bluuebunny/crossref_metadata_2025 huggingface dataset:
ORAL PHENAZOPYRIDINE HCL FOR URETER ORIFICE IDENTIFICATION AND RETROGRADE STENTING
Authors: Gumilar Ogi Bahaurini , Soebadi Doddy M , Djojodimedjo Tarmono , Askandar Brahmana , Pudjirahardjo Widodo J
Published: August 2019

Objective:  To compare the successful of the identification of the ureteral orifice at cervical cancer patients who received phenazopyridine orally and to analyze the correlation between hydronephrosis and successful rate for retrograde stenting. Material & Method: This was a comparative experimental study, using phenazopyridine hcl orally prior to cystoscopy to identify the ureteral orifice on cervical cancer patients and to perform retrograde stenting on spotted ureteral orifice. Forty samples provided consent to enroll in this study. Mean age was 49.2 ± 5.16 years. Thirty-four out of 40 samples was confirmed as squamous cell carcinoma type. Results: Chi-square test demonstrated no significant differentiation in finding ureteral orifice between treatment and control group on stage 3B (p = 0.408). However, result shown conversely on stage 4A (p = 0.046). There was no significant disparity in conducting retrograde stenting between treatment and control group on stage 2B and 3B (p = 0.221 and p = 0.197). There was no significant correlation between hydronephrosis gradation and retrograde stenting on control group (p = 0.144). Conclusion: Administration of phenazopyridine HCL orally in cervical cancer patients increase success for ureteral orifice identification and retrograde stenting, but not statistically significant. There is no correlation between hydronephrosis with a success retrograde stenting.Keywords: Cervical cancer, hydronephrosis, phenazopyridine hcl, ureteral orifice, retrograde stenting.
Laparoscopic transperitoneal approach for vesicovaginal repair : The first experience in Hasan Sadikin Hospital
Authors: Santoso Jumadi , Pramod Sawkar Vijay
Published: August 2019

Introduction : Obstetric ﬁstula is a severe and debilitating condition occurring throughout the developing world. Although there are no accurate data on the incidence and prevalence of the condition, the majority of vesicovaginal fistulas develop after gynaecologic surgery, with transperitoneal hysterectomy accounting for 90% of cases. Several techniques are available for repairing the fistulas. Transperitoneal  approaches give good results even for difficult posterior located fistulas, but are associated with increased morbidity compared with the transvaginal approach. We performed a laparoscopic repair and omentum interposition. Objective : To report our first experience in transperitoneal laparoscopic repair of vesicovaginal fistula in Hasan Sadikin Hospital. Patient and Method : A 31-year-old female presented with vesicovaginal fistula after sectio caersaeran. After a failed trial of conservative treatment with catheter drainage, a transperitoneal laparoscopic repair was performed. Cystoscopy was performed initially to confirm the fistula location and for bilateral ureteric catheterization. A 4-port technique was performed with the patient in the position with her legs in lithotomy position. Without opening the bladder, the fistula tract was excised with separation of the bladder from the anterior vagina wall. Both the bladder and vagina walls were then closed separately using intracorporeal suturing with an interpositional omentum. Result : Total operative time was 270 min. Normal diet was resumed on day 1, drain was removed on  post operatif day 1 and patient was discharged on the second day  with an indwelling catheter. Good cosmetic result on wound operation  and no leakage under cystogram after 2 weeks. The catheter was removed after 2 weeks. Conclusion : Laparoscopic transperitoneal repair of vesicovaginal fistula  with omentum inteposition  is feasible in  Hasan Sadikin Hospital with good outcomes, short hospital days,  and good cosmetics result. Keywords : Fistula vesico vaginal, laparoscopic.
EFFICACY OF INTRAVESICAL INSTILLATION OF NETILMICIN ON MANAGING UTI
Authors: Praba Barry Arief , Utomo Trisula
Published: August 2019

INTRODUCTION Urinary tract infections (UTIs) are common, affect men and women of all ages, and vary dramatically in their presentation and sequelae. They are a common cause of morbidity and can lead to significant mortality. New antimicrobial agents that achieve high urinary and tissue levels, that can be administered orally, and that are not nephrotoxic have significantly reduced the need for hospitalization for severe infection. Shorter-course therapy and prophylactic antimicrobial agents have reduced the morbidity and cost associated with recurrent cystitis in women. Intravesical instillation of aminoglycoside has been used empirically as prophylaxis and to treat bacilluria in spinal-cord-injured patients undergoing clean intermittent catheterization.METHODS In a prospective clinical trial performed in the urologic ward of Dr. Sardjito Hospital, yogyakarta, Indonesia, we studied 56 patients who has indwelling urethral catheter more than 4 days. Patients were divided into two groups. In group 1 (28 patients) one-time intravesical instillation of Netilmicin 25 mg was administred, and in group 2 (28 patients) none were given any treatment. Urinalysis was evaluated before and after instillation of Netilmicin. Statistical data and results were studied using descriptive statistics as median (minimum and maximum). To compare the response to treatment, Chi-Square test was used in two groups. Consequently, the data were analyzed using the SPSS 17 software.RESULTS Urinalysis were evaluated in two groups 4 days after intravesical instillation of 50 mg netilmicin. The patients we studied, the median age 59 years old (min. 29; max. 81). In the first group we found 22 (78,5 %) patients still without UTI, 6 (21,5 %) patients with UTI, in the second group we found 4 (14,3 %) still without UTI, 24 (85,7 %) patients with UTI. The difference was statistically significant (p=0.0001)CONCLUSIONS Intravesical instillation of netilmicin on patients with indwelliing urethral catheter were effective on preventing catheter-related UTI.Keywords : UTI, indwelling catheter, netilmicin, intravesical antibiotic instillation.
Diagnostic Value of Ureteric Jet Frequency Examination using Color Doppler Ultrasonography to Predict Success of Retrograde DJ Stent Insertion in Uterine Cervicis Carcinoma patients with Hydronephrosis
Authors: Sriyono Sriyono , Santoso Adi , Djojodimedjo Tarmono , Soebadi Moh Ayodhia , Pudjirahardjo Widodo J
Published: August 2019

