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Safendra Siregar,1 Jupiter Sibarani,1 Bambang Sasongko Noegroho,1 Irfan Firmansyah,1 Ani Melani Maskoen2 1Department of Urology, Faculty of Medicine Universitas Padjadjaran, General Hospital Hasan Sadikin Bandung, Indonesia; 2Department of Molecular Genetic Laboratory Universitas Padjadjaran, Bandung City, West Java Province, IndonesiaCorrespondence: Safendra Siregar; Bambang Sasongko NoegrohoDepartment of Urology, Faculty of Medicine Universitas Padjadjaran, General Hospital Hasan Sadikin, Jl. Pasteur No. 38, Bandung, IndonesiaTel +62811227180; +62811215058Email safendra.sir@yahoo.co.id; basanoe@yahoo.comIntroduction: The prevalence of hypospadias ranges between 1: 250 to 300 per live birth. Estrogen exposure has been associated with the increasing incidence of hypospadias in humans and a significant relationship between Estrogen Receptor 1 (ESR1) polymorphisms and hypospadias was determined from the previous study. This study aims to determine the proportion of ESR1 polymorphism.Methods: This was a descriptive study aimed to find the incidence of ESR1 gene polymorphism in hypospadias patients visiting the Urology Outpatient Unit of the Hasan Sadikin Bandung Hospital who will undergo hypospadias surgery. Deoxyribonucleic acid (DNA) was performed using foreskin of hypospadias patient during the surgery then being extracted and will be analyzed using polymerase chain reaction (PCR) sequencing.Results: Thirty eight samples of hypospadias were identified, 5 samples were unable to sequence and 33 samples were successfully sequenced using the PCR method. The Pvull ESR1 gene was dominated by the T allele which is a wild-type allele and the genotype containing the T allele, namely TT + TC (57,2%). Normal genotype (TT) were more frequent in distal hypospadias, and Heterozygous polymorphisms (TC) was higher in proximal hypospadias. The ESR1 Xba1 gene polymorphism was dominated by the A allele which is a wild-type allele and the AA + AG genotype (76,1%). Normal genotype (AA) was more frequent in distal hypospadias, and both heterozygous hypospadias (AG) and homozygous hypospadias (GG) were found only in proximal hypospadias. The ESR1 SNP 12 gene polymorphisms were found in the combination of genotypes that played a role, namely GA + AA (81%) and the G allele which is a wild-type allele. Heterozygous polymorphisms (GA) was the most finding genotype and more frequent in proximal hypospadias.Conclusion: ESR1 gene polymorphisms (PvuII, XbaI, and SNP 12) were found in hypospadias patients. ESR1 polymorphisms may correlate with the severity of hypospadias. Further research with a larger sample and better hypospadias grouping is needed to confirm.Keywords: estrogen receptor 1, hypospadias, polymorphism

Safendra Siregar, Ricky Adriansjah, Jupiter Sibarani, Akhmad Mustafa Department of Urology, Faculty of Medicine, Universitas Padjadjaran, General Hospital Hasan Sadikin, Bandung, IndonesiaCorrespondence: Safendra SiregarDepartment of Urology, Faculty of Medicine, Universitas Padjadjaran, General Hospital Hasan Sadikin Bandung, 16 Jalan Makmur, Bandung, IndonesiaTel +62 811 227 180Email safendra.sir@yahoo.co.idAkhmad MustafaDepartment of Urology, Faculty of Medicine, Universitas Padjadjaran, General Hospital Hasan Sadikin Bandung, 28A Jalan Cikutra Baru Raya, Bandung 40124, IndonesiaTel +62 811 232 827Email mustafa.urologi@gmail.comIntroduction: The ischemic process in priapism can lead to displacement of normal tissue with fibrotic tissue, due to collagen deposition, and eventually leads to erectile dysfunction. Many studies have identified that the supernatant of adipose tissue–derived stem cells (ADSCs) significantly ameliorates fibrosis of different tissue, but limited attention has been paid to its efficacy on fibrosis of the corpora cavernosa.Methods: A total of 22 Wistar rats divided into five groups, with two groups each consisting of five male wistar rats with priapism without human ADSC (hADSC) therapy (group I) and two other groups consisting of five rats with priapism, were given 10 6 cells’ intracorporeal hADSC injection after 12 hours of penile clamping (group II) were euthanized after 2 and 4 weeks of observation. The last group consisted of two rats without any treatment or model (group III). Following euthanasia, penises were harvested for TGFβ 1 and collagen type I measurement using ELISA. Statistical analysis using independent-sample t-tests was done with SPSS 21.0.Results: Penile TGFβ 1 concentration in the treatment group was significantly lower in the second and fourth weeks of observation (p 2=0.004, p 4=0.003), and collagen type I was significantly lower in the second and fourth weeks (p 2=0.003, p 4=0.011).Conclusion: Intracorporeal hADSC injection limited the fibrosis process in a priapism model. Although the mechanism was unclear, it may be related to the potential of hADSCs to produce various growth factors that could limit TGFβ 1 and collagen production.Keywords: human adipose–derived stem cell, collagen type I, priapism, TGFβ 1

Safendra Siregar,1 Aga Parardya,1 Jupiter Sibarani,1 Tjahjodjati Romdan,1 Kuncoro Adi,1 Bethy S Hernowo,2 Anglita Yantisetiasti2 1Department of Urology, 2Department of Pathological Anatomy, Hasan Sadikin Hospital, Faculty of Medicine University of Padjadjaran, Bandung, Indonesia Background: Urethral stricture has a high recurrence rate. There is a common doctrine stating that “once a stricture, always a stricture”. This fibrotic disease pathophysiology, pathologically characterized by excessive production, deposition and contraction of extracellular matrix is unknown. Angiotensin II type 1 (AT1) receptor primarily induces angiogenesis, cellular proliferation and inflammatory responses. AT1 receptors are also expressed in the fibroblasts of hypertrophic scars, whereas angiotensin II (AngII) regulates DNA synthesis in hypertrophic scar fibroblasts through a negative cross talk between AT1 and angiotensin II type 2 (AT2) receptors, which might contribute to the formation and maturation of human hypertrophic scars.Objective: This study was conducted to determine the expression of AT1 receptors in urethral stricture tissues.Methods: Urethral stricture tissues were collected from patients during anastomotic urethroplasty surgery. There were 24 tissue samples collected in this study with 2 samples of normal urethra for the control group. Immunohistochemistry study was performed to detect the presence of AT1 receptor expression. Data were analyzed using Mann–Whitney U test, and statistical analysis was performed with SPSS version 20.Results: This study showed that positive staining of AT1 receptor was found in all urethral stricture tissues (n=24). A total of 8.33% patients had low intensity, 41.67% had moderate intensity and 50% had high intensity of AT1 receptors, while in the control group, 100% patients had no intensity of AT1 receptors. Using the Mann–Whitney U test, it was found that urethral stricture tissue had a higher intensity of AT1 receptors than normal urethral tissue with a p-value = 0.012.Conclusion: The results showed that AT1 receptor had a higher intensity in the urethral stricture tissue and that AT1 receptor may play an important role in the development of urethral stricture. Keywords: angiotensin, AT1 receptor, urethral stricture