bluuebunny/crossref_metadata_2025 huggingface dataset:
PERCUTANEOUS NEPHROSTOMY FOR RELIEF OBSTRUCTIVE UROPATHY: BENIGN VERSUS MALIGNANT DISEASE
Authors: Yuri Prahara , Rochadi Sungsang
Published: August 2019

Objective: This study aimed to find out the effectiveness of percutaneous nephrostomy (PCN) as palliative decompression of the obstructed urinary system. Materials & Methods: A case control study was performed with 118 patients (69 female and 49 male) with obstructive uropathy who were undergoing PCN during 2009 until 2012, retrospectively. The mean of age was 50.03 years. The PCN technique involves an ultrasound-guided puncture of the dilated collecting system with nephrostomy trocar than insert an 8 Fr nasogastric tube as nephrostomy catheter. Differences of renal function between benign and malignancy were assessed using Independent t-test. Changes in renal function after procedure were expressed as mean ± SD and analyzed using Pair t-test.  Results: There was no procedure-related mortality. The most cause of malignancy was cervix cancer (36.4%) while the result of a benign process was 28.8% of urinary tract stones. Dialysis before procedure were performed in 43 (36.4%) consisting of 42 malignancies and 1 benign process. Improvement in renal function were statistically significant both benign and malignant groups seen in the levels of creatinine and blood urea nitrogen (BUN) before and after procedure (p<0.001). The mean differences were also statistically significant at the preoperative creatinine values between benign and malignant processes (p=0.019) but BUN levels before and after as well as postoperative creatinine levels showed no significant difference. Conclusion: PCN is a widely used technique, with a high technical success rate and low rate of complications. Obstructive uropathy due to benign processes had a better prognosis than malignancy after PCN treatment. Hemodialysis was mainly performed in patients with malignancy prior to PCN.
PREDICTIVE FACTORS OF POST EXTRACORPOREAL SHOCK WAVE LITHOTRIPSI COMPLICATION EVENTS
Authors: Yuniarso Fajar Nugroho , Tranggono Untung
Published: August 2019

Objective: To know if pre-morbid factors such as maximum power, maximum frequency, repeated extracorporeal shock wave lithotripsy (ESWL), age, hypertension, diabetic, nutrition, blood coagulation disorders, kidney function disorders, pain perception, stone burden, and stone location, can be use to predict ESWL complication. Material & methods: This study is done retrospectively. Analysis was done on 50 patients undergoing ESWL between July 2014 to December 2015. Free variables which evaluated were maximum power, maximum frequency, repeated ESWL, age, hypertension, diabetic, nutrition, blood coagulation disorders, kidney function disorders, pain perception, stone burden, and stone location. Dependent variable which evaluated was steinstrasse event, post ESWL fever, post-ESWL renal colic, post-ESWL hematuria. Age variable were distributed normally and done bivariate analysis by student T-test. Others were abnormally distributed and analyzed univariately by Mann U Whitney. Results: During study period, 50 patients were collected. Among them, 60% were men and 40% were women. Mean age of patients undergo ESWL were 50.9 +12.7 years. Mean stone size that undergo ESWL were 172.7 + 277.8 mm2. Patients with hypertension before ESWL were 9 patients. Stones were mostly located on kidney pyelum (29 patients), inferior calix (11 patients), superior calix (5 patients), middle calix (4 patients), and 1 patients has staghorn stone. After ESWL, none of the patients complaining severe pain, 35 patient complaining mild pain, and 15 patient complaining moderate pain. Repeated ESWL done in 16 patients (32%). Post-ESWL complication such as hematuria happened on 12 patients, steinstrasse on 1 patient, and colic on 6 patients. None of patients complaining fever. Repeated ESWL happened on 32% patients and have complication risk of hematuria (p=0.043). Hypertension is significantly effecting on hematuria event after ESWL (p=0.015). Conclusion: Hypertension and repeated ESWL can be used as predicting factor of hematuria complication.
PREDICTIVE FACTORS OF BLOOD TRANSFUSION AFTER TURP AT SARDJITO GENERAL HOSPITAL YOGYAKARTA
Authors: Arifin Bobbi , Tranggono Untung
Published: August 2019

