Hubungan Intravesical Prostatic Protrusion (IPP) terhadap Perubahan International Prostate Symptoms Score (IPSS) pada Pasien Benign Prostatic Hyperplasia (BPH) yang Diterapi dengan Α1- Blocker di Kota Padang

Abstract

Background. Benign prostatic hyperplasia (BPH) is a benign enlargement of the prostate gland caused by the proliferation of epithelial cells and stroma, causing Lower Urinary Tract Symptoms (LUTS). One ways to treat BPH is through medical therapy with α1-blockers. The success of medical therapy is influenced by many factors, one of which is Intravesical Prostatic Protrusion (IPP).

Method. This study was a comparative prospective study that aimed to find the effect of IPP on response to therapy with α1-blockers in BPH patients. IPSS was used as a measuring tool. IPP was examined using transabdominal ultrasound. The study was conducted from July 2020 to December 2020. Data were analyzed using the one way ANOVA average comparison test and Pearson correlation test.

Results. A sample of 30 patients was divided into 3 groups based on the IPP degree, namely grade I (<5mm), grade II (5-10mm) and grade III (> 10mm). There were no significant differences in the mean initial IPSS scores in each group, namely 19.6, 18.90, and 21.30 (p = 0.216). There was a significant decrease in mean IPSS after 1 month of α1-blocker therapy. In addition, there was also found a significant correlation between the IPP value and the decrease in the final IPSS with a negative correlation.

Conclusion. There is a significant correlation between the IPP degree and the decrease in IPSS in BPH patients after receiving α1-blocker therapy as the higher the IPP degree, the lower the final IPSS improvement.

Latar Belakang. Benign Prostatic Hyperplasia (BPH) merupakan pembesaran jinak kelenjar prostat akibat proliferasi sel epitel dan stroma sehingga menimbulkan gejala Lower Urinary Tract Symptoms (LUTS). Salah satu penanganan BPH adalah terapi medikamentosa dengan α1-blocker. Keberhasilan terapi medikamentosa dipengaruhi banyak faktor salah satunya adalah Intravesical Prostatic Protrusion (IPP).

Metode. Penelitian prospektif komparatif yang bertujuan untuk mencari pengaruh IPP terhadap respon terapi α1-blocker  pada pasien BPH. IPSS dipakai sebagai alat ukur tersebut. IPP diperiksa dengan menggunakan USG transabdominal. Penelitian dilakukan dari Juli 2020 sampai Desember 2020. Data dianalisis dengan uji perbandingan rata-rata one way anova dan uji korelasi Pearson.

Hasil. Dari sampel 30 orang, pasien dibagi menjadi 3 kelompok berdasarkan derajat IPP yaitu, derajat I (<5mm), derajat II (5-10mm) dan derajat III (>10mm). Tidak terdapat perbedaan bermakna skor rata-rata IPSS awal pada masing – masing kelompok, yaitu 19.6, 18.90, dan 21,30 (p=0.216). Terdapat penurunan bermakna rata-rata IPSS setalah 1 bulan terapi dengan α1-blocker. Terdapat korelasi yang bermakna nilai IPP terhadap penurunan IPSS akhir dengan arah korelasi negatif.

Kesimpulan. Terdapat hubungan bermakna antara derajat IPP terhadap penurunan IPSS pada pasien BPH setelah mendapatkan terapi α1-blocker, semakin tinggi derajat IPP maka semakin rendah perbaikan IPSS akhir.