AbstractObjective:  To prove that ureteric jet examination using Color Doppler Ultrasonography (CDU) can be used as a diagnostic tool to predict success of retrograde Double J Stent insertion in uterine cervicis carcinoma patients with hydronephrosis.Materials and Methods: This observational analytic study took 32 samples since May until October 2013. Before, the ureteric jet were counted for 5 minutes using CDU, then continued on the same day with cystoscopy and retrograde DJ Stent insertion. The analysis was using Chi-Square and also Coefficient Contingency test.Results: In both Chi-Square and Coefficient Contingency test, it is proven a significant correlation between success of retrograde DJ Stent insertion and Blood Urea Nitrogen (BUN), creatinine value, grade of hydronephrosis and also ureteric jet examination using CDU, with probability value (p < 0,005). The normal of BUN, creatinine level and the lower grading of hydronephrosis, the more likely successful DJ Stent insertion. Successfulness of DJ Stent insertion is also greater in a positive ureteric jet samples on examination using CDU, with sensitivity value 90,9% and specificity 89,5%, positive predictor value 83,3%, negative predictor value 95% and accuracy value 0,9.Conclusion: Ureteric jet frequency examination using CDU can be used as a success predictor of retrograde DJ Stent insertion in hydronephrosis uterine cervicis carcinoma patients with sensitivity value 90,9% and specificity 89,5%.Keywords: Ureteric jet, Color Doppler Ultrasonography, Double J Stent, Uterine Cervicis Carcinoma
URINARY CONTINENCE DIVERSION IN CHILDREN WITH NEUROGENIC BLADDER
Authors: Satyawan Yopie T , Rodjani Arry , Wahyudi Irfan
Published: August 2019

Objective: We evaluate the initial experience of the implementation of the urinary diversion procedure in patients with neurogenic bladder continence in children. Material & method: The study was conducted retrospectively by collecting data contained in patient medical records of patients who come for treatment to Cipto Mangunkusumo Hospital Jakarta, from 2003 to 2012, and by interviews with parents of patients over the phone or when the patients control to the clinic. The patient is a child (age 0-18 years), diagnosed with congenital neurogenic bladder, and had urinary diversion continence procedure. Results: There are eight cases with urinary diversion continence undertaken in Cipto Mangunkusumo Hospital and found only 7 cases met the inclusion criteria with more girls than boys. Common etiology was spina bifida (57%). Most of the patients complained of recurrent UTI, and the most techniques used are Mitrofanoff (72%) with complications 33%. Conclusion: Urinary diversion continence procedure that has been done in Urology of Cipto Mangunkusumo Hospital is Mitrofanoff-Monti. Of the total of seven cases performed, the initial evaluation gives good results after urinary diversion continence procedure. Improved quality of life of patients with the achievement continence, overcome recurrent UTI problems and kidney function can be retained.
Keywords: Neurogenic bladder, Mitrofanoff techniques, Yang-Monti.
DIAGNOSTIC VALUE OF NON-CONTRAST HELICAL CT-SCAN AND INTRAVENOUS UROGRAPHY IN UROLITHIASIS EVALUATION
Authors: Hasan Fadhli , Soebadi Doddy M , Hardjowijoto Sunaryo , Soebadi Mohamad Ayodhia , Pria Triyono Karmawan Sukmana , Pudjirahardjo Widodo J
Published: August 2019

Objective: To evaluate the diagnostic value of Non Contrast Helical Computed Tomography (NCHCT) scanning as the first choice diagnostic modality for detecting urolithiasis cases in Soetomo General Hospital Surabaya and evaluate the feasibility as alternative to Intravenous Urography (IVU). Material & Methods: Seventeen patients with clinical manifestation of suspected urolithiasis underwent NCHCT and IVU to evaluate suspected urolithiasis. Reformatted three-dimensional CT was performed in all patients. The images were correlated with findings from surgical procedure (ureteroscopy, percutaneous nephrolithotomy, and open surgery). Sensitivity, specificity, positive predictive value, negative predictive value, and diagnostic accuracy were determined for NCHCT and IVU. Results: The diagnosis of urolithiasis was defined as unequivocal evidence of urolithiasis on either NCHCT or IVU. Sixteen of seventeen patients evaluated were diagnosed with urolithiasis. NCHCT established the diagnosis in 16 of 17 patients while IVU was positive in 11 of 17 patients. IVU was negative in 6 of the 17 cases. The sensitivity, specificity and accuracy of NCHCT was 100%, 100%, and 100% respectively (p = 0.05) and the sensitivity, specificity, and accuracy of IVU was 68%, 100% and 70% respectively (p = 0.35). There was no statistically significant difference between IVU and NCHCT using Fisher’s exact test. Conclusions: NCHCT accurately diagnosed urolithiasis in patients with suspected urolithiasis. Considering that NCHCT is more effective and efficient than IVU as diagnostic modality in determining the presence of urolithiasis, it may be considered to replace IVU as the first line diagnostic tool for urolithiasis in Soetomo General Hospital Surabaya.
Keywords: Non Contrast Helical CT Scan, Intravenous Urography, Urolithiasis.
SUCCESS OF PERCUTANEOUS NEPHROLITHOTOMY: COMPARING SPINAL ANESTHESIA WITH GENERAL ANESTHESIA
Authors: Astram Ari , Birowo Ponco , Rasyid Nur , Pryambodho P , Susilo C
Published: August 2019