Objective: To know the factors that can predict the need for blood transfusions after transurethral resection of the prostate (TURP) at Dr. Sardjito General Hospital. Material & method: This is a retrospective study. Analysis performed on 250 patients who underwent TURP between the years 2013 to 2015. The independent variables evaluated were age, body mass index (BMI), the estimated size of the prostate by transabdominal ultrasonography (TAUS), duration of surgery, hemoglobin level (Hb), the value of international normalized ratio (INR), history of hypertension, diabetes mellitus (DM) and the use of aspirin, and leukosituria. The dependent variable evaluated was the estimated amount of bleeding which was described by the blood transfusion requirements in patients after TURP. Results: Hb levels before surgery (p=0.000), history of hypertension (p=0.001) and a history of aspirin consumption (p=0.008) had a significant association with blood transfusion after TURP. The Hb cut-off value was 12.45 g/dl. Age, BMI, the estimated size of the prostate by TAUS, duration of surgery, history of diabetes and leukosituria did not have a significant association with blood transfusion after TURP. Conclusion: The results showed that Hb levels before surgery, a history of hypertension and aspirin usage can be predictive factors for blood transfusions after TURP.
Patients’ Characteristics and Factors Influencing Success Rate of ESWL in Rumah Sakit Umum Daerah Kardinah, Tegal
Authors: Cipta Wahid , Ali Zulfikar
Published: August 2019

Objective: To evaluate which factors influencing success rate of extracorporeal shock wave lithotripsy (ESWL) in Kardinah Hospital Tegal. Material & methods: This was a retrospective study from secondary database of patients diagnosed with ureter or kidney stone whom underwent ESWL procedure in RSUD Kardinah Tegal from April 2012 to November 2015. Multivariate analysis and Chi-square analysis from SPSS ver. 19 were used to evaluate all the factors related to success rate of ESWL. Results: There were 314 patients included in this study with 59.5% of them were male patients. The average age of patients was 50 ± 5.5 years old. In 256 cases of kidney stones, there were 69 (26.9%) cases with size <10mm, 160 (62.5%) cases with a size of 10-20mm, and with a size >20mm by 27 (10.5%) cases. For ureteral stones, there were 46 (79.3%) cases with size <10mm, 11 (18.9%) cases with a size of 10-20mm, and 1 (1.7%) case with size >20mm. In general there were 238 (75.7%) of patients received no additional ESWL procedure while 61 (19.4%) patients underwent 2nd ESWL procedure, 33 (10.5%) patients underwent 3rd ESWL procedure, and 11 (3.5%) patients underwent more than 4 ESWL procedures. Kidney stones with a size <10mm, ureteral stones with size <10mm got, and location of the stone had p value of p=0.0015, p=0.001, and p=0.031 respectively. Other factors such as gender, age, stone opacity, and the number of shock given did not affect the success of ESWL. Type of lithotripter were not related to SFR in patient with kidney stone but was significantly related in ureter stone with p=0.078 and p=0.04 respectively. Conclusion: Most of patients reached stone free condition after the first ESWL procedure. Factors that influence the success of ESWL were the stone size and stone location. Kidney stone size <10mm and ureter stone <10mm had the highest SFR. Types of lithotripter were not related to SFRs in patients with kidney stone but were significantly related in ureteral stone with Medispec EM1000 electromagnetic and Huikang HK-V electromagnetic had the highest SFRs.
THE EFFECT OF PERIOPERATIVE AND PROPHYLACTIC ANTIBIOTICS AGAINST THE INCIDENCE OF UTI AND SURGICAL SITE INFECTIONS AFTER HYPOSPADIAS SURGERY
Authors: Kusuma Raditya , Renaldo Johan , Djojodimedjo Tarmono , Hardjowijoto Sunaryo
Published: August 2019

