Brawijaya Journal of Urology

Can Yoga-Based Therapy Improve Urinary Incontinence in Women? A Systematic Review and Meta-Analysis

2025-10-03T11:47:26+07:00

Introduction. Urinary incontinence (UI) is the involuntary leakage of urine, significantly impacting quality of life, including contributing to depression, sexual dysfunction, and substantial medical, psychosocial, and economic

burdens. Aims to evaluate the effectiveness of yoga-based therapy as a treatment intervention for urinary incontinence in women.

Methods. This systematic review followed the PRISMA 2020 guidelines using the PICO framework (population: women with UI; intervention: yoga therapy; control: standard care; outcomes: UI frequency, symptom severity [ICIQ-UI-SF], quality of life [IIQ/UDI-6], and adverse effects). A comprehensive search was conducted in PubMed, ProQuest, Scopus, Cochrane Library, Web of Science, and Google Scholar up to April 1, 2025, using keywords related to yoga and UI. Risk of bias was assessed using Cochrane RoB2, and statistical analysis was performed using R 4.4.3.

Results. Out of 1,926 screened articles, 5 RCTs met the inclusion criteria. Results indicated a significant reduction in symptom severity (ICIQ-SF; MD: -5.6748; 95% CI: -14.3359 to 2.9862; p=0.1991) and improved quality of life (IIQ: MD -1.4795; 95% CI: -18.3035 to 15.3446; UDI-6: MD 3.3937; 95% CI: 0.2439 to 6.5435), despite high heterogeneity (I²=50.6–97.8%). UI frequency did not show significant improvement (MD 0.7413; 95% CI: 0.0948 to 1.3877; p=0.0246). No serious adverse effects were reported.

Conclusion. Yoga is effective in reducing symptom severity and improving quality of life in women with UI but does not significantly decrease UI frequency. These findings support the consideration of yoga as an adjunct therapy in UI management.

Keywords: efficacy, urinary incontinence, woman, yoga

MicroRNA As Prognostic And Diagnostic Biomarker In Upper Tract Urothelial Carcinoma: A Systematic Review and Meta-Analysis

2025-09-02T10:29:46+07:00

Introduction. Upper tract urothelial carcinoma (UTUC) is a relatively rare but aggressive form of cancer that affects the urinary system. Early detection and accurate prognosis are critical for improving patient outcomes. Recent studies suggest that microRNAs, small non-coding RNA molecules, may serve as potential biomarkers for various cancers, including UTUC. This systematic review and meta-analysis aim to evaluate the effectiveness of microRNAs as prognostic and diagnostic tools in UTUC.

Methods. We searched PubMed and EuropePMC for studies published until December 2024 and performed a meta-analysis using RevMan 5.4 and MetaDisc.

Results. The review included a total of 6 studies, encompassing data from over 300 sample patients. Our analysis confirmed that specific microRNAs are significantly associated with both the presence and progression of UTUC. MicroRNAs demonstrated significant prognostic outcomes, such as progression-free survival (3.72; 95% CI: 2.46-5.62; p < 0.00001) and cancer-specific survival (3.46; 95% CI: 1.68-7.15; p = 0.0008). These biomarkers showed high sensitivity (0.75; 95% CI: 0.72-0.78; p = 0.0000) and specificity (0.82; 95% CI: 0.79-0.85; p = 0.0000), with the following diagnostic indices Positive Likelihood Ratio (PLR) (4.45, 95% CI: 3.22-6.14), Negative Likelihood Ratio (NLR) (0.31, 95% CI: 0.24-0.39), Diagnostic Odds Ratio (DOR) (18.04, 95% CI: 10.46-31.14), and Area Under Curve (AUC) 0.86 in the diagnosis of UTUC. Subgroup analysis of diagnostic studies based on countries revealed higher results in Asian countries. MicroRNAs showed significant associations with UTUC progression and survival, with high diagnostic accuracy (AUC 0.86).

Conclusion. MicroRNA could be used as potential diagnostic and prognostic biomarkers in UTUC.

Keywords: biomarker, diagnostic, microRNA, prognostic, upper tract urothelial carcinoma

Impact of Smoke Exposure on Kidney Stone Formation: A Systematic Review

2025-10-21T09:14:55+07:00

Introduction. Nephrolithiasis, or kidney stone disease (KSD), involves crystal formation in the kidneys and may increase the risk of end-stage renal failure. More than 1 in 5 of the Indonesian population identifies as smokers. Smoking is known to be the culprit of multisystem disease and conditions. In the urologic field, smoking is thought to increase the risk of nephrolithasis; nonetheless, this association has not yet been extensively studied. This study aims to assess the association between smoking and nephrolithiasis.