Objective: The purpose of this study compared the outcome of PCNL under general and spinal anesthesia for the outcome. Material & Methods: PCNL had been performed from 2000 until 2011 with total 760 PCNL divided into 220 PCNL using general anesthesia (Group A) and the remaining 540 PCNL using spinal anesthesia (Group B) The data of both groups were evaluated with Chi square test, and Mann-Whitney test. Result: Stone free rate in Group A was 71.37% similar with Group B 72.97% (p > 0.05). Spinal anesthesia was used more often in patient who had previous surgery 65.5% compared with general anesthesia 36.82% (p < 0.05). The average surgery duration in Group A was longer than group B (77.10 ± 35.59 minutes vs 68.42 ± 30.55 minutes) (p < 0.05). The average length of hospital stay in Group B was shorter than Group A (3.90 ± 2.72 days vs 5.47 ± 4.25 days) (p < 0.05). There was no difference between Group A and Group B in complication and the needs of tranfusion. Conclusion: PCNL under spinal anesthsia was feasible and safe even better in the shorter surgery duration and the length of hospital stay.
URINARY STONE RISK PROFILE IN STONE FORMER PATIENT
Authors: Prasetyo Tommie , Birowo Ponco , Rasyid Nur
Published: August 2019

Objective: We were comparing the urinary stone risk profiles in stone former subjects group with normal population (non stone-former) group. Material & method: In this study, each group consist of 10 subjects. Urine samples used was a 24-hour-urine. All subjects in this study were previously informed and voluntarily participating. Inclusion criteria in this study were adult, stone free, residing in Jakarta. Measurement was performed in Department of Molecular Biology and Biochemistry Faculty of Medicine Indonesia University. Statistical analysis was performed using SPSS 20 (Chicago, USA) with Student’s t-test or Mann-Whitney (p < 0.05 was considered significant). Results: There was a significant difference in the mean age of two groups with no significant difference in weight and height. Significant difference (p < 0.05) in urinary profile was found in urea, uric acid, chloride, potassium, phosphate, and ammonia. Conversely, we found no significant differences (p > 0.05) in sodium, creatinine, calcium, magnesium, oxalate, and citrate levels. Conclusion: There were no significant differences in urinary stone promoting and inhibiting factors between two groups. Bigger number of sample size with better sampling method must be conducted for future studies.
LAPAROSCOPIC RADICAL CYSTECTOMY WITH ILEAL CONDUIT URINARY DIVERSION, FIRST EXPERIENCE IN BANDUNG
Authors: Jouwena Davis Roland Gustav , Pramod Sawkar Vijay
Published: August 2019

Objective: To report our experience in performing laparoscopic radical cystectomy with ileal conduit urinary diversion (extracorporeal reconstruction). Material & method: This study was take place in Hasan Sadikin Hospital Bandung. A 54-year-old male with histologically proven transitional cell carcinoma of the bladder cT2bN0M0 underwent a laparoscopic radical cystoprostatectomy and ileum dissection was performed under laparoscopy. Ileal conduit and stoma reconstruction performed extracorporeal through small incision between ports (about 4cm). Results: The surgical margins were free of disease. The operative time was 360 minutes. Estimated blood loss was 600cc. Hospital stay was 5 days. Patient was discharge with no complication of post-op wound, and urine production about 1500cc/24hrs via stoma. Conclusion: Laparoscopic radical cystectomy with ileal conduit extracorporeal reconstructive urinary diversion could be the preferred means in managing bladder tumor on selective case.
UNPALPABLE UNDESCENDANT TESTES MANAGEMENT EVALUATION IN CIPTO MANGUNKUSUMO HOSPITAL
Authors: Siregar Ginanda Putra , Rodjani Arry , Wahyudi Irfan
Published: August 2019

Objective: This study is to evaluate imaging modalities used in unpalpable undescended testes (UDT) patient at our centre. We evaluate the data descriptively. Material & methods: This is a descriptive and retrospective study. Data was taken from medical record in Cipto Mangunkusumo Hospital from January 2010 until June 2014. Sampling method is total sampling. Inclusion criteria for this study was unpalpable UDT patients at Urology Department Cipto Mangunkusumo Hospital, whereas patients with incomplete data and have XX chromosomes were excluded. Results: Mean ages in this study was 9.35 years old (7 month to 41 year old). Diagnostic tools was not performed in half of the patients. Abdominal ultrasound was performed in 9 patients (34.6%), and 4 patients with CT-Scan. We found that most of patients were unilateral UDT (57.7%). Bilateral UDT was found in 11 patients (42.3%). Twenty one patients undergo laparoscopic orchidopexy (80.8%). There were 7 patients undergo full laparoscopy orchidopexy. Fowler Stephen technique applied to 4 patients, and eleven patients underwent inguinal exploration and orchidopexy. Laparoscopic biopsy was performed in 4 patients and agenesis of the testis was found in one patient. There are 13 cases with other abnormalities; hypospadias (38.5%), DSD 46 XY (53.8%), and testicular tumor (7.7%). Conclusion: Unpalpable UDT is adequately diagnosed by history and physical examination. Half of our patient in this study were not performed additional examination such as ultrasound, CT-Scan, and MRI for diagnostic tools and directly underwent laparoscopic orchidopexy. The best management of unpalpable UDT is laparoscopic orchidopexy.
EXPERIENCE ON TRANSPERITONEAL LAPAROSCOPIC DIVERTICULECTOMY IN UROLOGY DEPARTMENT HASAN SADIKIN HOSPITAL BANDUNG
Authors: Ferdian Vicky , Pramod Sawkar Vijay
Published: August 2019

