1.

Apa faktor resiko dari pembesaran prostat (Benign prostatic hyperplasia (BPH)) dan bagaimana pola makan yang baik untuk
mencegah pembesaran prostat (Benign prostatic hyperplasia (BPH))?
Faktor risiko yang dapat meningkatkan batu ginjal terjadi antara lain:
Memiliki seseorang dalam keluarga dengan kasus batu ginjal
Mereka yang berusia 40 tahun keatas, meskipun batu ginjal dapat terjadi pada usia berapapun
Laki-laki lebih cenderung mengalami batu ginjal
Dehidrasi
Makanan tertentu yang tinggi protein, tinggi sodium dan gula dapat meningkatkan risiko beberapa jenis batu ginjal
Obesitas
Memiliki penyakit atau operasi pada saluran pencernaan
Kondisi medis lain, antara lain renal tubular acidosis, cystinuria, hyperparathyroidism dan infeksi saluran urin tertentu
cara pencegahan:
Membatasi atau menghindari produk hewani dan minyak nabati: Beberapa studi telah melihat kaitan antara asupan total daging
dan produk hewani yang tinggi (terutama daging sapi dan produk susu) dengan BPH. The Health Professionals Follow-Up Study
menemukan bahwa konsumsi yang lebih tinggi dalam total protein, protein hewani, asam lemak tak jenuh ganda, dan minyak nabati
semuanya terkait dengan
Asupan produk kedelai: Bukti epidemiologi menunjukkan bahwa pria Asia memiliki risiko lebih rendah terkena penyakit prostat
daripada pria Barat; perbedaannya tampak terkait sebagian dengan asupan tinggi isoflavon yang ditemukan dalam makanan Asia,
khususnya produk kedelai.
Asupan energi yang lebih rendah: Beberapa penelitian telah menunjukkan hubungan antara asupan kalori yang lebih tinggi dengan
risiko yang lebih besar untuk BPH. The Health Professionals Follow-Up Study melaporkan peningkatan 50 persen dalam risiko BPH
pada pria yang mengkonsumsi paling banyak kalori dibandingkan dengan pria yang mengkonsumsi paling sedikit, serta risiko 70
persen lebih tinggi terkena gejala tingkat sedang sampai berat pada pria yang mengkonsumsi paling banyak kalori.
2. What are the risk factors of prostate enlargement and how a good diet to prevent prostate enlargement?
Factors that may increase the risk of kidney stones may include:
Having someone in the family with a case of kidney stones
Those aged 40 years and above, although kidney stones can occur at any age
Men are more prone to kidney stones
Dehydration
Certain foods are high in protein, high in sodium and sugar can increase the risk of some types of kidney stones
Obesity
Have an illness or surgery of the digestive tract
Other medical conditions, such as renal tubular acidosis, cystinuria, hyperparathyroidism and certain urinary tract infections
Prevention:

Limiting or avoiding animal products and vegetable oils: Several studies have looked at the relationship between intake of total
meat and animal products are high (especially beef and dairy products) with BPH. The Health Professionals Follow-Up Study
found that higher intake of total protein, animal protein, polyunsaturated fatty acids, and vegetable oil are all associated with
BPH.
Intake of soy products: Epidemiological evidence suggests that Asian men have a lower risk of prostate disease than Western
men; difference appears to be associated in part with a high intake of isoflavones that are found in Asian foods, especially soy
products.
lower energy intake: Some studies have shown an association between higher calorie intake to a greater risk for BPH. The
Health Professionals Follow-Up Study reported a 50 percent increase in the risk of BPH in men who consumed the most calories
compared with men who ate the least, as well as 70 percent higher risk of developing moderate to severe symptoms in men who
consumed the most calories.
3. Mengapa pria cenderung lebih sering mengalami batu ginjal ?
Penyakit batu ginjal merupakan salah satu penyakit paling sering ditemui dan dialami oleh banyak masyarakat indonesia yang umumnya
dialami pria. Pada umumnya penyakit ginjal disebabkan oleh rutinitas pekerjaan yang membuat pola makan menjadi tidak teratur, adanya
faktor keturunan yang juga memiliki peranan penting karena jika terdapat keluarga yang memiliki penyakit ginjal, resiko diturunkan
penyakit ginjal pada anak 6 kali lebih besar, kurangnya konsumsi air putih, jarang buang air kecil atau sering ditahan, banyak
mengkonsumsi makanan atau minuman yang mengandung bahan kimia, bahan pengawet dan lingkungan suhu udara disekitar tempat tinggal
dan tempat bekerja yang tidak mendukung aktivitas sehari-hari.
Penyakit batu ginjal memang banyak melanda orang Asia dan Afrika khusuusnya Indonesia yang diliputi berbagai macam kultur, suhu udara
yang cenderung sering kali berubah tidak menentu, pola hidup dan gaya hidup yang terkadang salah, dsb. Penyakit ginjal memang lebih
dominan menyerang kaum pria dibanding wanita, hal in terbukti dari survei yang diperkirakan bahwa pria yang berusia 70 tahun keatas
memiliki resiko lebih besar terserang penyakit ginjal hingga 80% dibanding wanita.
2. Why men are more prone to kidney stones?
Kidney stone disease is one of the diseases most frequently encountered and experienced by many Indonesian people are
generally experienced by men. In general, kidney disease caused by routine work that makes eating patterns become irregular,
the hereditary factors that also have an important role because if there is a family who have kidney disease, reduced risk of
kidney disease in children 6 times greater, the lack of water consumption, rarely frequent urination or detained, many foods or
beverages that contain chemicals, preservatives and temperature environment around the residence and place of work which does
not support the day-to-day activities.
Kidney stone disease is a lot of Asians and Africans struck khusuusnya Indonesia that covered a wide range of cultures,
temperatures tend to change often uncertain, and lifestyle patterns that are sometimes wrong, and so on. Kidney disease is more
dominant than the men attacking women, it in evident from the survey that estimated that men aged 70 years and older who have
a higher risk of kidney disease by 80% compared to women

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kelompok 7
1. dimanakah letak pembesaran prostat pada kasus tersebut?
biasanya terjadi pembesaran pada prostat bagian proximal yang dekat dengan spincter externa

2. adakah hubungan antara pembesaran prostat dengan susah kencing karena batu ginjal?
keduanya mengakibatkan susah kencing, tetapi untuk hipertropi prostat biasanya karena faktor usia.
gejalanya adalah merasa tidak puas saat kencing . Orang dengan keadaan seperti ini akan sulit untuk memulai kencing, nyeri saat
berkemih, tidak lancar berkemih, kesulitan mengosongkan kandung kemih.

sedangkan pada batu ginjal, gejalanya yaitu
- Buang air kecil yang semakin sering terjadi
- Nyeri di bagian pinggang
- Terkadang disertai demam dan kejang
- Air seni berwarna kuning keruh
- Adanya riwayat batu ginjal yang sebelumnya di derita oleh salah satu anggota keluarga

1. where is the location of prostate enlargement in these cases?
Prostate enlargement usually occurs in the proximal part near spincter externa

2. is there a relationship between an enlarged prostate with difficulty urinating due to kidney stones?
both resulting in difficulty urinating, but for prostate hypertrophy usually due to age factor.
the symptoms is not satisfied when urinating. People with this condition will be difficult to start urination, pain during urination,
not smooth urination, difficulty emptying the bladder.

whereas in kidney stones, the symptoms are
- Urinate are becoming more frequent
- Pain at the waist
- Sometimes accompanied by fever and spasms
- Urine turbid yellow
- A history of kidney stones in the family

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What causes urinary retention?
Urinary retention can be caused by an obstruction in the urinary tract or by nerve problems that interfere with signals between the brain and
the bladder. If the nerves aren't working properly, the brain may not get the message that the bladder is full. Even if you know that your
bladder is full, the bladder muscle that squeezes urine out may not get the signal that it is time to push, or the sphincter muscles may not get
the signal that it is time to relax. A weak bladder muscle can also cause retention.