Methods. A systematic search was conducted in PubMed, Cochrane, Scopus, and ResearchGate (October 10–12, 2024), including systematic reviews, meta-analyses, cohort, case-control, and cross-sectional studies. Studies found were then underwent quantitative analysis using RevMan version 5.4.

Results. Seven studies showed a significant association between smoking and nephrolithiasis; two found no link. Quantitative analysis from five studies showed that smoking exposure was associated with a significantly increased risk of nephrolithiasis (OR 2.36, 95% CI 1.18–4.73, p = 0,02, I2 = 98%).

Conclusion. Smoke exposure is significantly linked to increased risk of nephrolithiasis.

Keywords: kidney stones, nephrolithiasis, smoke, smoking

The Profile of Urinary Tract Stone Patients and Challenges in Eastern Region of West Nusa Tenggara

2025-10-21T13:46:06+07:00

Introduction. Indonesia is among the most populated countries inside the stone belt region. Evaluation and management of urinary tract stones (UTS) may be influenced by several constraints. This study aims to describe characteristics of UTS patients and associated challenges in the eastern part of West Nusa Tenggara Province.

Methods. A retrospective cross-sectional study was conducted at Bima Regional General Hospital. We included 235 UTS patients who underwent ultrasonographic (USG) and had complete medical records from January 2022 until June 2024.

Results. UTS patients were more common in males—158 patients (67.2%), the age group of 46–60 years (34.5%), and kidney stone (KS) cases (72.8%). The majority of stone sizes were <5 mm in 123 patients (52.3%), followed by >20 mm in 52 patients (22.1%). There were only 9 patients (3.8%) who were referred. There were 42 (17.8%) hydronephrosis patients, which has a significant relationship with the location of the stone (p<0.001). There were 18 patients (7.7%) who experienced chronic kidney disease (CKD), and 48 of 140 adult males (34.3%) had benign prostate hyperplasia (BPH), which has a significant relationship with age (p<0.001).

Conclusion. Most of UTS patients were males in the age range of 46–60 years, predominantly with KS cases, and only a few patients referred. The presence of related diseases such as hydronephrosis, CKD, and BPH added complexities. Several constraints also made management of UTS more challenging. It is crucial to improve facilities, provide health education, and fulfill the needs of urologists in certain regions for better UTS management.

Keywords: challenges, Indonesia, urologist, urinary tract stone

Patient Profile and Treatment Selection in Urolithiasis in Tertiary Hospital: A Retrospective Analysis

2025-11-01T01:43:15+07:00

Introduction. Urolithiasis remains a prevalent urological disorder, often leading to significant morbidity, burden and a high rate of recurrence . Multiple factors, including age, sex, stone location, imaging characteristics, urinalysis parameters, and urine culture findings, could play crucial roles in guiding therapeutic decisions. This study aims to analyze the relationships between urine pH, urine culture results, stone location and the selection of surgical interventions and stone compositions in patients diagnosed with urinary stones at Dr. Saiful Anwar General Hospital, Malang.

Methods. This retrospective study utilized medical records of patients diagnosed with urolithiasis in Dr. Saiful Anwar General Hospital between 2018 and 2024. The collected data included age, sex, stone location (renal, ureteral, vesical), stone image in NCCT, urinalysis parameters (pH, erythrocyte), urine culture results, stone composition, and surgical intervention. Descriptive analysis was conducted to characterize patient demographics and clinical profiles, while further statistical evaluation was performed to assess relationship between factors that determined stone composition and treatment selection using Chi Square or Fischer’s Exact Test.

Results. A total of 343 patients with urolithiasis met the inclusion criteria, among them, 71.1% were male with mean age of 52.75 ± 17.18 years, and 88.95% presented hematuria. The most common stone composition was mixed calcium and MAP (33.8%), most frequently presenting at multiple locations (45.1%). 311 patients had endourological procedures, PCNL (61.5%) as the management of choice. However, open surgery has been done in 22 (6.41%) patients with open surgery, most of whom have various locations of urolithiasis (59.0%). The results showed a significant relationship between stone location and treatment options (p < 0.001). In addition, there was a significant relationship between pH, urine culture and stone composition (p = 0.018; 0.034).

Conclusion. This study highlights that stone locations serve as valuable indicators in determining treatment strategies for urolithiasis patients. In addition, pH and urine culture serve as valuable indicators in determining stone composition. Further analysis is warranted to explore causal relationships between these factors and refine predictive models for personalized stone management.

Keywords: stone composition, treatment, urinary stone disease, urolithiasis