Objective: The aim of this study is to analyze the effect of perioperative and prophylactic antibiotics against the incidence of urinary tract infections (UTI) and surgical site infections (SSI) after hypospadias surgery (hypospadias repair operation). Materials & Methods: This study is an observational study of explanation with 24 hypospadias patients (2 groups) during the period of October 2015 to February 2016. Samples were divided into two groups, 12 patients received prophylactic antibiotics and 12 patients received perioperative antibiotics (random sampling). Inclusion criteria included patients with glandular hypospadias to proximal penile hypospadias, aged 6 months until 15 years and underwent hypospadias surgery with one surgical technique namely Tubularized Incised Plate (TIP). The examination of urine culture and evaluation of the wounds were performed on day 4, 10, and 20 day after surgery to determine the incidence of urinary tract infections and surgical site infections. Results: There is no significant difference in the incidence of UTI on on day 4, 10 and 20  in perioperative group and prophylaxis group with p=0.282 and p=0.500 at day 4 and 10  (p>0.05). There is no significant difference in the incidence of SSI on day 4, 10 and 20 in the group of perioperative antibiotic and prophylactic antibiotic with p=0.680 and p=0.217 at day 4 and 10 (p>0.05). Conclusion: There is no effect of the prophylactic antibiotic as well as perioperative antibiotic treatment on the incidence of UTI and SSI
SUBURETERAL MUCOSA INJECTION WITH DETRANOMER/HYALURONIC ACID FOR VESICOURETERAL REFLUX TREATMENT: SYSTEMATIC REVIEW
Authors: Tambunan Nicholas , Rodjani Arry , Wahyudi Irfan
Published: August 2019

Objective: The aim of this study is to search the success rate of detranomer-hyaluronic acid (Dx/HA) used as injection through endoscopy approach and grades of vesicoureteral reflux (VUR) that could affect it success rate. Material & methods: We searched the literatures from MEDLINE database and PubMed from year 2001 until 2013. The data was analyzed using Random Effects Model with the method of Mantzel-Haenzel to analyze the success rates of dextranomer/hyaluronic acid and was determined by 95% Confidence of Interval (CI) disclosure. Meta-regression was performed to adjust the success rate compared with the grade of VUR as covariate. We assessed the heterogeneity by calculating the I2 statistic. All analyses were performed with Stata Statistical Software Version 12.0 (StataCorp). Results: We identified 9 literatures in full review. Of 1105 ureters that were injected with dextranomer/hyaluronic acid, 817 (72%; CI: 67-76%) were successfully treated according to author’s definition. The success rates of Dx/HA for pediatric with grade 1 VUR reached 80% (95% CI: 66-89%), whereas in grade 5 VUR only 50% (95% CI: 34-66%; p<0.05). Conclusion: The overall success rate of dextranomer/hyaluronic acid injection treatment was 72% after 3 months, although success rates varied widely among studies. Preoperative grade of VUR was significantly associated with treatment outcome. Increased VUR grade negatively affected success rates.
CORRELATION BETWEEN S.T.O.N.E NEPHROLITHOMETRY SCORING IN PREDICTING FREE-STONE RATE AFTER PERCUTANEOUS NEPHROLITHOTOMY
Authors: Putri Karinda triharyu caesari , Djojodimejo Tarmono , Rizaldi Fikri , Hardjowijoto Sunaryo
Published: August 2019

Objective: To investigate free-stone rate after Percutaneous Nephrolithotomy (PNL) using S.T.O.N.E nephrolitometry scoring system, with regards of stone size (S), skin-to-stone distance (T), obstruction degree (O), number of calyx involved (N), and stone density (E) in Non Contrast CT Scan (NCCT). Material & methods: This is an analytic observational study on patients with renal stones undergoing PNL. All patients underwent NCCT before and after PNL; each variables was measured and counted for a total score. Post-operative evaluation was done using NCCT. Results: Thirty patients met inclusion criteria, 19 (63.3%) were stone-free, and 11 (36.7%) were with residual stone. Among the five variables, stone size (p=0.005), number of calyx involved (p=0.002) affected the outcome of surgery, while skin-to-stone distance, obstruction degree, and stone density did not. The overall total score of S.T.O.N.E nephrolithometry is correlated with the outcome of PNL (p=0.001). Conclusion: S.T.O.N.E nephrolithometry is a simple scoring system, while it is also easy to use, and can be used to predict the free-stone rate after PNL.
INFLUENCE OF DIABETES MELITUS, BMI, AND HBA1C IN HIGH GRADE PROSTATE CANCER
Authors: Hadibrata Exsa , Danarto H R
Published: August 2019