Objective: To described our experiences in treating large bladder diverticulum using transperitoneal laparoscopic techniques in Urology Department Hasan Sadikin Hospital, Bandung. Material & method: There were 3 patients with bladder diverticulum due to bladder outlet obstruction. There are 2 males and 1 female patients. The bladder outlet obstruction was caused by BPH in both male patients and urethral stenosis in female patient. The bladder diverticles were located in left lateral bladder wall in 2 patients and right lateral bladder wall in 1 patient. All the patients underwent two stages procedure. Initially, we perform correction of the obstruction. Next stages were transperitoneal laparoscopic diverticulectomy. Result: The operating time was improving in each procedure, with average time was 180 minutes. Drain was removed in 3 days in one patient and 2 days in 2 patients. Cystostomy was removed in POD 14 in all patients. One month post operatively, we performed cystography and all of the patients had a normal result without any extravasation. The patients was discharge on day 7 in one patient and day 4 in 2 patients post operatively, with minimal pain. Until now, patient was still under follow up and no major complication was found. Conclusion: Transperitoneal laparoscopic diverticulectomy is a save alternative for the management of bladder diverticulum with minimal post-operative pain and length of stay.
RETROPERITONEAL VS TRANSPERITONEAL LAPAROSCOPIC URETEROLITHOTOMY
Authors: Putra Rosadi , Safriadi Ferry , Pramod Sawkar Vijay
Published: August 2019

Objective: To compare retroperitoneal versus transperitoneal laparoscopic ureterolithotomy in effectivity, pain scale and early complications. Material & methods: In this prospective comparison study from January 2013 to June 2014, 32 patients with proximal and mid ureteral stones underwent retroperitoneal laparoscopic ureterolithotomy or transperitoneal laparoscopic ureterolithotomy. The randomization occured on consecutive sampling on a 1 : 1 basis. Group 1 and 2 consisted of patients who underwent retroperitoneal laparoscopic ureterolithotomy and transperitoneal laparoscopic ureterolithotomy, respectively. Demographic and clinical variable, operative time, length of stay, ureteral suturing, pain scale according to visual analog scale (VAS) and early complications data were collected and analyzed. Statistical analysis was performed with SPSS® version 17.0 using student T-test and Mann-Whitney U tests with p value < 0.05 considered statistically significant. Results:VAS on day 1 between the 2 groups was statistically significant, and was higher in group 2 (p < 0.05). According to the Clavien-Dindo classification of surgical complication all the patients were in grade 1 classification. The differences in operative time, length of stay, ureteral suturing, visual pain analog score on day 3, and early complications between the 2 groups were not statistically significant.Conclusion: Transperitoneal laparoscopic ureterolithotomy is significantly associated with pain than retroperitoneal laparoscopic ureterolithotomy in first day after surgery. Successful stone removal remains the same in both groups.
CORRELATION OF PROSTATIC VOLUME MEASUREMENT BETWEEN TRANSABDOMINAL ULTRASOUND AND CT SCAN
Authors: Sujana Biddulth , Mulyadi Rahmad , Birowo Ponco , Prihartono Joedo
Published: August 2019

Objective: This study aims to determine correlation between measurement of prostatic volume and dimensions using transabdominal ultrasound (TAUS) and Computed Tomographic scan (CT scan) in male population ages 50 years and above. Material & method: Research was conducted at Radiology Department, Cipto Mangunkusumo Hospital, Jakarta. Twenty two patients who underwent whole abdominal CT from Desember 2013 to January 2014, were enrolled and examined using TAUS. Results: The calculation shows there is strong correlation between volume measurement, width, and height dimensions between TAUS and CT scan, where the Spearman correlation indicates r = 0.80 with p = 0.000 for volume measurement and r = 0.81 with p = 0.000 for width dimension and r = 0.64 with p = 0.001 for height dimension. There are also regression formula for estimating volume and dimensions measurements using TAUS. Conclusion: This study show strong correlation between volume and dimensions measurement using TAUS and CT scan.
UROLOGY RETROPERITONEOSCOPY: INITIAL EXPERIENCE IN CIPTO MANGUNKUSUMO HOSPITAL
Authors: Siregar Ginanda Putra , Wahyudi Irfan , Mochtar Chaidir Arif , Hamid Agus Rizal Ardy Hariandy
Published: August 2019

Objective: This study was conducted to evaluate the initial experience of retroperitoneoscopy surgery. Material & method: This is a descriptive study with cross-sectional design. Data was collected from medical records of Urology Department in Cipto Mangunkusumo General Hospital Jakarta, from March 2013 until February 2014. Subjects were all patients who performed retroperitoneoscopic surgery between the time periods. Results: Patients consisted of 9 males (42.85%) and 11 females (57.14%). Mean age was 38.95 + 21.88 years old. Proportion based on diagnosis were 5 renal failures (23.8%), 5 ureteral stones (23.8%), 3 renal cysts (14.3%), 2 PUJOs (9.5%), double 3 collecting systems (14.3%), 1 tumor (4.8%), 1 ureteral tumor (4.8%), and 1 renal diverticle (4.8%). Proportion based on kind of retroperitoneoscopy were ureterolithotomy (23.8%), nephrectomy 3 (14.3%), nephroureterectomy 3 (14.3%), renal cyst unroofing 3 (14.3%), heminephrectomy 3 (14.3%), pyeloplasty 2 (9.5%), partial nephrectomy 1 (4.8%), and diverticle coagulation 1 (4.8%). Mean operating time was 178.81 + 55.72 minutes with mean length hospitalization 8.05 + 4.4 days. Mean amount of bleeding was 98 + 69.47 cc, wound operation infection 0 (0%), peritoneal perforation 1 (4.76%), open surgery conversion 2 (9.52%), and transperitoneal laparoscopy conversion 1 (4.76%). Conclusion: In this study, total number of retroperitoneoscopy surgery cases still less than others abroad. Demographic characteristic showed variety than other study. Compared to other studies, the operating time was comparable but the length of stay was longer. We had higher open surgery conversion rate, while another complication was relatively the same.
EVALUATION OF TENCKHOFF CATHETER INSERTION USING OPEN SURGERY IN CHRONIC RENAL FAILURE PATIENTS
Authors: Nugroho Indra Bayu , Singodimedjo Prawito , Indrawarman Indrawarman
Published: August 2019

