' a%a' "a'3a

&!a'3"a'3 /!( )%"# :(! (' &" !(3&' (*&: "&* "&! (*#. D#*#:a a!# f)'3"#('a* :#" (*(3#",

/!(" a &! #!# a!# )a a3#a' a# ) "&' !a* "&%# a! )!& !a a'3 &!&a%"# &!:a a/ &" !(3&' a'

a3#a' /&!#f&! a'3 # a% &!&a%"# &!:a a/ &" !(3&'.

#9 Teori Gro1th .actor ;%aktor pertum?uhan<

P&!a'a' a!# 3!(- : fa9 (! #'# "& a3a# /& a9) /&! ) ):a' " !( a %&*&' a! /!(" a .

T&! a/a & /a /&/ #9 3!(- : fa9 (! a# ) a"#9 !a'"f(! #'3 3!(- : fa9 (!, !a'"f(! #'3

3!(- : fa9 (! F1, !a'"f(! #'3 3!(- : fa9 (! F2, a' &/# &! a* 3!(- : fa9 (!.

39 Teori eningkatan 4ama :idup Sel-sel rostat karena Berkurangn>a Sel >ang

2ati

K& a #a' "&* /!(" a a/( ("#" /a a "&* /!(" a a a*a: &%a'#" & f"#(*(3#% )' )% & /&! a:a'%a' :( &(" a"#" %&*&' a! /!(" a . Pa a a/( ("#" &! a # %(' &'"a"# a'

f!a3 &' a"# "&* a'3 "&*a' ) ' a "&* "&* a'3 &'3a*a # a/(/ ("#" a%a' #fa3("# ("#" (*&: "&*"&* #"&%# a!' a %& ) #a' # &3!a a"# (*&: &' # *#"("("( .

&!%)!a'3' a ) *a: "&*;"&* a*a /!(" a a'3 &'3a*a # a/(/ ("#" &' & a %a' ) *a: "&* "&* a*a /!(" a "&9a!a %&"&*)!):a' &' a # &'#'3%a "&:#'33a &' & a %a'

/& a a:a' a""a /!(" a . D# )3a :(! (' a !(3&' &!/&!a' a*a &'3:a a /!("&"%& a #a' "&* %a!&'a "& &*a: #*a%)%a' %a" !a"#, &! a # /&'#'3%a a' a% #@# a" %& a #a' "&*

13


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S&*a#' &(!#; &(!# # a a" a"#: a' a% *a3# &(!# a'3 &'&!a'3%a' &' a'3 /&' & a

&! a #' a PH "&/&! # &(!# ) (! #'a%, &(!# !a"#a* a' fa% (! "("#a*, &(!# #'f&%"# a!# a ;

a a'3 &*) #%& a:)#, &(!# a'3 &!:) )'3a' &'3a' a% #f# a" :) )'3a' "&%", &(!#

/&'#'3%a a' %(*&" &!(* a' ' a'3 %&"& )a' a &!"& ) a"#: &*) &*a" :) )'3a' "& a ;

a%# a ' a. D& J('3. 2004

393 pidemiologi

D# )'#a, #/&!%#!a%a' #*a'3a' /&' &!# a PH a a*a: "&!a a# +0 ) a, #*a'3a' #'#

:a' a /a a %a) /!#a %&!a'a -a'# a # a% & /)' a# %a*&' a! /!(" a , a%a (*&: "& a # ),

PH &! a # :a' a /a a %a) /!#a & & #9#'&, 2008 . J#%a #*#:a "&9a!a &/# & #(*(3#' a, #

)'#a, a' %# a a!a"%a' &')!) )"#a, a%a a/a # *#:a %a a! #'"# &'"# PH, /a a )"#a 40;

a', %& )'3%#'a' "&"&(!a'3 # ) &' &!# a /&' a%# #'# a a*a: "& &"a! 40 , a' "& &*a:

&'#'3%a ' a )"#a, a%'# a*a !&' a'3 )"#a 60 :#'33a 70 a:)', /&!"&' a"&' a &'#'3%a&' a # 50 a' #a a" 70 a:)', /&!"&' )' )% &' a/a %a'' a #"a "&:#'33a 80 A.K.

A a", 2005 . A%a' & a/#, #%a # *#:a "&9a!a :#" (*(3# /&' a%# PH, "&9a!a ) )

& a # %a' 20 /!#a /a a )"#a 40;a', a' &'#'3%a "&9a!a !a a #" /a a /!#a &!)"#a 60;

a', a' 80 /a a )"#a 70 .

D# #' ('&"#a, /&' a%# /& &"a!a' /!(" a #'a% &' a # )!) a' %& )a "& &*a:

/&' a%# a ) "a*)!a' %& #:, a' #%a #*#:a "&9a!a ) ) ' a, #/&!%#!a%a' :a /#! 50 /&!"&'

/!#a I' ('&"#a a'3 &!)"#a # a a" 50 a:)', &'3a' %#'# )"#a :a!a/a' :# )/ &'9a/a# 65

a:)' # & )%a' &' &!# a /&' a%# PPJ a a) PH #'#. S&*a' ) ' a, 5 /&!"&' /!#a I' ('&"#a

") a: a")% %& a*a *#'3%)'3a' )"#a # a a" 60 a:)'. O*&: # ), #%a #*#:a , a!# 200 ) a

*& #: #*a'3a' !a% a #' ('&"#a, a%a a/a #/&!%#!a%a' 100 ) a a a*a: /!#a, a' a'3

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#' a a%a' a:-a %#!a;%#!a 2.5 ) a /!#a I' ('&"#a &' &!# a /&' a%# PH a a) PPJ #'#.

39( Klasi%ikasi

M&')!) R) a:(! ( 2000 ? 71 , &! a/a & /a &!a a /& &"a!a' %&*&' a! /!(" a a# )

"& a3a# &!#%) ?a9 erajat $ektal

D&!a a !&% a* #/&!3)'a%a' "& a3a# )%)!a' a!# /& &"a!a' %&*&' a! /!(" a %& a!a:!&% ) . R&9 a* ()9:&! #%a a%a' '(! a* #%a a a" a a" &!a a %('"#" &'"# &*a" #", a/a

#3&!a%a', # a% a a ' &!# #*a # &%a' a' /&! )%aa'' a !a a. T& a/# !&9 a* ()9:&! /a a:#/&! !(/# /!(" a # a/a %a' a a" a a" &!a a &'(' (* *& #: a!# 1 9 a' &!a /!(" a

#a a" +5 3!a .