Objective: This study aims to determine the effect of diabetes mellitus (DM) and body mass index (BMI) on the risk of prostate cancer and high grade prostate cancer. Materials & method: This study is a retrospective observational study with cross-sectional design, using secondary data to determine the relationship of diabetes mellitus, body mass index and HbA1c levels with the degree of differentiation histopathologic prostate cancer. Data were analyzed using Chi-Square test, T-test and Man Whitney test with a confidence level of p<0.05 and a=0.05. Results: There are 78 samples diagnosed with prostate cancer. A total of 12 (15.4%) samples are diabetes mellitus, 18 (22.9%) samples classified as body mass index more than 23.4 (5.1%) samples have elevated levels of HbA1c levels >6.5. On histopathologic examination, it was found as many as 45 (57.7%) samples with high grade prostate cancer, as much as 9 (11.5%) samples with moderate grade prostate cancer, and as many as 24 (30.8%) samples with low grade prostate cancer. In bivariate analysis diabetes mellitus, BMI>23, and HbA1c level relationship with high grade prostate cancer is not statistically significant with p>0.05. Conclusion: There were no statistically significant relationship between diabetes, BMI and increased levels of HbA1c with high grade prostate cancer.
A 87 YEARS OLD MALE WITH GIANT PROSTATIC HYPERPLASIA AND BLADDER STONES, THE LARGEST PROSTATE REPORTED IN INDONESIA
Authors: Vera Vera , Pramod Sawkar Vijay
Published: August 2019

Objective: The aim of this article is to report a case of Giant Prostatic Hyperplasia and see the correlation between volume of prostate and benign prostate hyperplasia (BPH) symptoms. Giant BPH is defined as a prostate weight over 200 g or 500 g; the lower threshold was suggested by Japanese authors. It’s extremely rare, with only 16 cases exceeding 500 g till 2013. Case presentation: Patient was an 87-year-old male with chief complaint of haematuria. We performed Transabdominal Ultra Sonography (USG) on the patient. Discussion: Transabdominal USG showed enlarged prostate with median lobe protruding into the bladder measuring 86 x 102 x 76 mm and 348 cc in volume. We performed transvesical prostatectomy. The large prostate was enucleated completely in one piece with 23 stones measuring about 1 cm in size. Grossly, the mass measured 12 x 8 cm and weighed 300 g. Histopathology evaluation revealed BPH. Conclusion: To our knowledge, this is the first giant BPH case being reported in Indonesia. We would like to emphasize that severity of BPH symptoms does not correlate with volume of the prostate. Unfortunately, we can not conclude that there were correlation between body mass index (BMI) and volume due to lack of BMI data from the literature.
HAEMATURIA AND COLIC CORRELATION AS CLINICAL PREDICTORS IN URETERAL STONES PATIENTS AT UROLOGY OUTPATIENT UNIT SOETOMO HOSPITAL WITHIN JANUARY 2011 - DECEMBER 2015 PERIOD
Authors: Laksmana Wisnu , Renaldo Johan , Djojodimedjo Tarmono
Published: August 2019

Objective: Determine the relationship between clinical symptoms of colic pain and haematuria as a predictor of ureteral stones incident at Dr Soetomo Hospital within a period of five years. Material & methods: This study is a descriptive analytic study using the sensitivity-specificity test with retrospective design. Data were collected from patient's medical records with a ureteral stone diagnosis at outpatient unit Dr Soetomo Hospital within 2011-2015. Results: Renal colic or ureter colic without haematuria had 88.32% specificity and 53.07% sensitivity in the incidence of ureteral stones at Urology Outpatient Unit Dr Soetomo Hospital within 2011-2015 period. Haematuria without colic complaint had 29.37% sensitivity and 90.17% specificity in the incidence of ureteral stones. Colic and haematuria compared with colic had 55.76% sensitivity for the incidence of ureteral stones and 70.09% specificity. While colic and haematuria compared with haematuria had a sensitivity of 77.41% for the incidence of ureteral stones and 65.92% specificity. Colic and haematuria compared to other complaints has a 58.77% sensitivity for ureteral stones incidence and 94.66% specificity. Conclusion: Colic and haematuria are clinical predictors that have a better value than the complaints of colic without haematuria and haematuria without colic, in the ureteral stones incident at Urology Outpatient Unit Dr Soetomo Hospital within 2011-2015 period. This is consistent with the literature that mentions prominent complaint in the incidence of ureteral stones is their colic pain caused by the stone through the ureteral passage, and followed by haematuria for their mucosal surface injury.
EFFECT OF PURWOCENG EXTRACT ON THE EXPRESSION OF NITRIC OXIDE NEURONAL SYNTHASE IN PENILE TISSUE OF WHITE MALE RATTUS NOVERGICUS
Authors: Pratama I Gede Andre Arda , Danarto H R
Published: August 2019