Objective: To evaluate the dysfunction rate of Tenckhoff catheter insertion for end stage renal disease patients at Sardjito General Hospital Yogyakarta. Material & method: Data were collected from medical record retrospectively for all chronic kidney disease (CKD) patients underwent continuous ambulatory peritoneal dialysis (CAPD), by open surgery at Sardjito General Hospital Yogyakarta, from January 2010 until Desember 2013. The cause of CKD and dysfunction rate was studied. Data was analyzed using SPSS ver 18.0 (IBM corp, USA). Results: There were 43 CKD patients underwent Tenckhoff cateter placement using open surgery. Tenckhoff catheter dysfunction was found in 11.7% patients. Disfunction was caused by blockage of the catheter by omentum (6.9%) and catheter migration (4.8%). Peritonitis complication was found in 2.3% patients. The cause of CKD at Sardjito General Hospital Yogyakarta was diabetes mellitus (53.5%), hypertension (44.2%), and glomerulonefritis (2.3%). There were no correlation of dysfunction rate with gender and the cause of CKD. Conclusion: Tenckhoff catheter placement by open surgery at Sardjito General Hospital Yogyakarta have good outcome.
AGE, TOTAL PSA, PSA DENSITY AND GLEASON SCORE, TAUS AS PREDICTIVE FACTORS IN PATIENTS WITH PROSTATE CANCER
Authors: Albar Daruqutni , Rochadi Sungsang
Published: August 2019

Objective: To find the factors related as predictive factors for Gleason score in prostate cancer patients. Material & methods: This study obtained a total sample of 144 patients with prostate cancer in Sardjito General Hospital Yogyakarta in 2009-2013. Of the total 144 patients, only 64 patients had complete medical records. All patient samples were patients who had biopsy of the prostate. This study is a retrospective case-control study to predict the Gleason Score in patients with prostate cancer in terms of age, total prostate specific antigen (PSA), PSA density and TAUS. Normality test assessed the distribution of the data. Pearson test assessed normal distribution and Spearman test for normal distribution. All data were analyzed using SPSS version 18. Results: Analysis of data from 64 patients with prostate cancer with a normal distribution of the variables obtained on age and TAUS with p > 0.05 whereas abnormal distribution obtained on total PSA, PSA density with p < 0.05. Of the data on the data with a normal distribution, age and TAUS with values obtained p 0.039 and p 0.738. From these data it can be said there is a relationship between age and Gleason score where the higher the age the higher the Gleason score. TAUS of the data can be said there is no relationship between TAUS and Gleason score. Then the abnormal distribution of the data obtained with a total PSA p < 0.001 and PSA density p < 0.001. The data is obtained from the relationship between total PSA and PSA density with Gleason score. Conclusion: It was found that age, total PSA, PSA density affect the increase in Gleason score where the higher the age, total PSA and PSA density the higher the Gleason score in patients.
EVALUATION OF SIGN AND SYMPTOMS RELATED TO INDWELLING URETERAL STENTS
Authors: Suryawan Joko anom , Danarto H R , Budiyono Nur
Published: August 2019

Objective: To study factors that influence signs and symptoms related to stented ureter. Material & methods: This was a prospective-cross sectional study, from March 2014 to August 2014, to know factors that influence signs and symptoms of patients with ureteral stent. All patients were inserted ureteral stent participated in this study. Exclusion criteria were patients with malignancy, patients who had history of DJ stent placement previously, patients with bilateral DJ stents and patients with urinary tract infection. All patients completed IPSS questionnaire before inserted stents. After 1 month, when removal DJ stents performed, all patients completed IPSS, USSQ and VAS. All data was analyzed with Chi-square/fisher exact test, Pearson/Spearman correlation and Mann Whitney. Results: Fourty patients consisted of 23 man (57.5%) and 17 women (42.5%) completed this study. The mean age was 44.92 years old and length of stented ureter was 38.22 days. There was significance correlation between IPSS of DJ stent pre-insertion and post insertion (p < 0.001; r = 0.628). Of the patients reported dysuria (62.5%), frequency (55%), nocturia (52.5%), incomplete emptying (47.5%), hematuria (35%) and urgency (15%). On bivariate analysis, there was significance correlation between DJ stent position and frequency (p < 0.001), nocturia (< 0.001), urgency (p = 0.002), incomplete emptying (p = 0.049), dysuria (p = 0.030), hematuria (p = 0.026) and pain (p < 0.001). Conclusion: Previous urinary symptoms and DJ stent position were factors that influenced sign and symptoms related to ureteral stent insertion.
CUT-OFF POINT OF PSA AND PSA DENSITY IN PROSTATE CANCER SUSPECTED PATIENTS
Authors: Simanjuntak Daniel , Safriadi Ferry
Published: August 2019

Objective: In Hasan Sadikin General Hospital Bandung prostate biopsy is recommended for patients with prostate specific antigen (PSA) levels above 10 ng/mL or PSA density (PSAD) above 0.15 if PSA in between 4–10 ng/mL. However, there were other factors beside of prostate cancer (PCa) that could influence PSA value, such as racial differences and prostatitis. Thus, the optimal cut-off point for PSA is still debatable in national level. This research aimed to determine PSA and PSAD cut-off point for patient suspected of PCa in Hasan Sadikin Hospital Bandung. Material & Methods: A total of 502 patients underwent prostate biopsy for suspicion PCa from 2010–2014. The cut-off point of PSA and PSAD is generated from receiver operating characteristic (ROC) curve. Results: The cut-off point for PSA was 14.6 ng/mL (sensitivity 81.4%, specificity 29.8%). The cut-off point for PSAD was 0.23 (sensitivity 81.4%, specificity 34.8%). Positive predictive value (PPV) for this new cut-off point of PSA and PSAD were 41.1% and 37.6% respectively. Conclusion: PSA and PSAD cut-off point for patients in our center was 14.6 ng/mL and 0.23 respectively. This value is relatively higher compared to the Indonesian consensus. The difference might occur due to high rate of urinary tract infection in patients attending Hasan Sadikin General Hospital Bandung.
INITIAL EXPERIENCE OF LAPAROSCOPIC PARTIAL NEPHRECTOMY IN HASAN SADIKIN GENERAL HOSPITAL BANDUNG
Authors: Daniswara Nanda , Pramod Sawkar Vijay , Sibarani Jupiter , Safriadi Ferry
Published: August 2019