U%)!a' a!# /& &"a!a' %&*&' a! /!(" a a/a &'&' )%a' &!a a !&9 a* a# ) "& a3a# &!#%) ?1 . D&!a a O ? U%)!a' /& &"a!a' /!(" a 0;1 92 . D&!a a I ? U%)!a' /& &"a!a' /!(" a 1;2 9

15


17/31

+ . D&!a a II ? U%)!a' /& &"a!a' /!(" a 2;+ 94 . D&!a a III ? U%)!a' /& &"a!a' /!(" a +;4 95 . D&!a a I> ? U%)!a' /& &"a!a' /!(" a *& #: a!# 4 9

& a*a PH # a% "&*a*) "&")a# &'3a' &!a a !&9 a*, %a a'3;%a a'3 &'3a' !&9 a*()9:&! # a% &!a a &'(' (* & a/# &*a: a a 3& a*a, :a* #'# a/a &! a # #*a a3#a' a'3& &"a! a a*a: *( )" & #a*#" a' *( )" *a &!a*#". Pa a &!a a #'# %*#&' &'3&*): #%aAK # a% "a /a# )' a" a' /)a", /a'9a!a' )!#'& *& a:, :a!)" &'3& a' "aa AK,

'(9 )!#a & a/# &*) a a "#"a )!#'&.

?9 erajat Klinik

D&!a a %*#'#% &! a"a!%a' %&/a a !&"# )a* )!#'& a'3 &! a #. K*#&' #")!): AK "a /a# "&*&"a# a' /)a", %& ) #a' #*a%)%a' %a &!#"a"#. U!#'& a'3 %&*)a! a!# %a & &!

#"& ) "#"a )!#'& a a) !&"# )a* )!#'&. R&"# )a* )!#'& # a3# & &!a/a &!a a a# ) "& a3a# &!#%) ?

1 . N(! a* "#"a )!#'& a a*a: '(*2 . D&!a a I "#"a )!#'& 0;50 *+ . D&!a a II "#"a )!#'& 50;100 *4 . D&!a a III "#"a )!#'& 100;150 *5 . D&!a a I> &*a: &! a # !& &'"# ( a* a a) %*#&' # a% a/a AK "a a "&%a*#.

#*a %a' )'3 %& #: &*a: /&'): a' %*#&' &!a"a %&"a%# a', a%a )!#'& a%a' %&*)a! "&9a!a &'& &" a' /&!#( #%, :a* #'# #"& ) O@&! F*(- I'9(' #'&'9#a. Pa a &!a a #'# &*a:

&! a/a "#"a )!#'& "&:#'33a a/a &! a # #'f&%"# a a) 9 " # #", '(9 )!#a "& a%#' &! a a:a' %a a'3;%a a'3 &! a # :& a )!#a.

c9 erajat 7ntra 8esikal

D&!a a #'# a/a # &' )%a' &'3a' & /&!3)'a%a' f( ( !(' 3&' a a) 9 " (3!a , /a'&' ("9(/ . #*a *( )" & #a*#" &*&-a # )a!a )!& !a, &!a! # &*a: "a /a# /a a " a #)

# a &!a a #' !a @&"#%a*. & a*a a'3 # )* /a a " a #) #'# a a*a: "#"a )!#'& ") a:&'9a/a# 50;150 *, %& )'3%#'a' &! a # #'f&%"# "& a%#' :& a # a' a# &'3a'

/&'#'3%a a' "):) ) ):, &'33#3#* a' ' &!# # a&!a: /#'33a'3 "&! a %& )'3%#'a' &*a:&! a # / &*# #" a' !a &%)*a"# &! a a:.

d9 erajat 7ntra Uretral

D&!a a #'# a/a # &' )%a' &'3a' &'33)'a%a' /a'&' ("9(/ )' )% &*#:a"a /a# "& &!a/a a): *( )" *a &!a*#" &'(' (* %&*)a! *) &' )!& !a. Pa a " a #) #'# &*a:

&! a # !& &'"#( )!#'& ( a*.

395 ato%isiologi

16


18/31

U ) ' a 3a'33)a' #'# &! a # "& &*a: )"#a /&! &'3a:a' a%# a /&!) a:a' :(! ('a*.

a3#a' /a*#'3 a*a /!(" a & &"a! &'3a' &! &' )%' a a &'( a a'3 &!"& a!.

P& &"a!a' a &'( a /!(3!&"#f &'&%a' a a) &' &"a% a!#'3a' /!(" a a'3 '(! a* %&

%a/")*a "& a # a'3 &'3:a"#*%a' %a/")*a & a:. Ka/")*a & a: #'# &'a:a' /&!*)a"a'' a

a' a &'( a 9&' &!)'3 ) ): %& a*a &') ) *) &'' a, a'3 & a a"# /&'3&*)a!a'

)!#'. A%:#!' a #/&!*)%a' /&'#'3%a a' /&'&%a'a' )' )% &'3("('3%a' %a' )'3 %& #:.

S&!a ;"&!a )"%)*)" &" !)"(! &!&"/(' :#/&! !(/#, a'3 &'3:a"#*%a' !a &%)*a"# # a*a

%a' )'3 %& #:.

Pa a & &!a/a %a")" #%a ( "!)%"# %&*)a! &!*a*) :& a , &! a # &%( /&'"a"# %a' )'3

%& #: &' a # " !)% )! a'3 f*a"# , &! #*a a"# a' "a'33)/ &!%(' !a%"# "&9a!a &f&% #f.

Ka!&'a &! a/a "#"# )!#', a%a &! a/a /&'#'3%a a' #'f&%"# a' a ) %a' )'3 %& #:.

P&'#'3%a a' &%a'a' a*#% a/a &' & a %a' :# !('&f!("#". R& &'"# /!(3!&"#f a3# a#!,

'a !#) , a' )!&a a/a &'# )*%a' & & a :& a . E & a #'# &!&"/(' 9&/a &'3a'

!a#'a3& %a & &!. D#)!&"#" /a"%a (/&!a"# a/a &! a # /a a /a"#&' &'3a' & & a :& a a'

:# !('&f!("#" "& &*a: #:#*a'3%a' ( " !)%"#' a. Pa a a-a*' a a#!, &*&%!(*# , )!#' a' & a'

"(*) *a#' a &'#'3%a %a' #)!&"#" #'#, a%:#!' a %&:#*a'3a' 9a#!a' a'3 /!(3!&"#f #"a

&!)"a%%a' %& a /)a' 3#' a* )' )% &'3%('"&' !a"#%a' "&! a &'a:a' a#! a' 'a !#)

a%# a %&:#*a'3a' 9a#!a' a' &*&%!(*# a'3 &!*& #:a' #"a &' & a %a' :#/(@&*& #a.