Prostate Enlargement: Benign Prostatic Hyperplasia
As a man ages, his prostate gland may enlarge. Doctors call the condition benign prostatic hyperplasia (BPH), or benign prostatic
hypertrophy.
As the prostate enlarges, the layer of tissue surrounding it stops it from expanding, causing the gland to press against the urethra like a clamp
on a garden hose. As a result, the bladder wall becomes thicker and irritable. The bladder begins to contract even when it contains small
amounts of urine, causing more frequent urination. Eventually, the bladder weakens and loses the ability to empty itself, so urine remains in
the bladder.

Enlarged Prostate: Causes
One theory regarding the origin of an enlarged prostate involves the presence of a hormone called dihydrotestosterone (DHT) in the blood.
DHT is a natural hormone that is responsible for the initial stages of prostate growth. As men age, DHT may cause the prostate to continue
growing after it has reached full size. Studies have shown a high positive correlation between DHT levels and enlarged prostate. Physicians
have noted that men who do not produce DHT do not experience an enlarged prostate. Research has also shown evidence that estrogen and
genetics may play roles in BPH as well.

The role of estrogen can be explained by changing levels of testosterone. It is known that men produce testosterone and a small amount of
estrogen throughout their lives; with aging, the amount of testosterone in the blood decreases, which leaves a larger proportion of estrogen.
Studies have shown that higher levels of estrogen have been found in men who have enlarged prostate glands. Many physicians believe that
genetics play a role as well. Men with a family history of enlarged prostate may be at greater risk than others.

It is important to note that the actual size of the prostate does not necessarily denote the severity of the symptoms. Constriction of the urethra
by the prostate may occur in small as well as large glands. It is important to establish the presence of obstruction by clinical testing when
considering treatments for symptoms.

the size of the prostate gland does not necessarily predict the severity of the enlarged prostate symptoms. A large gland may not cause any
obstruction, and a small gland may cause a lot. However, it is known that very large prostate glands almost always cause significant
problems.
The portion of the prostate gland that is enlarged can be very significant; for example, enlargement involving the median lobe is more likely
to be associated with more severe symptoms. In the case of prostates, just as in real estate, location matters most.
Enlarged prostate is frequently associated with increased tone in the smooth muscle of the urethra, and many of the irritative symptoms
associated with enlarged prostate are due to this increased muscle tone and the resulting interference with urine flow.

Infection
Infections cause swelling and irritation, or inflammation. A urinary tract infection (UTI) may cause retention if the urethra becomes
inflamed and swells shut.

What are the complications of urinary retention?
-Urinary Tract Infection
Urine is normally sterile, and the normal flow of urine usually prevents bacteria from growing in the urinary tract. When urine stays in the
bladder, however, bacteria have a chance to grow and infect the urinary tract.
Bladder Damage
If the bladder becomes stretched too far or for long periods, the muscle may be permanently damaged and lose its ability to contract.
Chronic Kidney Disease
If urine backs up into the kidneys, permanent kidney damage can lead to reduced kidney function and chronic kidney disease. If you lose too
much of your kidney function, you will need dialysis or a kidney transplant to stay alive.