Objective: To know the effect of purwoceng extract (Pimpinella alpine) on the expression of neuronal nitric oxide synthase (nNOS) in the penile tissue of white male rats (Rattus novergicus) through immunohistochemical examination. Material & Methods: Animal experiments consisted of 27 male rats, three months of age with a mean body weight of approximately 200 grams were divided into three groups randomly, one group consisted of 10 rats. Treatment 1 rats receive Pimpinella alpina extract with 50 mg/ml, Treatment 2 rats receive Pimpinella alpina extract with 100 mg/ml. In the control group rats receive aquadest as much as 1 ml. Results: In the control group the average is 75.67, in the treatment group 1 is 113, and in group 2 is 181.44. The difference in treatment between groups was performed using one-way ANOVA test. Between control and treatment groups 1 the different is significant with p value of 0.013 (p<0.05). The mean expression of nNOS between treatment groups 1 and 2 differ significantly with p=0.00 (p<0.05). Conclusion: Purwoceng extract (Pimpinella alpine) can increase the expression of nNOS on NANC nerve fibers (nonadrenergic noncholinergic) in the corpora cavernosa of the penis that causes smooth muscle relaxation in penile erection.
CHARACTERISTIC OF PEDIATRIC UROLITHIASIS PATIENTS IN ZAINOEL ABIDIN HOSPITAL
Authors: Yohanes Simon Natanel , Dahril Dahril
Published: August 2019

Objective: We conducted a study to describe the characteristics of pediatric urolithiasis patients in Zainoel Abidin Hospital, Aceh-Indonesia. Material & Methods: Between January 2013 and March 2016, we retrospectively reviewed the medical records of 16 pediatric patients with urolithiasis in Zainoel Abidin Hospital, Aceh-Indonesia. The patients were come from whole Aceh region and the variables are sex, age, family history of stone disease, and stone location. The data were described in graphics and tables. Results: From 16 pediatric urolithiasis patients, 9 patients (56.3%) were males and 7 patients (43.7%) were females. In 2013 there were 4 pediatric urolithiasis patients (1.2%), in 2014 there were 5 (1.6%), and in 2015 there were 3 (2.3%). From January – March 2016 there were 4 pediatric urolithiasis patients (4.5% of all urolithiasis patients). The mean age of all pediatric patients were 7.7 ± 5.5 years (1-17 years). The incidence of urolithiasis for group < 5 years of age were 6 patients (37.5%) with mean age of 2 ± 1.14 years (1-4 years), in 5–10 years age group, there were 4 patients (25.0%) with mean age 7 ± 2.16 years (5-10 years), and 11–18 years age group, there were 6 patients (37.5%) with mean age 13.8 ± 2.16 years (12-16 years). Stones were located in the upper urinary tract in 9 cases (56.3%), lower urinary tract in 6 cases (37.5%), and combine stone located in upper and lower urinary tract in 1 case (6.2%). There were 5 patients (31.3%) with family history of stone disease. Conclusion: Pediatric urolithiasis case in Aceh Province is slightly predominant in male children, with mean age of 7.7 ± 5.5 years (1-16 years). The most common age group is evenly distribute between <5 years old and 11-18 years old. The most common stone location is in the upper urinary tract.
TESTICULAR TORSION: CAUSATIVE FACTOR IN DELAYED MANAGEMENT
Authors: Abshari Fatan , Wahyudi Irfan , Rodjani Arry
Published: August 2019