39@ 2ani%estasi Klinis

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& a*a :#/&!/*a"#a /!(" a a/a &'# )*%a' %&*):a' /a a "a*)!a' %& #: a)/)' %&*):a'# *)a! "a*)!a' %& #:.

1. & a*a /a a "a*)!a' %& #:?♣ & a*a /a a "a*)!a' %& #: a3#a' a a"

N &!# /#'33a'3, & a #'f&%"# , :# !('&f!("#".

♣ & a*a /a a "a*)!a' %& #: a3#a' a-a:

K&*):a' /a a "a*)!a' %& #: "& &*a: a-a: LUTS &! #!# a a" 3& a*a ( " !)% #f a'3& a*a #!# a #f. & a*a ( " !)% #f #"& a %a' (*&: %a!&'a /&' & /# a' U!& !a /a!" /!(" a #%a%a!&'a # &"a% (*&: /!(" a a'3 & &"a! a' %&3a3a*a' ( ( & !)"(! )' )% &!%(' !a%"#9)%)/ %)a a' a a) 9)%)/ *a a "&:#'33a %(' !a%"# &!/) )";/) )".

& a*a ( " !)% #f #a*a: ?

o Ha!)" &')'33) /a a /&! )*aa' #%"# esistancyo Pa'9a!a' #%"# a'3 *& a: !ea" streamo M#%"# &!/) )" Intermittencyo M&'& &" /a a a%:#! #%"# Terminal dribbling o Ra"a &*) /)a" "&:a #" #%"# Sensation of Incomplete #ladder $mptying

Ma'#f&" a"# %*#'#" &!)/a ( " !)%"# /a a /&' &!# a :#/&/*a"#a /!(" a a"#: &!3a' )'3 #3afa% (!, a# ) ?

o >(*) & %&*&' a! /&!#)!& !a*o E*a" #"# a" *&:&! @&"#%a, ( ( /(*(" /!(" a a' %a/")* /!(" ao K&%)a a' %(' !a%"# ( ( & !)"(!

T# a% "& )a /!(" a a'3 & &"a! a%a' &'# )*%a' 3& a*a ( " !)%"#, "&:#'33a&"%#/)' @(*) & %&*&' a! /&!#)!& :!a* ") a: & &"a! a' &*a" #"# a" *&:&! @&"#%a, ( (

/(*(" /!(" a a' %a/")* /!(" a &')!)', & a/# a/a #*a a"#: #%( /&'"a"# &'3a'%&'a#%a' a a %(' !a%"# ( ( & !)"(! a%a 3& a*a ( " !)%"# &*) #!a"a%a'.

& a*a #!# a #f #"& a %a' (*&: %a!&'a /&'3("('3a' @&"#9a )!#'a!#a a'3 # a% "& /)!'a /a a "aa #%"# a a) #"& a %a' (*&: :#/&!"&'"# #@# a" ( ( & !)"(! %a!&'a

/& &"a!a' /!(" a &' & a %a' !a'3"a'3a' /a a @&"#9a, "&:#'33a @&"#9a "&!#'3 &!%(' !a%"# &"%#/)' &*) /&'):. & a*a #!# a #f #a*a: ?

o &! a a:' a f!&%)&'"# #%"# %re&'encyo N(% )!#ao M#%"# ")*# # a:a' Urgencyo D#")!#a N &!# /a a -a% ) #%"#

& a*a;3& a*a &!"& ) # a a" "&!#'3 #"& ) "#' !( a /!(" a #" )". S&9a!a %*#'#" &!a a &!a3& a*a /!(" a #" )" # ) # a3# &' a # ?

o Grade 7 ? & a*a /!(" a #" )" "#"a %&'9#'3 50 *o Grade 77 ? & a*a /!(" a #" )" "#"a %&'9#'3 < 50 *o Grade 777 ? R& &'"# )!#' &'3a' ") a: a a 3a'33)a' "a*)!a' %& #: a3#a' a a"

"#"a )!#' < 150 *

18


20/31


21/31

o U!3&'9 (!('3a' a'3 &' &"a% a' &' a a% )' )% &'3&*)a!%a' )!#' .o K&")*# a' &'3a-a*# a' &'3a%:#!# #%"#.o K(*#% !&'a* %&!)"a%a' !&'a*, "&:#'33a !&'a* # a% a/a &!f)'3"# .o &!a a a' )!)'.o A'& #a, %a a'3;%a a'3 a'/a "& a a'3 #%& a:)#.o Pa"#&' "a a "&%a*# # a% a/a &!%& #: "&:#'33a :a!)" #%&*)a!%a' &'3a' %a & &!.

Ka!&'a )!#' "&*a*) &!#"# a*a %a' )'3 %& #:, a%a ) a: "&%a*# &! a # 9 " # #"a' "&*a/) ' a &!)"a% 3#' a*.

& a*a 3&'&!a*#"a a )3a )'3%#' a /a%, &! a")% %&*& #:a', a'(!&%"#a, )a* a' )' a:,a' !a"a # a% ' a a' /a a &/#3a" !#%.

S&9a!a %*#'#% &!a a &!a , # a3# &' a # 4 3!a #a"#, a# )?

o D&!a a 1 ? A/a #*a # & )%a' %&*):a' /!(" a #" )", /a a DRE 9(*(% ) )!# & )%a' /&'(' (*a' /!(" a a' "#"a )!#'& %)!a'3 a!# 50 *.

o

D&!a a 2 ? D# & )%a' a' a a' 3& a*a "&/&! # /a a &!a a 1, /!(" a *& #: &'(' (*, a a" a a" a"#: &!a a a' "#"a )!#'& *& #: a!# 50 * & a/# %)!a'3 a!# 100 *.o D&!a a + ? S&/&! # &!a a 2, :a' a a a" a a" /!(" a # a% &!a a *a3# a' "#"a )!#'

*& #: a!# 100 *.o D&!a a 4 ? A/a #*a ") a: &! a # !& &'"# ( a*.

