Table Of Content

Clinical Pathway 10 Penyakit Urologi Tersering IKATAN AHLI UROLOGI INDONESIA Introduction Pedoman pelayanan standar berdasar  tingkat pelayanan kesehatan Clinical Pathway  Form Checklist Clinical Pathway  Top 10 Most Common Disease in Urology  1. BPH 2. Batu (batu ginjal, batu ureter, batu uretra, batu buli)  3. Trauma (trauma ginjal, trauma ureter, trauma uretra, trauma buli)  4. Ca Prostat  5. Ca Testis  6. Ca Ginjal  7. Ca Buli  8. Kongenital Anomali Urogenital  9. Inkontinensia Urine  10. Obstruksi dan Infeksi  REFERENCES IAUI Guidelines  EAU Guidelines  NCCN Guidelines  AUA Guidelines  Campbell Text Book of Urology 10 th Edition  Clinical Pathways RS Soetomo, RS Hasan  Sadikin, & RS Cipto Mangunkusumo BPH (Benign Prostate Hyperplasia) Pembesaran Prostat Jinak BPH (BENIGN PROSTATE HYPERPLASIA/ PEMBESARAN PROSTAT JINAK) : TANPA OPERASI PEMBESARAN PROSTAT JINAK (BPH) TANPA OPERASI JenisAktivitas Rawat Jalan Rawat Jalan Rawat Jalan Tindakan Hari 1 Hari 2 Hari 3 Penilaian Awal Anamnesis, pemeriksaanfisik, tanda vital, Tanda vital Tandavital rectal toucher Pemeriksaan Lab: DPL (Hb/Leu/Ht/Plt), Urinalisis + BNO-IVP - Kultur urine, PT/INR/APTT, BT/CT, Uroflowmetri, Urodinamik Alb/Prot total, Asam Urat, Cl/Na/K, Ur/Cr, USG Ginjal-Buli, Prostat Transabdominal PSA total danTransrektal, EKG/Thorax PA Biopsi prostat bila PSA > 4 Treatment Dokter umumboleh memberikan Dokter umumboleh memberikan Penentuantindakan terhadap BPH medication pelayananatau mengobati BPH, Edukasi, pelayananatau mengobati BPH, Edukasi, α-blocker dan 5α-reduktase inhibitor bila pasang kateter atau pungsi suprapubis pasang kateter atau pungsi suprapubis volume prostat >40ml. Lepaskateter, biopsi (bila retensi), α-blocker, antibiotik (bila retensi), α-blocker, antibiotik prostat, edukasi Diet Edukasi cukup minumair mineral, Edukasi cukup minumair mineral, Edukasi cukup minumair mineral, makanantinggi serat, makananrendah makanantinggi serat, makananrendah makanantinggi serat, makananrendah garam, rendah protein, hindarikopi dan garam, rendah protein, hindarikopi dan garam, rendah protein, hindarikopi dan makananpedas makananpedas makananpedas Penyuluhan Kurangiobesitas, hindaristres, olah raga Kurangiobesitas, hindaristres, olah raga Kurangiobesitas, hindaristres, olah raga Rujuk/konsultasi Outcome LUTS berkurang, BAK spontan Rencanaperawatan Rawat jalan Rawat jalan Rawat jalan PEMBESARAN PROSTAT JINAK (BPH) TANPA OPERASI JenisAktivitas Perawatan Perawatan Perawatan Tindakan (Rawat Jalan) (Rawat Jalan) (Rawat Jalan) Bulan 1 Bulan 3 Bulan 6 – 12 Penilaian Awal Tandavital Tandavital, evaluasi hasil pemeriksaan Tandavital, evaluasi hasil pemeriksaan Pemeriksaan evaluasi keluhan berkemih evaluasi keluhan berkemih evaluasi keluhan berkemih uroflowmetri uroflowmetri Treatment α-blocker bila volume prostat <40ml, 5α- α-blocker bila volume prostat <40ml, 5α- α-blocker bila volume prostat <40ml, 5α- medication reduktase inhibitor bila volume prostat reduktase inhibitor bila volume prostat reduktase inhibitor bila volume prostat >40ml >40ml >40ml Diet Edukasi cukup minumair mineral, Edukasi cukup minumair mineral, Edukasi cukup minumair mineral, makanantinggi serat, makananrendah makanantinggi serat, makananrendah makanantinggi serat, makananrendah garam, rendah protein, hindarikopi dan garam, rendah protein, hindarikopi dan garam, rendah protein, hindarikopi dan makananpedas makananpedas makananpedas Penyuluhan Kurangi obesitas, hindari stres, exercise , Kurangiobesitas, hindaristres, exercise Kurangiobesitas, hindaristres, exercise Rujuk/konsultasi Outcome LUTS berkurang LUTS minimal LUTS minimal Rencana perawatan Rawat jalan Rawat jalan Rawat jalan BPH (BENIGN PROSTATE HYPERPLASIA/ PEMBESARAN PROSTAT JINAK) : TUR-PROSTAT PEMBESARAN PROSTAT JINAK (BPH) OPERATIF: TUR-PROSTAT JenisAktivitas Kunjungan Pre operasi Kunjungan Pre operasi Kunjungan Pre operasi Tindakan (Rawat Jalan) (Rawat Jalan) (Rawat Jalan) Hari 1 Hari 2 Hari 3 Penilaian Awal Anamnesis Tandavital Tandavital Pemeriksaanfisik, tanda-tandavital, rectal toucher Pemeriksaan Lab: DPL (Hb/Leu/Ht/Plt), Urinalisis + BNO-IVP Evaluasi hasil pemeriksaan penunjang Kultur urine, PT/INR/APTT, BT/CT, Alb/Prot Uroflowmetri total, Asam Urat, Cl/Na/K, Ur/Cr, PSA total Urodinamik (bila perlu) USG Ginjal-Buli, Prostat Transabdominal dan Transrektal EKG/Thorax PA Biopsi prostat (bila PSA > 4) Treatment medication Edukasi, pasang kateter atau sistostomi Edukasi persiapan operasiTUR-P Operasi: TUR-Prostat bila retensi, antibiotik Diet Bebas, hindarikopi dan makananpedas Bebas, hindarikopi dan makananpedas Bebas, hindarikopi dan makananpedas Penyuluhan Kurangiobesitas, hindaristres, olah raga Kurangiobesitas, hindaristres, olah raga Informed-consent Rujuk/konsultasi Perioperatif Perioperatif Outcome Rencanaperawatan Penegakkandiagnosis Penentuantindakan Penentuantindakan

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Tanda vital, Hb dan elektrolit pasca operasi Rencana perawatan Masuk ruang rawat, Persiapan operasi, Open Surgery dengan Sectio Alta.

Clinical Pathway 10 Penyakit Urologi Tersering dr. Chaidir Arif Mochtar, SpU, PhD PDF

262 Pages·2013·4.82 MB·Indonesian

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Tanda vital, Hb dan elektrolit pasca operasi Rencana perawatan Masuk ruang rawat, Persiapan operasi, Open Surgery dengan Sectio Alta.

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