Objective: Analyzing the factors causing delays in the management of patients with testicular torsion in Dr. Cipto Mangunkusumo General Hospital Jakarta. Material & methods: This research is a retrospective research using questionnaire from patients as primary data and from Dr. Cipto Mangunkusumo General Hospital medical records or urologic reports as secondary data from 1st January 2011 to 30th April 2015. Results: 4 patients diagnosed with left testicular torsion admitted to hospital with >4 hours onset (as a prehospital factor). 3 of 4 patients were adult, who came with left testicle pain. The minimum VAS score perceived is 2. 3 of 4 patients had 540o medial left testicle rotation intraoperatively while all patients left testicles were unvital. Conclusion: Further examination is required to diagnose testicular torsion in adult-geriatric. Non-specific complaints, such as lower abdominal pain or painful testicles and mild pain in scrotum  were some of the most important factors, thus causing delays in testicular torsion management. However, a comprehensive education to all health workers, especially for doctors is still required, because the complaints of pain in patients with testicular torsion does not always appear acutely. This becomes important for early identification of patients with testicular torsion, in order to prevent delay in management.
TESTICULAR CANCER IN SOETOMO HOSPITAL SURABAYA: RETROSPECTIVE STUDY
Authors: Mukti Ade Indra , Hakim Lukman , Djatisoesanto Wahjoe , Hardjowijoto Sunaryo
Published: August 2019

Objective: The aim of this study was to determine the characteristics of the testicular cancer that were managed in Soetomo Hospital. Materials & Methods: This was a retrospective descriptive study. We reviewed the medical records of patient with testicular tumor admitted in Soetomo Teaching Hospital Surabaya, from January 2008 until December 2013. The data regarding demographic characteristics, clinical presentation, grading and staging based on pathological examination result, and the management of the cancer. Data was presented in tabular and narrative in order to know the number and percentage of testicular cancer in Surabaya. Results: There were 46 patients with testicular cancer with mean age of 27.1 ± 7.9 years. Peak incidence was 15–35 years old (54%). Testicular mass was the most frequent clinical presentation in 42 patients (91%), abdominal mass and other complaints in 4 patients (9%). Most of the patients live outside Surabaya in 34 patients (72%). Location of the tumor was more frequently in scrotum, which occured in 42 patients (91%). A total of 4 patients (9%) were found to have a history of UDT. Based on the TNM staging, patients with stage pT3 were as many as 20 patients (43%), pT4 11 patients (24%), pT2 7 patients (15%) and pT1 4 patients (9%). In regional lymph nodes staging (N) N3 were as many as 26 patients (57%), N0 9 patients (20%), N2 5 patients (11%) and N1 2 patients (4%). Metastase staging (M) M0 was found in 27 patients (58%) and M1 tumor was found 42%. The major pathological finding was seminoma in 37 patients (80%), Yolk sac tumor in 4 patients (9%), Embryonal Ca in 1 patient (2%), Teratoma in 1 patient (2%) and mixed germ cell tumor in 3 patients (7%). The most widely theraphy was underwent orchidectomy followed by PEB chemotheraphy in 29 patients (64%), 3 patients (6%) underwent EBRT and PEB chemotheraphy, 5 patients (11%) underwent PEB chemotheraphy, There were 9 patients (19%) underwent orchidectomy alone. Group of seminoma tumor show normal limit of tumor marker α-FP and β-HCG and increased in non seminoma. Conclusion: Testicular cancer mostly appears in younger males. Most of testicular cancer was seminoma, diagnosed in advanced stage with metastase 42% of the patient. Most of the patients received orchidectomy followed by PEB chemotheraphy.
PHENOTYPE-GENOTYPE AND PEDIGREE ANALYSIS OF ISOLATED HYPOSPADIAS PATIENTS
Authors: Vikawati Nura Eky , Santosa Ardy , Juniarto Achmad Zulfa , Faradz Sultana MH
Published: August 2019