39, iagnosis dan iagnosis Banding

Anamnesis

P& &!#%"aa' a-a* &!:a a/ /a"#&' PH a a*a: &*a%)%a' a'a '&"#" a a) -a-a'9a!aa'3 9&! a 3)'a &' a/a %a' a a &' a'3 !#-a a /&' a%# a'3 # &!# a' a. A'a '&"#"

# ) &*#/) #?

o K&*):a' a'3 #!a"a%a' a' "& &!a/a *a a %&*):a' # ) &*a: &'33a'33)o R#-a a /&' a%# *a#' a' /&' a%# /a a "a*)!a' )!(3&'# a*#a /&!'a: &'3a*a #

9& &!a, #'f&%"#, a a) /& ; & a:a'o R#-a a %&"&:a a' "&9a!a ) ) a' %&a aa' f)'3"# "&%")a*o O a ;( a a' a'3 "aa #'# #%('") "# a'3 a/a &'# )*%a' %&*):a' #%"#o T#'3%a %& )3a!a' /a"#&' a'3 )'3%#' #/&!*)%a' )' )% #' a%a' /& & a:a'.

Sa*a: "a ) /& a' ) a'3 &/a )' )% &'3a!a:%a' a' &'&' )%a' a a' a 3& a*a( " !)%"# a%# a /& &"a!a' /!(" a a a*a: I' &!'a #('a* P!(" a & S / ( S9(!& IPSS .

HO a' AUA &*a: &'3& a'3%a' a' &'"a:%a' /!(" a & " / ( "9(!& a'3 &*a:#" a' a!#"a"#. S%(! #'# &!3)'a )' )% &'#*a# a' & a' a) %&a aa' /a"#&' PH.

A'a*#"#" 3& a*a #'# &! #!# a a" 7 /&! a' aa' a'3 a"#'3; a"#'3 & #*#%# '#*a# 0:#'33a 5 &'3a' ( a* a%"# ) +5. K)&"#('&! IPSS # a3#%a' %&/a a /a"#&' a'

#:a!a/%a' /a"#&' &'3#"# "&' #!# #a/; #a/ /&! a' aa'. K&a aa' /a"#&' PH a/a#3(*('3%a' &! a"a!%a' "%(! a'3 #/&!(*&: a a*a: "& a3a# &!#%) ?

20


22/31

o S%(! 0;7? &!3& a*a !#'3a'o S%(! ;18? &!3& a*a "& a'3o S%(! 20;+5? &!3& a*a &!a .

S&*a#' 7 /&! a' aa' # a a", # a*a af a! /&! a' aa' IPSS &! a/a "a ) /&! a' aa' )'33a*

&'3&'a# %)a*# a" :# )/ )a*# (f *#f&a a) =(L a'3 )3a &! #!# a a" 7 %& )'3%#'a' a-a a'.

emeriksaan .isikP& &!#%"aa' 9(*(% ) )! a/a & &!#%a' 3a a!a' &' a'3 %&a aa' (')"

"/#'3 &! a'#, !&f*&% )* ( 9a@&!'(")", )%("a !&% ) , a a' a %&*a#'a' *a#' "&/&! # &' (*a'# a*a !&% ) a' &' ) "a a &!a a /!(" a . Pa a /&!a aa' /!(" a :a!)" #/&!:a #%a' ?

K('"#" &'"# /!(" a /a a :#/&!/*a"#a /!(" a %('"#" &'"#' a %&' a*A a%a: a"# & !#"A a%a: '( )* /a a /!(" a &A/a%a: a a" a a" a/a #!a aS)*9)" & #a')" /!(" a &A a%a: %!&/# a"#

C(*(% ) )! /a a :#/&!/*a"#a /!(" a &')' )%%a' /!(" a &!a a & &"a!,%('"#" &'"# /!(" a %&' a* "&/&! # &!a a ) )'3 :# )'3, /&! )%aa' !a a, *( )" %a'a' a' %#!#"# & !#", # a% # a/a %a' '( )*, a' &'(' (* %& a*a !&% ) . S& a%#' &!a &!a a:#/&!/*a"#a /!(" a , a a" a a" "& a%#' ")*# )' )% #!a a. S& a'3%a' /a a %a'%&! /!(" a ,%('"#" &'"# /!(" a %&!a" a' a a) &!a a '( )* a' # a' a!a *( )" /!(" a # a% "# & !#".

S& a'3%a' /a a a ) /!(" a a%a' &!a a %!&/# a"#. P& &!#%"aa' f#"#% a/a #*a ") a: &! a #

21


23/31

%&*a#'a' /a a !a% )" )!#'a!#a a3#a' a a" %a a'3;%a a'3 3#' a* a/a &!a a a' a/a #*a") a: &! a # /#&*('&f!# #" a%a' #"&! a# "a%# /#'33a'3 a'' &!# %& (% /a a /#'33a'3.

>&"#9a )!#'a!#a a/a &!a a a/a #*a ") a: &! a # !& &'"# ( a*, a&!a: #'3)#'a* :a!)")*a# #/&!:a #%a' )' )% &'3& a:)# a a' a :&!'#a. &'# a*#a &%" &!'a :a!)" /)*a #/&!#%"a

)' )% &*#:a a a' a %& )'3%#'a' "& a a'3 *a#' a'3 a/a &' & a %a' 3a'33)a'

#%"# "&/&! # a ) # F(""a 'a@#%)*a!#" a a) )!& !a a' &!#(!, f# !("#" a&!a: )!& !a, f# ("#",9(' #*( a # a&!a: &a )".Pa a /& &!#%"aa' a ( &' # & )%a' %a' )'3 %&'9#'3 a'3

&!#"# /&'): a' &!a a a"a%#" )" # a&!a: ")/!a "# f#"#" a%# a !& &'"# )!#' a' %a a'3&! a/a ' &!# &%a' ")/!a "# f#"#".

emeriksaan 4a?oratorium

P& &!#%"aa' *a (!a (!#) &!/&!a' a*a &'&' )%a' a a # a%' a %( /*#%a"#.

Da!a: ? ; U!&) a' K!&a #'#'o E*&% !(*#o *(( )!&a '# !(3&'o P!(" a & S/&9#f#9 A' #3&' PSAo )*a a!a:2.

