Lecturer of the Faculty of Medicine, Universitas Brawijaya (FKUB) dr. Paksi Satyagraha, M.Kes., Sp.U (K) presented the results of his dissertation, Tuesday (07/16/2024), at the Auditorium on the sixth Floor of A Building, FKUB. Through the research conducted for the Doctoral Program dissertation of the Medical Science Study Program, Biomedical Interest, Paksi was declared to have passed and was entitled to hold a doctoral degree.
He explained his dissertation research entitled “The Effect of Modified Platelet Rich Plasma (mPRP) Administration on Preventing Recurrence of Urethral Stricture in New Zealand Rabbit Models through Changes in the Extracellular Matrix, iNOS and TNF-α Expression”.
Paksi said that urethral stricture or narrowing of the urethral lumen can interfere with the flow of urine from the bladder. This is due to the formation of scar tissue on the urethral wall.
Urethroplasty is the gold standard for the management of urethral stricture with a success rate of 85-95 percent. However, urethroplasty has weaknesses, namely a high level of difficulty, and not all urologists can do it.
Internal Urethrotomy and urethral dilation are still the most frequently chosen procedures for the management of anterior stricture, but this procedure has a high failure rate of 40-60 percent. In addition, the recurrence rate of stricture for this procedure is also high.
To suppress the recurrence rate, there are several adjuvant therapies, including the addition of Mitomycin C (MMC) and Triamcinolone. The combination of Direct Visual Internal Urethrotomy (DVIU) and MMC can prevent scar formation by inhibiting fibroblast proliferation.
Platelet Rich Plasma (PRP) is known to be able to increase the viability and proliferative ability of myoblast cell lines and inhibit TGF-β expression to prevent fibrosis, which in the process will also inhibit the upregulation of inducible nitric oxide (iNOS) and Tumor Necrosis Factor (TNF-α), and inhibit the increase in total collagen.
This study used a laboratory experimental design on male New Zealand rabbits. Modified PRP (mPRP) is made by adding anti-transforming growth factor (TGF-β1 to PRP.
Through this study, it was found that administering mPRP reduces the inflammatory pathway by reducing the number of periluminal inflammatory cells, iNOS and TNF-α. Administration of mPRP can also reduce the extracellular matrix pathway in New Zealand rabbits. And it can inhibit the recurrence of urethral stricture in experimental animals as evidenced by decreasing the length of the stricture and increasing the diameter of the urethral lumen.
Dr. dr. Paksi Satyagraha, M.Kes., Sp.U (K) received his undergraduate and postgraduate education at Padjajaran University, and took a specialist in Urology at Airlangga University. He currently serves as a Lecturer at FKUB and Functional Medical Staff at the Urology Department of dr. Saiful Anwar Malang Hospital. [Irene/ UB PR/ Trans. Iir]