Objective: Hypospadias is a malformation in urethra which has many range of severity. A patient with Isolated hypospadias (IH), a mild disorder of sex development (DSD) has a hypospadias phenotype only. Hypospadias is considered as multifactorial disease in which genetic factors contribute to its development. Chromosome analysis in DSD including hypospadias is conducted for gender assignment and other possible genetic contributions. This analysis solely could not elucidate all genetic causes of hypospadias. Polymorphism of V89L in SRD5A2 is suggested as one of genetic risk factors of hypospadias. To determine the genetic risk factor and pattern of inheritance, a good pedigree construction is required. Material & methods: 35 eligible subjects with IH admitted to Center for Biomedical Research (CEBIOR) during 2012-2015 were randomly selected. 35 normal male as control were included in this study. Data on three generation pedigrees were collected from medical records in 35 affected subjects. Chromosome analyses were done by using G-banding technique. Polymorphism analysis of V89L in SRD5A2 gene was done using PCR-RFLP technique in all samples. Results: From the 35 affected subjects, the most frequent phenotype was penile hypospadias (47%), a pair of twins were monozygotic and one had a cousin diagnosed with urogenital abnormalities (i.e micropenis and chordae). All subjects had 46,XY chromosome. No chromosomal aberration was found. No positive correlation between polymorphism of V89L in SRD5A2 and risk of hypospadias (PR of CC+CG vs GG=1.0, 95% CI: 0.342−2.921, p value=1.0). Conclusion: The pedigree data from our study implies tendency of genetic involvement in hypospadias cases. There were no chromosomal aberrations in hypospadias cases. The finding on polymorphism of V89L in SRD5A2 gene does not support that of previous studies.
ROBOTIC-ASSISTED KIDNEY TRANSPLANTATION: A REVIEW
Authors: Prasetyo Dimas Tri , Birowo Ponco , Hamid Agus Rizal Ardy Hariandy , Wahyudi Irfan , Rodjani Arry , Mochtar Chaidir , Rasyid Nur
Published: August 2019

Objective: To discuss about kidney transplantation (KT), primarily on robotic-assisted kidney transplantation (RAKT) and to present the current updates on RAKT techniques performed by different centres worldwide. Material & methods: We searched and compiled various literatures on RAKT, focussing on different techniques used to perform the procedure. All the references cited in this review are indexed in PubMed or Scopus. Results: Since the first successful kidney allograft transplantation in human was performed in 1954, KT has become the preferred treatment modality for patients with end-stage renal disease (ESRD) seeking a more definitive outcome and better quality of life. Over the years, newer techniques of KT have been introduced, including minimally-invasive laparoscopic KT. However, laparoscopic KT has its own limitations, which include loss of hand-eye coordination and poor ergonomics for the surgeon. RAKT offers the same benefits as laparoscopic KT without its limitations. There are several transplantation centres worldwide performing RAKT regularly. The differences in RAKT technique between these centres are regarding patient’s position during surgery, location of incision for graft placement, use of regional hypothermia, and techniques of graft placement and ureteric reimplantation. Conclusion: The invention of RAKT as a minimally-invasive KT technique has enabled surgeon to perform surgeries when the operative field is deep and narrow and when fine dissection and microsuturing are required.
PROGNOSTIC PARAMETERS FOR THE RECOVERY OF RENAL FUNCTION IN PATIENTS WITH OBSTRUCTIVE UROPATHY
Authors: Bundu Aristo , Danarto H R
Published: August 2019

Objective: The aim of this study was to determine the prognostic parameters for the recovery of renal function in patients with obstructive uropathy after the release of obstruction. Material & methods: This is a retrospective cohort study. Secondary data from the patient's medical record was used to determine whether the ratio of blood urea nitrogen (BUN)/creatinine, hemoglobin, hyperkalemia, blood glucose, renal parenchymal thickness, and obstruction etiology are prognostic parameters for recovery of renal function in patients with obstructive uropathy after release of obstruction. Bivariate was used to analyze the data using Chi-square and Fisher's exact test with significance level of p<0.05 to evaluate the significance. Results: Based on total of 66 research samples, it was found that renal parenchymal thickness was ≥10 mm (p=0.001), hemoglobin level was ≥10 mg/dL (p=0.001), and BUN/creatinine ratio was ≥10 (p=0.003), it had significant correlation with the recovery of renal function, meanwhile, obstruction etiology variable (p=0.566), and hyperkalemia (p=0.792) did not provide significant recovery of renal function. Conclusion: Renal parenchymal thickness, hemoglobin level, and BUN/Creatinin ratio are the prognostic parameters for recovery of renal function after release of obstruction.
STONE FREE RATES OF KIDNEY STONE WAS LOWER THAN THE ONE OF URETER STONE PATIENTS MANAGED BY ESWL AND THE ONE OF URETER STONE MANAGED BY URETEROLITHOTRIPSY
Authors: Zamzami Zuhirman
Published: August 2019