U!#' ? ; K)* )! )!#' "&'"# #f# a" &"o U!#'a*#"#" a' /& &!#%"aa' #%!("%(/#%o S& # &'

S& # &' )!#' #/&!#%"a )' )% &'9a!# %& )'3%#'a' a a' a /!("&" #'f&%"# a a)#'f*a a"# /a a "a*)!a' %& #:. P& &!#%"aa' %)* )! )!#'& &!3)'a a*a &'9a!# &'#" %) a'

a'3 &' & a %a' #'f&%"# a' "&%a*#3)" &'&' )%a' "&'"# #f# a" %) a' &!:a a/ & &!a/aa' # #%!( a a'3 #) #%a'. Faa* 3#' a* #/&!#%"a )' )% &'3& a:)# %& )'3%#'a' a a' a

/&' )*# a'3 &'3&'a# "a*)!a' %& #: a3#a' a a". S& a'3%a' 3)*a a!a: # a%") %a')' )% &'9a!# %& )'3%#'a' a a' a /&' a%# #a & &" &**# )" a'3 a/a &'# )*%a'%&*a#'a' /&!"a!afa' /a a @&"#9a )!#'a!#a.

emeriksaan pencitraan .oto polos a?domen ;B*6<

NO &!3)'a )' )% &'9a!# a a' a a ) (/a% # "a*)!a' %& #:, a a' a a ) %a*%)*("a /!(" a a' %a a'3 %a*a a/a &')' )%%a' a a'3a' @&"#9a )!#'a!#a a'3 /&'): &!#"# )!#', a'3 &!)/a%a' a' a a!# ")a ) !& &'"# )!#'&. S&*a#' # ) )3a #"a

&')' )%%a' a a' a :# !('&f!("#", #@&! #%&* %a' )'3 %& #: a a) a a' a & a" a"#" %&

)*a'3 a!# 9a!"#'( a /!(" a . ielogra%i 7ntra ena ;78 <

P& &!#%"aa' I>P a/a &'&!a'3%a' %& )'3%#'a' a a' a?o %&*a#'a' /a a 3#' a* a)/)' )!& &! &!)/a :# !()!& &! a a) :# !('&f!("#".o & /&!%#!a%a' &"a!' a %&*&' a! /!(" a a'3 # )' )%%a' (*&: a a' a #' &' a"#

/!(" a /&' &"a%a' @&"#9a )!#'a!#a (*&: %&*&' a! /!(" a a a) )!& &! # "& &*a: #" a*a'3 &! &' )% "&/&! # a a %a#* a a)(oo"ed fis( .

o /&' )*# a'3 &! a # /a a @&"#9a )!#'a!#a a# ) a a' a !a &%)*a"#, #@&! #%&*, a a)"a%)*a"# @&"#9a )!#'a!#a.

o f( ( "& &*a: #%"# a/a #*#:a a a' a !&"# ) )!#'

Sistogram retrograd

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24/31

A/a #*a /&' &!# a ") a: #/a"a'3 %a & &! (*&: %a!&'a !& &'"# )!#', a%a "#" (3!a!& !(3!a a/a /)*a & &!# 3a a!a' #' &' a"#.

USG secara transrektal (Transrectal Ultrasonography TU$S<U' )% &'3& a:)# &"a! a a) @(*) & %&*&' a! /!(" a , a a' a %& )'3%#'a'

/& &"a!a' /!(" a a*#3'a, "& a3a# /& )' )% )' )% &*a%)%a' #(/"# a"/#!a"# /!(" a ,&'&' )%a' @(*) & @&"#9a)!#'a!#a a' ) *a: !&"# )a* )!#'&, "&! a &'9a!# %&*a#'a' *a#'a'3 )'3%#' a a # a*a @&"#9a )!#'a!#a "&/&! # a ), ) (! a' #@&! #%&*.

emeriksaan Sistogra%iD#*a%)%a' a/a #*a /a a a'a '&"#" # & )%a' :& a )!#a a a) /a a /& &!#%"aa' )!#'&

# & )%a' #%!(:& a )!#a. S#" (3!af# a/a & &!#%a' 3a a!a' %& )'3%#'a' ) (! #a*a @&"#9a a)!#'a!#a a a) ") &! /&! a!a:a' a!# a a" #*a a!a: a a'3 a!# )a!a )!& &!,

a a) a ) !a #(*)"&' # a*a @&"#9a. S&*a#' # ) )3a & &!# %& &!a'3a' &'3&'a# a"a! /!(" a &'3a' &'3)%)! /a' a'3 )!& !a /a!" /!(" a #%a a' &*#:a /&'(' (*a' /!(" a %&

a*a )!& !a.

2$7 atau T jarang dilakukanD#3)'a%a' )' )% &*#:a /& &"a!a' /!(" a a' &'3a' &! a9a a9a

/( ('3a'.

emeriksaan 4ain Uro%lo1metri

U' )% &'3)%)! *a ) /a'9a!a' )!#' #%"#. La ) /a'9a!a' )!#' # &' )%a' (*&: ?

- a a %(' !a%"# ( ( & !)"(!- &%a'a' #' !a@&"#9a- !&"#" &'"# )!& !a

A'3%a '(! a* *a ) /a'9a!a' )!#' #a*a: 10;12 * & #% &'3a' /)'9a% *a ) /a'9a!a' &' &%a # 20 * & #%. Pa a ( " !)%"# !#'3a', *a ) /a'9a!a' &*& a: &' a # 6

* & #% &'3a' /)'9a%' a "&%# a! 11 15 * & #%. S& a%#' &!a &!a a ( " !)%"# "& a%#'*& a: /a'9a!a' )!#' a'3 #:a"#*%a'.

emeriksaan Tekanan ancaran ; Pressure Flow Studies <Pa'9a!a' )!#' &*& a: a'3 #/&!(*&: a a" a"a! /& &!#%"aa' )!(f*(- & !# # a%

a/a & & a%a' a/a%a: /&' & a ' a a a*a: ( " !)%"# a a) a a %(' !a%"# ( ( & !)"(! a'3 &*& a:. U' )% & & a%a' %& )a :a* &!"& ) , #*a%)%a' /& &!#%"aa' &%a'a'

/a'9a!a' &'3a' &'33)'a%a' )brams*+riffit(s ,omogram . D&'3a' 9a!a #'# a%a"&%a*#3)" &%a'a' #' !a@&"#9a a' *a ) /a'9a!a' )!#' a/a #)%)!.

emeriksaan 8olume $esidu Urin>(*) & !&"# ) )!#' "& &*a: #%"# "/(' a' a/a # &' )%a' &'3a' 9a!a "a'3a

"& &!:a'a &'3a' & a"a'3 %a & &! )!& !a a' &'3)%)! &!a/a @(*) & )!#' a'3 a"#:#'33a* a a) # &' )%a' &'3a' /& &!#%"aa' )* !a"('(3!af# "& &*a: #%"#, a/a /)*a#*a%)%a' &'3a' & )a f( ( /(" @(# #'3 /a a -a% ) & )a I>P. Pa a (!a'3 '(! a*