Cause of urinarr retention
cause men women both
Obstructive Benign prostatic hyperplasia;
meatal stenosis; paraphimosis;
penile constricting bands;
phimosis; prostate cancer
Organ prolapse (cystocele,
rectocele, uterine prolapse);
pelvic mass (gynecologic
malignancy, uterine fibroid,
ovarian cyst); retroverted
impacted gravid uterus
Aneurysmal dilation; bladder
calculi; bladder neoplasm; fecal
impaction; gastrointestinal or
retroperitoneal
malignancy/mass; urethral
strictures, foreign bodies, stones,
edema
Infectious and inflammatory Balanitis; prostatic abscess;
prostatitis
Acute vulvovaginitis; vaginal
lichen planus; vaginal lichen
sclerosis; vaginal pemphigus
Bilharziasis; cystitis;
echinococcosis; Guillain-Barr
syndrome; herpes simplex virus;
Lyme disease; periurethral
abscess; transverses myelitis;
tubercular cystitis; urethritis;
varicella-zoster virus
other Penile trauma, fracture, or
laceration
Postpartum complication;
urethral sphincter dysfunction
(Fowler's syndrome)
Disruption of posterior urethra
and bladder neck in pelvic
trauma; postoperative
complication; psychogenic

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1. Apakah terlalu sering duduk bisa menyebabkan batu ginjal?
Kemungkinan disebabkan karena statisnya urin ataupun akibat terlalu pekatnya urin. Akibatnya, urin yang pekat sekaligus
statis/tetap alias tidak bergerak menyebabkan urin tersebut mudah mengendap menjadi batu. Walaupun secara pasti tidak diketahui
penyebab batu ginjal, kemungkinannya adalah bila urine menjadi terlalu pekat dan zat-zat yang ada di dalam urine membentuk
kristal batu. Penyebab lain adalah infeksi, adanya obstruksi, kelebihan sekresi hormon paratiroid, asidosis pada tubulus ginjal,
peningkatan kadar asam urat (biasanya bersamaan dengan radang persendian), kerusakan metabolisme dari beberapa jenis bahan di
dalam tubuh, terlalu banyak mempergunakan vitamin D atau terlalu banyak memakan kalsium.
1. Is too much sitting can cause kidney stones?
Likely due to its static result of too concentrated urine. As a result, urine is concentrated as well as static / fixed easily cause the
urine settles into stone. Although the exact cause of kidney stones is unknown, it may be that when the urine becomes too
concentrated and substances in the urine to form crystals in the rock. Other causes are infection, obstruction, excess secretion of
parathyroid hormone, renal tubular acidosis, increased levels of uric acid (usually in conjunction with arthritis), metabolic damage
of some kind of substance in the body, too much use of vitamin D or calcium consuming too much .
2. Apa penyebab pembentukan batu pelvis renalis?
Berdasarkan komposisi dari batu tersebut mengandung unsur: kalsium oksalat, kalsium fosfat, asam urat, magnesium-
amonium-fosfat (MAP), xanthyn dan sistin. Jadi segala sesuatu yang dapat menyebabkan konsentrasi substrat tersebut
bertambah banyak dapat menyebabkan terbentuknya batu pada saluran kencing.
Kurangnya zat penghambat pembentuk kristal seperti magnesium, sitrat, pirofosfat, mukoprotein dan beberapa peptida.
Banyak mengonsumsi vit c dan d. Karena vit c banyak mengandung kalsium oksalat yang tinggi, dan vit d dosis tinggi dapat
menyebabkan absorbs kalsium ke dalam usus meningkat.
Mengonsumsi makanan dan minuman yang kurang bersih menyebabkan air seni lebih pekat dan gelap sehingga
menyebabkan infeksi atau kristal batu.
2. What causes the formation of renal pelvis stones?
Based on the composition of the rock containing the elements: calcium oxalate, calcium phosphate, uric acid, magnesium-
ammonium-phosphate (MAP), xanthyn and cystine. So anything that can lead to increased concentrations of the substrate
can lead to the formation of many stones in the urinary tract.
Lack of crystal-forming inhibitors such as magnesium, citrate, pyrophosphate, mukoprotein and some peptides.
Many of taking vit c and d. Because it contains a lot of vitamin c calcium oxalate is high, and high doses of vitamin D can
cause calcium into the intestine absorbs increased.
Eating foods and drinks that are less clean cause urine more concentrated and darker causing infection or crystal stones.