Objective: To describe our experience about laparoscopic partial nephrectomy to treat localized renal tumour patients in Urology Department Hasan Sadikin General Hospital Bandung. Material & method: In 2014, there were 6 female patients that underwent laparoscopic partial nephrectomy in Hasan Sadikin General Hospital Bandung. In one case, there were tumours on both kidneys. Five patients were underwent transperitoneal approach and 1 patient were undergo retroperitoneal approach. All patients were examined with ultrasonography and Abdominal CT scan with contrast. We also calculate RENAL nephrometry score. Results: There were 6 female patients with left flank pain that undergo laparoscopic partial nephrectomy. In one case, there are tumours on both kidneys. In RENAL nephrometry score calculation, there were 3 patients with 10x score, 1 patient with 11x score, 1 patient with 7x score, and 1 patient with 6p score. From all of them, 4 patients were successfully performed laparoscopic partial nephrectomy, 1 patients was undergo laparoscopic nephrectomyand 1 patient is converted to open partial nephrectomy. Five patients were undergo transperitoneal approach and 1 patient was undergo retroperitoneal approach. Surgery ranged from 180-240 minutes. Intra operative bleeding was ranged from 50-200 cc. Tramadol intravenous was used for post operative pain control. With VAS score in first post operative day was 6, and 2 at the time of discharge. Hospitalized time was ranged from 4-6 days. Conclusion: Laparoscopic partial nephrectomy is an alternative treatment that safe for localized renal tumour. This procedure is depend on the technique and approach from each Urologist. Our limitations are we didn’t have laparoscopic ultrasonography and the tumour close to pelvocalyces system.
THE ROLE OF BEDSIDE BLADDER SONOGRAPHY FOR DETECTION OF BLADDER TRAUMA
Authors: Santoso Jumadi , Adi Kuncoro
Published: August 2019

Objective: To evaluate the role of bedside bladder sonography along with retrograde instilation of saline as a novel diagnostic procedure for suspected bladder trauma. Material & methods: Prospective evaluation of all patients with suspected bladder injuries admitted to the Emergency Department of Hasan Sadikin General Hospital, Bandung, Indonesia, from 2010–2013. Suspected urethral injury patients were excluded. Along with routine Focused Assessment Sonography for Trauma (FAST) procedure, bedside bladder sonography was performed concurrently with retrograde instillation of normal saline 350cc through a Foley catheter. The objective of real-time bladder sonogram was to examine the presence of peri-vesical free fluid turbulence and accumulation during saline instillation, which subsequently indicated a suspected bladder perforation. The accuracy of sonographic results were compared with computerized tomography (CT), cystogram or intraoperative findings. Time to diagnosis was recorded. Statistical analysis was performed to evaluate the sensitivity, specificity, positive predictive value (PPV), negative predictive value(NPV) and diagnostic accuracy. Results: 23 patients met the inclusion criteria. The mean age was 27.21 years old, 87% were males. Based on cystogram or intraoperative finding there are 21 patients have bladder rupture. Among these patients, 14 patients had positive result onbladder sonogram, and all confirmed positive on cystogram and operative finding. Nine patients had negative result on bladder sonogram. While 7 among them have positive result on cystogram or intraoperative finding. Analysis revealed 67% sensitivity, 100% specificity, 100% PPV, and 22.2% NPV. Overall diagnostic accuracy of bladder sonogram was 83.5%. Time to diagnosis were significantly shorter in bedside bladder sonogram compared to CT or cystogram (11.82 ± 2.99 min vs 181.30 ± 88.89 min; p < 0.05). Conclusion: Bedside bladder sonogram is a useful adjunct procedure for diagnosis of bladder trauma. It is time and cost effective, and can be performed in bed-side emergency setting with acceptable accuracy.
DELAYED GRAFT FUNCTION FOLLOWING LAPAROSCOPIC LIVE DONOR NEPHRECTOMY: A MULTIVARIATE ANALYSIS
Authors: Tirtayasa Pande Made Wisnu , Situmorang Gerhard Reinaldi , Rodjani Arry , Rasyid Nur
Published: August 2019

Objective: This study was performed to define and investigate the incidence, risk factors, and clinical characteristics of delayed graft function (DGF) in laparoscopic live donor nephrectomy (LDN). Material & methods: We retrospectively analyzed the medical records of donor and recipient from our first 100 cases of laparoscopic LDN in Cipto Mangunkusumo General Hospital Jakarta, from November 2011 to February 2014. The criteria used to define DGF were the requirement for dialysis in postoperative week 1 and/or serum creatinine greater than 2.5 mg/dl at postoperative day 7. Patients who did not match any of these criteria were define as having normal renal allograft function. Results: The overall prevalence of DGF was 14%. Recipients body mass index, cold ischemia time, vascular anastomosis time, and total ischemia time were higher among the delayed graft function group, but no risk factors for DGF were significantly associated after multivariate analysis. Conclusion: The incidence of DGF in our study was in the range of that observed in previous studies. The factors that previously reported and believed as risk factors of DGF in laparoscopic LDN were not significantly associated with the development of DGF in our study.
CORRELATION BETWEEN BLOOD SERUM PSA LEVEL AND MMP-2 IN PROSTATE ADENOCARCINOMA
Authors: Rahaju Anny Setijo , Meidi Aniek , Mastutik Gondo , Mustokoweni Sjahjenny , Mustika Arifa
Published: August 2019