"#"a )!#' #a"a' a %("('3, "& a'3 /a a !& &'"# )!#' ( a* "#"a )!#' a/a &*& #:# %a/a"# a"

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25/31

'(! a* @&"#%a. S#"a )!#' *& #: a!# 100 99 #a"a' a #a'33a/ "& a3a# a a" #' #%a"# )' )% &*a%)%a' #' &!@&'"# /a a /&' &!# a /!(" a :#/&! !(f#.

iagnosis Banding Benigna rostat :iperplasia

K&*& a:a' & !)"(! %a' )'3 %& #:?o %&*a#'a' & )*a "/#'a*#"o '&)!(/a #a #a & &" &**# )"o /a"9a & a: !a #%a* # /&*@#"o fa! a%(*(3#%

Ka' )'3 %& #: '&)!(/a #, #"& a %a' (*&:?o %&*a#'a' '&)!(*(3#%o '&)!(/a # /&!#f&!o #a & &" &**# )"o a*%(:(*#" &o fa! a%(*(3#% ( a /&'&'a'3, /&'3:a a a*fa a' /a!a"# /a (*# #%

O " !)%"# f)'3"#('a*?o #";"#'&!3# & !)"(!;"f#'3 &! &!3a'33)' a %((! #'a"# a' a!a %(' !a%"# & !)"(!

&'3a' !&*a%"a"# "f#'3 &!o %& # a%" a #*a' & !)"(!

K&%a%)a' *&:&! %a' )'3 %& #:?o F# !("#"

R&"#" &'"# )!& !a a'3 &'#'3%a #%a!&'a%a'?o :#/&!/*a"#a /!(" a #'a% a a) 3a'a"o %&*a#'a' a'3 &' ) a %a' )!& !ao )!& !a*# #a"#"o )!& !# #" a%) a a) %!('#%

P!(" a # #" a%) a a) %!('#%

39) Tatalaksana

T&!a/# PH a/a &!%#"a! a!# -a 9:f)* -a# #'3 # a'a # a% #/&!*)%a' &%'(*(3#

a'3 9a'33#: a' a/a #*a%)%a' (*&: (% &! ) ) , :#'33a &!a/# & a: #'# a* #'@a"#f

a'3 & &!*)%a' &%'(*(3# 9a'33#: "&! a #'3%a %& &!a /#*a' a'3 #'33#. &!#%) #'# a%a'

# a:a" /&'a a*a%"a'aa' PH &!)/a -a 9:f)* -a# #'3, & #%a &' ("a, &!a/# & a:

%('@&'"#('a*, a' &!a/# #'# a* #'@a"#f.

Watch%ul Waiting

a 9:f)* -a# #'3 #*a%)%a' /a a /&' &!# a &'3a' %&*):a' !#'3a'

a Pa"#&' # &!# 'a"#:a a3a! &'3)!a'3# #') "& &*a: a%a' a*a a3a!

&'3)!a'3# '(% )!#a. M&'3:#' a!# ( a ;( a /a!a"# /a (*# #% #"? &%('3&" a' .

LII M&'3)!a'3# %(/#.LIII M&*a!a'3 #') #') a' a*%(:(* a3a! # a% &!*a*) "&!#'3 )a'3 a#! %&9#*.

P&' &!# a #a' )!%a' )' )% %(' !(* "& #a/ #3a )*a' )' )% #/&!#%"a? "%(!#'3,)!(f*(- & !#, a' TRUS.

24


26/31

LI> #*a &! a # %& )' )!a', "&3&!a #a #* #' a%a'.

Terapi 2edikamentosa

P#*#:a' &!a/# '('; & a: a a*a: /&'3( a a' &'3a' ( a & #%a &' ("a . T&! a/a #3a

a9a &!a/# &'3a' ( a a'3 "a /a# "aa #'# #a'33a/ !a"#('a*, a# ) &'3a' /&'3:a aa !&'&!3#% a;1, /&'3:a a &' # 5a !& )% a"&, a' f# ( &!a/#.

" engham?at adrenergik a-"O a #'# &%&! a &'3a' &'3:a a !&"&/ (! a;1 a'3 a' a% # & )%a' /a a ( (

/(*(" # !#3(') , *&:&! )*#; )*#, /!(" a , a' %a/")* /!(" a . D&'3a' & #%#a', a%a'

&! a # !&*a%"a"# # a&!a: /!(" a "&:#'33a &%a'a' /a a )!& !a /a!" /!(" a #%a &')!)'

a' &'3)!a'3# &!a a ( " !)%"#. O a #'# a/a & &!#%a' /&! a#%a' 3& a*a ( " !)%"#

!&*a #f 9&/a . Ef&% "a /#'3 a!# ( a #'# a a*a: /&')!)'a' &%a'a' a!a: a'3 a/a

&'# )*%a' %&*):a' /)"#'3 # #'&"" , *&*a:, ") a a' :# )'3, a' !a"a *& a:

fa # )& .P&'3( a a' &'3a' /&'3:a a !&"&/ (! a;1 a"#: &'# )*%a' & &!a/a /&! a' aa',

"&/&! # &!a/a *a a a%a' # &!#%a' a' a/a%a: &f&% #@# a"' a a%a' & a/ a#% &'3#'3a

") a a' (*&: /!(" a a%#' *a a a%a' a%#' &!a &'3a' ) ):' a @(*) & /!(" a .

C(' (: ( a ? /!a ("#', &!a ("#' ("#" 1 3 :a!#, a' a/a #'a#%%a' :#'33a 2;4 3 :a!#.

Ta ")*("#' &'3a' ("#" 0.2;0.4 3 :a!#.# engham?at en/im 5a reduktase

O a #'# &%&! a &'3a' &'3:a a %&! a &' # 5a !& )% a"&, "&:#'33a &" (" &!(' # a%

#) a: &' a # &:# !( &" (" &!('. D&'3a' & #%#a', %('"&' !a"# DHT a*a a!#'3a'

/!(" a &')!)', "&:#'33a # a% a%a' &! a # "#' &"#" /!( '. O a #'# a!) a%a'

& &!#%a' /&! a#%a' "# / ( "& &*a: 6 )*a' &!a/#.Sa*a: "a ) &f&% "a /#'3 ( a #'# a a*a: &')!)'' a *# # ( a' %a a! "&!) PSA2.