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1. What are symptoms of BPH (Benign Prostatic Hyperplasia)?
Answer : Enlarged Prostate will clamp the urethra in it, so it doesnt flow smoothly into the urine, enlarged prostate also
pointing up, so that it will interfere with the process of emptying the bladder. BPH occurs gradually because not all patients
experience symptoms, patients complaints generally are :
Weak urinary stream
Prolonged emptying of the bladder
Abdominal straining
Irritation during urination
Frequent urination
Nocturia (need to urinate during the night)
Bladder pain
Dysuria (painful urination)
Problems in ejaculation


# Gejala-Gejala BPH (benign prostatic hyperplasia)?
Jawaban : Pembesaran Prostat akan menjepit uretra di dalamnya, sehingga does'nt mengalir lancar ke dalam urin, pembesaran
prostat juga mengarah ke atas, sehingga akan mengganggu proses pengosongan kandung kemih. BPH terjadi secara bertahap
karena tidak semua pasien mengalami gejala, pasien keluhan umumnya:
Pancaran kencing lemah
Pengosongan kandung kemih yang berkepanjangan
perut mengejan
Iritasi saat buang air kecil
Sering buang air kecil
Nokturia (perlu buang air kecil pada malam hari)
nyeri kandung kemih
Disuria (nyeri buang air kecil)
Permasalahan dalam ejakulasi

2. slide 59 Histology of Kidney on Proximal Convoluted Tubules.
In proximal convoluted tubule are differentiated into several segments on kidney because the cells have an irregular
luminal surface due to the presence of a brush border and glycocalyx. So, wahat is the function of brush border in
proximal convoluted tubules and what is the glycocalyx?
Answer :
a. On the apical proximal convoluted tubules cell has a brush border of microvilli for absorbing into the small cell molecules
from the filtrate in the tubular lumen. Microvilli help to Increased cell membrane surface through the sodium pump (transport of
ions)

b. Glycocalyx is located on the apical surface of cells which line the lumen. In proximal convoluted tubule surrounded by
glycocalyx. Glycocalyx serves to protect the bacterium on the proximal convoluted tubule from harmful phagocytes by creating
capsules or allowing the bacterium to attach itself to inert surfaces.

#Pada tubulus kontortus proximal memiliki sel yang berbeda dari beberapa segmen lain pada ginjal karena memiliki permukaan
lumen yang tidak beraturan yang berhubungan dengan adanya brush border dan glycocalyx. Apa fungsi dari brush border pada
tubulus proximal dan apa glycocalyx?
Jawaban :
a. Pada sel apikal tubulus proksimal memiliki brush border mikrovili untuk menyerap molekul sel kecil dari filtrasi urin yang
masih digunakan tubuh ke dalam lumen tubulus. Mikrovili membantu Peningkatan permukaan membran sel melalui pompa
natrium (transportasi ion)
b. Glycocalyx terletak pada permukaan apikal sel yang melapisi lumen. Dalam tubulus proksimal dikelilingi oleh glycocalyx.
Glycocalyx berfungsi untuk melindungi bakteri pada tubulus proksimal dari fagosit berbahaya dengan menciptakan kapsul atau
memungkinkan bakteri untuk menempelkan dirinya sendiri ke permukaan inert.
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1. Why does the older a man get the higher he has possibility to get bpn (benign prostate hyperplasia) ?
Answer : there're no scientist that sure what is actually the cause of bpn. But, some scientist prove that the older a man get, the
more DHT hormone he'll produce and scientist said when we're older, then our body will be more sensitive to DHT hormone
that's why bpn occure

2. There's a rumour saying that if someone have more sex, then his prostate is bigger? Is that true and why?
Answer: i don't know about that, what i know for sure is when someone have a bpn then they'll have a sexual problem. May be
one of our tutor can help us to find the answer