Objective: This study aims to prove the correlation between Prostate Specific Antigen (PSA) blood level and Matrix Metalloproteinase-2 (MMP-2) expression in patients with prostate adenocarcinoma. Material & method: Prostate cancer patients’ data from January 2009 to May 2012 were collected at the Department of Pathology, Soetomo General Hospital Surabaya. Data collected included patient medical documents, PSA blood examination, and histopathological examination. Histopathology slides and paraffin blocks of needle biopsies, Transurethral Resection of Prostate (TURP) and radical prostatectomy of prostate cancer patients werere-read, then the samples that met the inclusion criteria were stained by immunohistochemistry using antibodies MMP-2. Results: Data collection was done to obtain data samples of prostate cancer patients in 2009 to 2012 comprising as many as 22 patients between the ages of 52-91 years. Prostate adenocarcinoma in age of 70-79 was found in 8 patients, with a mean age of 68 years. PSA values obtained from medical documents were between 8.6-594.41 ng/ml. Spearman's test performed in this study showed a positive correlation (one-tailed) (correlation coefficient (r) 0431, p < 0.05) between blood PSA level and MMP-2 expression in patients with prostate adenocarcinoma. Conclusion: Blood PSA level correlates positively with MMP-2 expression in prostate adenocarcinoma.
THE CORRELATIONS AMONG COMPONENTS OF METABOLIC SYNDROME PSA AND PROSTATE VOLUME IN BPH PATIENTS
Authors: Sumasta Yanuar Wicaksana , Danarto Danarto
Published: August 2019

Objective: This study was to evaluate the associations among metabolic components, prostate specific antigen (PSA), and prostate volume (PV) in benign prostate hyperplasia (BPH) patients.Material & method: During the period from January 1, 2010 to August 31, 2013, 61 mens were diagnosed with BPH were enrolled. PV by transabdominal ultrasonography of the prostate, serum PSA, metabolic syndrome (MS) related parameters were investigated. MS was defined according to the modified National Cholesterol Education Program Third Adult Treatment Panel Guidelines. We evaluated the correlation between PSA, PV and MS components using Spearman’s test and Independent t test.Results: PV were not correlated with MS criteria (p=0.591) PSA total also were not correlated with MS criteria (p=0.305). PV were not correlated with each components MS; cholesterol total (p=0.593), trigliserid (p=0.479), HDL (p=0.702), LDL (p=0.512), blood glucose (p=0.317). PSA total were not correlated with each components MS; cholesterol total (p=0.255), trigliserid (p=0.543), HDL (p=0.446), LDL (p=0.615), blood glucose (p=0.987). Conclusion: There were no associations among metabolic syndrome criteria and each components, prostate volume and PSA total.
RELATION BETWEEN COMPLICATING FACTORS OF HYPOSPADIA AND COMPLICATIONS AFTER TIP: A RETROSPECTIVE STUDY
Authors: Aritonang Johannes , Rodjani Arry , Wahyudi Irfan
Published: August 2019

Objective: This study aims to find an association between hypospadias complicating factor for complications that occurred after hypospadias reconstruction, focusing on tubularized incised plate (TIP) as reconstruction techniques are most commonly used. Material & methods: The study data was obtained from medical records of urologic hypospadias patients in Cipto Mangunkusumo General Hospital, Jakarta. Samples are those who underwent hypospadias reconstruction in Cipto Mangunkusumo General Hospital, since April 2002 until May 2014 with a total sampling method. Data were analyzed using SPSS ver 14. Results: We collected 127 patients who underwent the TIP technique with a mean patient age and treatment duration was 7.58 years and 10.95 days. Fistule is the most common complication in patients with post-TIP hypospadias accounting for as high as 32 (25.2%). Bivariate analysis showed a significant correlation between the location of the hypospadias meatus (distal) with torsion of the penis (n = 2; p 0.019). Conclusion: On the basis of the technical complications TIP, such as fistules, meatus stenosis, urethral stricture, torsion of the penis, and glans dehiscence, then the indication for TIP should be clear or selective.
PERCUTANEUS NEPHROSTOMY IN PATIENTS WITH OBSTRUCTIVE UROPATHY DUE TO MALIGNANCY: A SURVIVAL ANALYSIS
Authors: Yuri Prahara , Rochadi Sungsang
Published: August 2019

Objective:To find out effectiveness of percutaneous nephrostomy (PCN) and patient survival rate as palliative decompression of the obstructed urinary system due to malignancy (urogenital neoplasias). Materials & Methods: A cohort retrospective study was performed with 76 patients (58 female and 18 male) with malignancy process who were undergoing percutaneous nephrostomy during January 2009 – December 2012, in Sardjito General Hospital Yogyakarta. Survival analysis was done by Kaplan-Meier method and differences were assessed using the log-rank test. Results:There was no procedure-related mortality. The mean of age was 49.14 years. The primary tumoral site was the uterine cervix in 56.6 %, the bladder in 17.1 %, the prostate in 2.6% and other sites (intestinal, ovarium and other malignancies caused obstructive uropathy) in 23.7%. The patients died during the hospitalization period due to advanced neoplasia are 17.1%. The mortality rate was higher in patients with interval between diagnose of obstructive uropathy and nephrostomy > 7 days (HR=5.7; 95%CI 4.5-6.9; p = 0.001) and in those who required hemodialysis before the procedure (HR=6.1; 95%CI 4.7-7.4; p = 0.001). The survival rate was 55.2% (42/76) at 6 months and 32.9% (25/76) at 12 months. The percentage of the lifetime spent in hospitalization was 17.1% (13/76). There are no differences on survival rate in that patients based on neoplasias type and age.Conclusion: The urinary obstruction must be immediately relieved. The percutaneous nephrostomy is a safe and effective method for relief the obstruction. Patient with hemodialysis before the procedure had a poor prognosis.
BODY MASS INDEX RELATIONS WITH THE DIFFICULTIES AND COMPLICATIONS OF PERCUTANEOUS NEPHROLITHOTOMY
Authors: Prapiska Fauriski Febrian , Hardjowijoto Sunaryo , Soebadi Doddy M , Djojodimedjo Tarmono
Published: August 2019