C(' (: ( a ? f#'a" &!# & ("#" 5 3 :a!#.3 Kom?inasi pengham?at adrenergik a- " dan pengham?at en/im 5a reduktase

T&!a/# %( #'a"# /&'3:a a a !&'&!3#% a;1 a' /&'3:a a &' # 5a !& )% a"&

/&! a a %a*# #*a/(!%a' (*&: L&/(! a' %a-a';%a-a' /a a 1886. T&! a/a /&')!)'a'

"%(! a' /&'#'3%a a' = aG /a a %&*( /(% a'3 &'33)'a%a' /&'3:a a a !&'&!3#%

a;1. Na )', a"#: &! a/a %&!a3)a' &'3#'3a /!(" a /a a %&*( /(% &!"& ) *& #:

%&9#* # a' #'3%a' %&*( /(% *a#'. P&'33)'aa' &!a/# %( #'a"# a"#: & &!*)%a'

/&'&*# #a' *& #: *a' ) .

.itoterapi

T&!a/# &'3a' a:a' a!# ) ):; ) ):a' /(*)*&! # &!#%a' # E!(/a a' a!); a!) #'# #

A &!#%a. O a ;( a a' &!"& ) &'3a' )'3 a:a' a!# ) ):a' "&/&! #H /(G#" !((/&!#",

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%&a a'a'' a.

25


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Terapi Bedah Kon ensional

P!(" a &% ( # #3(*('3%a' a*a 2 3(*('3a'?

P!(" a &% ( # &! )%a ?

a P!(" a &% ( # ")/!a/) #% !a'"@&"#%a*#" F!& &! P!(" a &% ( # !& !(/) #% T&!&'9& M#**#'9 P!(" a &% ( # /&!#'&a*#" ()'3

P!(" a &% ( # &! ) )/ ?

a R&"&%"# !a'")!& !a* & a: &%)

" 6pen simple prostatectom>I' #%a"# )' )% &*a%)%a' #' a%a' #'# a a*a: #*a )%)!a' /!(" a &!*a*) &"a!, # a a" 100

3!a , a a) #*a #"&! a# #@&! #%)*) a a) a ) )*#; )*#. Da/a #*a%)%a' &'3a' &%'#%

!a'"@&"#%a* a a) !& !(/) #%. O/&!a"# &! )%a & &!#%a' (! # # a" a' (! a*# a" a'3*& #: #'33# a!#/a a TUR;P1;2.

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&'# )*%a' ( " !)%"# &'3a' &'33)'a%a' !&"&% ("%(/ a' &*&% !(%a) &!. Sa /a# "aa

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/!(" a &% ( # a/a #*a%)%a' &'3a' &' ("%(/#. K( /*#%a"# a'3%a /&' &% a a*a:

/&! a!a:a', #'f&%"#, :#/('a !& #a "#' !( TUR , a' !& &'"# %a!&'a &%)a' a!a:.

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D#*a%)%a' &!:a a/ /&' &!# a &'3a' 3& a*a "& a'3 "a /a# &!a a' &'3a' )%)!a'

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a'3 #'33# . T&%'#% #'# &*#/) # #'"#"# /a a a!a: a 5 a' 7. P&' )*# a'3 #"a &! a #

a a*a: & a%)*a"# !& !(3!a .

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T&! a/a )a ") &! &'&!3# a'3 #3)'a%a', a# ) N A a' :(* #) A . T&%'#%' a

a' a!a *a#' T!a'")!& :!a* *a"&! #' )9& /!(" a &9 ( TULIP a'3 #*a%)%a' &'3a' a' )a' US , >#")a* 9(a3)*a #@& '&9!("#", >#")a* *a"&! a *a #(' (f :& /!(" a &

>ILAP , a' #' &!" # #a* *a"&! :&!a/ . K&)' )'3a' &!a/# *a"&! a a*a: /&! a!a:a' #'# a*,

a!a'3 &! a #' a "#' !( TUR, )'3%#' #*a%)%a' /a a /a"#&' a'3 &' a*a'# &!a/#

a' #%(a3)*a', a' a/a #*a%)%a' a'/a /&!*) #!a-a # !) a: "a%# . K&!)3#a'' a #

a' a!a' a # a% # a/a %a' a!#'3a' )' )% /& &!#%"aa' :#" (/a (*(3#, #/&!*)%a' -a% )

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2icro1a e h>perthermia

M& a'a"%a' a!#'3a' a &'( a &*a*)# a*a a'3 # a")%%a' &*a*)# )!& !a a a) !&% )

"a /a# "):) 42;45 ( C "&:#'33a #:a!a/%a' &! a # %(a3)*a"#.

" Trans urethral needle a?lation ;TU*A<

A*a a'3 # a")%%a' &*a*)# )!& !a a'3 a/a #*a /("#"# ") a: #a )!, a/a&'3&*)a!%a' 2 a!) a'3 a/a &')")% a &'( a a' &'3a*#!%a' /a'a", "&:#'33a

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#' &'"# a" #'33# a' &!f(%)".3 7ntraurethral stent

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& /&! a:a'%a' *) &' )!& !a & a/ &! )%a. D#*a%)%a' /a a /a"#&' &'3a' :a!a/a'

:# )/ &! a a" a' # a% a/a #*a%)%a' a'&" &"# a a) /& & a:a'.( Transurethral ?aloon dilatationD#*a%)%a' &'3a' & a")%%a' %a & &! a'3 a/a &' #*a a"# f("a /!(" a #%a a' *&:&!

%a' )'3 %& #:. P!("& )! #'# :a' a &f&% #f #*a )%)!a' /!(" a %)!a'3 a!# 40 3, "#fa ' a

"& &' a!a, a' a!a'3 #*a%)%a' *a3#.

39+ Komplikasi" 4okal

H#/&!/*a"# /!(" a a/a &' & a %a' /&' & /# a' *) &' )!& a /(" ( a'3&'3:a a a*#!a' )!#' a' &'#'3%a %a' &%a'a' #' !a@&"#%a*. )*#; )*# %(' a%"# *& #:

%)a )' )% &*a-a' a:a'a' &!"& ) a%a # )* /&) a:a' a'a ( #" a'3 #'a a%a'fa"& %( /&'"a a a%a' &! a # :#/& !(f# ( ( & )"(!, !a &%)*a"#, "a%)*a"#, #@&!%)*a"#.A/a #*a )*#; )*# &' a # &%( /&'"a"#, a%a' & a # !& &'"# )!#'. Ka!&'a /!( )%"# )!#'

&!)" &!*a' ) a%a /a a ")a ) "aa )*#; )*# # a% a /) *a3# &'a /)'3 )!#'"&:#'33a &%a'a' #' !a@&"#%a &'#'3%a , a/a # )* :# !()!& &!, :# !('&f!("#", a'3a3a* 3#' a*. Ka!&'a "&*a*) &! a/a "#"a )!#', a/a &! &' )% a ) &' a/a' /a a

)*#; )*#. a ) #'# a/a &'a a: %&*):a' #!# a"# a' &'# )*%a' :& a )!#a. a )&!"& ) a/a /)*a &'# )*%a' "#" # #" a' #*a &! a # !&f*)%" a/a &! a #

/#&*('&f!# #". I'# #'a a%a' %( /*#%a"# *(%a* a!# PH.

#9 General

P&!# ('# #", #*a @&"#9a )!#'a!#a /&9a: a' & & a! %& !('33a /&!# ('#) , a3a* 3#' a*A'& #a , S#' !( a U!& #a, A"# ("#" M& a (*#%

D#*#:a a!# ") ) /a' a'3 /&! a*a'a' /&' a%# ' a, :#/&!/*a"#a /!(" a a/a &'# )*%a'%( /*#%a"# "& a3a# &!#%)

I'%(' #'&'"#a Pa!a (%"a ) Ka' )'3 K& #:

H& a )!#aS#" # #"P#&*('&f!# #"

R& &'"# U!#' A%) A a) K!('#%R&f*)%" >&"#%(;U!& &!

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29/31

H# !()!& &! H# !('&f!("#"

a3a* #' a*

K( /*#%a"# O " !)%"# a' !&"# )a* )!#' &' & a %a' #'f&%"# /a a >U a'/!(" a a'

%a a'3;%a a'3 &' & a %a' / &*('&/:!# #" #'# )'3%#' ")*# )' )% #:#*a'3%a'. O " !)%"# )3a a/a &' & a %a' &! a #' a #@&! %&* >U. I'f&%"#!&"# )a* )!#' &!/&!a' &!:a a/ /& &' )%a' a ) 9a*9)*# . O " !)%"# f)'3"#('a* /a a#' !a@&"#9a* )!& &!, #"& a %a' (*&::#/&! !(/# !#3(') , a/a &' & a %a': !()!& &!('&/:!("#".

39"0 encegahan

a' a% &'3%('") "# @# a #' A, E, a' C, a' #(%"# a' a'3 &!/&!a' /&' #'3 a*a&'9&3a: /&! ) ):a' "&* %a'%&!, %a!&'a &')!) /&'&*# #a', 5;10 %a")" PH a/a

&!%& a'3 &' a # %a'%&! /!(" a . ># a #' 1, 2, a' 6, a'3 # ) ):%a' a*a /!("&" & a (*#" & %a! (:# !a , *& a%, a' /!( ', "&:#'33a %&! a 3#' a* a' (!3a'

) ): *a#' # a% &!*a*) &!aM&'3)!a'3# a%a'a' %a a *& a% :&-a'M&'#'3%a %a' a%a'a' %a a * 9(/&'& a*a ( a , "&*&'#) a*a a%a'a' *a) ,@# a #' E, #"(f*a@('(# a*a /!( )% %& &*a#Ma%a' "& #%# ' a 5 /(!"# )a: a' "a )!a' "&:a!#

&!(*a:!a3a "&9a!a !) #'P&! a:a'%a' &!a a a' # &a*Ja'3a' "&!#'3 a'a:a' a#! %&'9#'3

39"" rognosis

P!(3'("#" )' )% PH &!) a:;) a: a' # a% a/a #/!& #%"# /a a #a/ #' #@# )-a*a)/)' 3& a*a' a 9&' &!)'3 &'#'3%a . Na )' PH a'3 # a% "&3&!a # #' a% & #*#%#

/!(3'("#" a'3 )!)% %a!&'a a/a &!%& a'3 &' a # %a'%&! /!(" a . M&')!) /&'&*# #a',%a'%&! /!(" a &!)/a%a' %a'%&! /& )'): '( &! 2 /a a /!#a "& &*a: %a'%&! /a!);/a!)5.

PH a'3 &*a: # &!a/# )3a &')' )%%a' &! a3a# &f&% "a /#'3 a'3 9)%)/ &!)3#%a' a3# /&' &!# a.

479( 2emahami dan 2enjelaskan andangan 7slam 2engenai emeriksaan 4a1an=enis

Da*a a a"; a a" &! &' ), a (!# a" )*a a & /&! (*&:%a' &!( a %&/a a *a-a' &'#" #%a "&%#!a' a a'3 "& &'#" # a% a a, &'3a' " a!a # )'33)# (*&: a:!a a a) (!a'3a'3 "& &'#". A*a"a'' a, %a!&'a &!( a :)%) ' a :a' a ")''a: a' &!"#%a/ /a"!a:

a-a%%a* #'#*a# "& a3a# ")a ) %&) a aa' fa *#*a: . U*a a "&/a%a a:a-a /& (*&:a'a'3 #:a!a %a' a*a %&a aa' a!)!a , &! a")% /& (*&:a' &*#:a a)!a (!a'3 *a#',a a

a a"' a a'3 "&9a!a ) ) # &3a"%a' a*a a*; )! a' =.S A* ; a a!a: ? 17+ A*;a' a ?145 A';'a:* ? 115 &'3a' &' a):# %& a*# a' a' *&-a a a".

Da*a /&'3( a a', %& (*&:a' :a' a /a a a3#a' ) ): a'3 "a'3a #/&!*)%a', %a!&'a# ), a3#a' ) ): a'3 *a#' a'3 # a% &!%a# *a'3")'3 & a/ &!*a%) %& &' )a' ) ) # a%

(*&: &*#:a ' a. Na )', )' )% & #'# a*#"#! a a"a' a!)!a a*a /& &!#%"aa' (*&:

*a-a' &'#" "& a3a# )/a a "a a*;D a!# a &') )/ a*a' )' )% &!*a%"a'a' a %& a:a a' ,#"a!a'%a' #"&! a# a:!a a' /!#(!# a" #( a # (*&: a'3 "& &'#".

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S'&**, R#9:a! S. 2006. )natomi -lini" 'nt'" 3a(asiswa -edo"teran/ $disi 6 . Ja%a! a? E C

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