Objective: To identified outcomes and complications of percutaneous nephrolithotomy (PCNL) in patients of various body mass indices (BMI) to determine the safety of this procedure in patients with elevated BMI.Material & methods: The analytic observational prospective study of patients who underwent PCNL between February to July 2015 in the operating room Soetomo General Hospital Surabaya. Specifically, BMI, stone-free rates, difficulties duringsurgery, complications, and Clavien score were assessed. We evaluate the independent contribution of BMI as a predictor of outcomes. Results: There were 35 selected patients with kidney stone and planned to PCNL, 20 patients were included and 15 patients were excluded from this study. The patients consisted of 10 men (50%) and 10 women (50%). Mean age was 47.55 years (range 33-75). There were 4 patients with diabetes (20%), and 10 patients with hypertension (50%). Mean stone size was 23.30 mm. Stone location was 11 patients (55%) in the right kidney, and 9 patients (45%) in the left. There were 12 patients (60%) with a single stone, and 8 patients (40%) with multiple stones. BMI values were distributed as follows,underweight 1 patient (5%), normoweight 7 patients (35%), overweight 6 patients (30%), obesity 6 patients (30%). Mean skin to stone distance (SSD) was 87.56 mm. Stone free rate was 55%, and difficulties during surgery only seen in 1 patient (5%) bleeding profusely and open surgery was performed. Clavien score in these patients were grade I in 11 patients (55%), grade II in 7 patients (35%), and grade IIIB in 2 patients (10%). The BMI had no significant effect with Intra operative and postoperative difficulties (0.390. p <0.05. CI 95%). However the lower stone free rate had significant effect (0.040. p <0.05. CI 95%).Conclusion: BMI had no significant effect with Intraoperative and postoperative difficulties in PCNL.However, the lower stone-free rate risk associated with elevated BMI was significant.
MATURE RETROVESICAL TERATOMA IN AN ADULT MALE: A CASE REPORT AND LITERATURE REVIEW
Authors: Vera Vera , Safriadi Ferry
Published: August 2019

Objective:We reported a case of mature (benign) cystic retrovesical teratoma. Retrovesical teratoma is a very rare extragonadal tumour, especially in adults, moreover in male patients. Grading and classification of teratoma is important for management and prognosis.Material & method:The patient in this study was a 49-year-old male who had chief complaints of abdominal mass and difficulty in urination. We performed Ultrasonography (USG) and Abdominal Multislice Computed Tomography (MSCT) scan on the patient. Results: USG showed a large mass in the pelvic region demonstrating a well-defined hypoechoic mass with septations at posterior of vesica urinaria. MSCT scan showed a large inhomogeneous hypodense mass with thin septations as well as multiple areas of fatty collections and coarse calcifications in pelvic region. We performed complete surgical resection per laparotomy. Grossly, the mass measured 12 x 10 x 5 cm and had rubbery consistency. Cut section of the mass revealed multilocular cystic spaces, whitish-gray walls, scattered yellowish adipose tissue collection, mucus secretions, and areas of calcifications. Pathological diagnosis of the resected tumour was a matured teratoma. The diagnosis was made because the tumour showed signs of a mature teratoma such as lined by stratified squamous and respiratory columnar eptithelium, fat and muscle tissue, nerve tissue, and calcifications. Conclusion: There were no neuroepithelium appearance. To our knowledge, this is the first retrovesical teratoma case being reported in Indonesia.
SURVIVAL OF PATIENTS WITH BLADDER CANCER WHO HAD PARTIAL CYSTECTOMY IS BETTER THAN THOSE WHO HAD RADIOTHERAPY
Authors: Prayoga Denny Achmad , Tranggono Untung
Published: August 2019

Objective: To evaluate the survival on patient who had muscle invasive bladder cancer that had been operated or radiotherapy at Sardjito Hospital Yogyakarta. Material & method: From the year 2004-2010, we were data the patients with muscle invasive bladder cancer that had been operated or radiotherapy at Sardjito Hospital. We studied the age when diagnosed, gender, TNM status, histophatologic finding, histophatologic grade, kinds of surgery and status when follow-up. We evaluated the survival of each patient until 5-years post-surgery. We did bivariate analyze to assess the correlation of patient survival and TNM status, histophatologic grade, clinical stadium and kinds of management. We use Kaplan Meier curve to assess the the survival of patient who had muscle invasive bladder cancer. Results: There were 37 patients with bladder cancer, 3 female patients (8.1%) and 34 male patients (91.9%). Five patients were performed radical cystectomy, 4 patients performed partial cystectomy and 28 patients performed TUR-BT and radiotherapy. There were no significant correlation on the patient survival who had muscle invasive bladder cancer with gender, age, stadium, TNM staging, histopathologic grade and kinds of management (p>0.05). From Kaplan Meier curve, we found that the patients survival was better on stadium I, staging T1, N0, M0 and histopathologic G1 grade. While based on kinds of management, patients were performed partial cystectomy had the survival rate better than the one who only performed TUR-BT and radiotherapy. Conclusion: The surgery of partial cystectomy had a better survival rate than TUR-BT and radiotherapy..