Objective: To evaluate the stone free rates of kidney and ureter stone patients managed by Extracorporeal Shockwave Lithotripsy (ESWL), and the ureter stone free rate managed by ureterolithotripsy. Material & method: We reviewed the medical records of kidney and ureter stone patients managed by ESWL and ureter stone patients managed by ureterolithotripsy in Arifin Achmad Regional General Hospital Pekanbaru Riau Province, Indonesia, from January 2010 - December 2016. ESWL and ureterolithotripsy stone free rates were examined by the control of KUB röngents. Results: There were 891 kidney and ureter stone patients consisting of 325 (36.5%) were kidney stone patients and 566 (63.5%) were ureter stone patients. The pyelum stones were the most (78.2%) in kidney stones and the lower ureter stones were the most (57.2%) in ureter stones. There were more male patients than the female ones in which most of the patients were in the group age of 49-59 years. The amount of patients increased each year. The kidney stone free rate managed by ESWL was lower (71.7%) than ureter stone free rate (84.1%) by ESWL, while the stone free rate of ureter stone patients managed by ureterolithotripsy was 100%. Conclusion: The ESWL stone free rate of the kidney stone patients was lower than the one in ureter stone patients while the ureterolithotripsy stone free rate was 100%.
COMPARISON OF EFFECTIVENESS OF MELOXICAM 15 MG ONLY, COMBINATION OF MELOXICAM 15 MG AND TAMSULOSIN 0.4 MG, AND TAMSULOSIN 0.4 MG ONLY FOR SUCCESS OF TWOC IN BPH PATIENTS WITH FIRST EPISODE OF ACUTE URINARY RETENTION
Authors: Yasa Muhammad Asro Abdih , Soebadi Doddy M , Rizaldi Fikri
Published: August 2019

Objective: To prove that Meloxicam 15 mg only, combination of Meloxicam 15 mg and Tamsulosin 0.4 mg were more effective for the success of Trial Without Catheter (TWOC) in BPH patients with first episode of urinary retention compared to Tamsulosin 0.4 mg only. Material & methods: Benign Prostatic Hyperplasia (BPH) patients with first episode of urinary retention that met the inclusion criteria and did not fulfill the exclusion criteria were randomized to form 3 treatment groups, n=11 for each group. Group I was given Meloxicam 15 mg only, group II was given a combination of Meloxicam 15 mg and Tamsulosin 0.4 mg, and group III was given Tamsulosin 0.4 mg only. For each group the drug given once orally for 7 days. The success of TWOC assessed by an ability to spontaneous micturition after that each treatment in the first 24 hours after urethral catheter removal, accompanied by Qmax in uroflowmetry ≥ 5 cc/sec and PVR ≤ 100 cc. Results: All Meloxicam 15 mg only group samples have recurred urinary retention (100%). The success rate of TWOC for combination of Meloxicam 15 mg and Tamsulosin 0.4 mg group was 72.7%; while for the Tamsulosin 0.4 mg only one was 63.6%. The success rate of TWOC for combination of Meloxicam 15 mg and Tamsulosin 0.4 mg group was higher than Tamsulosin 0.4 mg only one (p=0.003). Conclusion: The combination of Meloxicam 15 mg and Tamsulosin 0.4 mg orally once daily for 7 days was more effective in the success of TWOC in BPH patients with first episode of urinary retention compared to Tamsulosin 0.4 mg only orally once daily for 7 days.
GIANT CLEAR CELL RENAL CARCINOMA: A CASE REPORT
Authors: Palgunadi I Nyoman , Pramod Sawkar Vijay
Published: August 2019

Objective: This article is aimed to report an unusual presentation of renal cancer T4N0M0 in which the tumor weighed about 5 kilograms in a patient admitted to Urology Department of Hasan Sadikin Hospital in Bandung, Indonesia, in August 2016. Case presentation: We report a case 62 year old male with history of growing mass in his left abdominal. There are also painless hematuria and weight loss of approximately 10 kg over the past 2 years. Discussion: Physical examination found a significant palpable, immobile and mild tender mass in the left upper quadrant of the abdomen. Abdominal Pelvic Computed Tomography (CT) scan revealed inhomogenous hypodens mass in the left kidney. Resection of the tumor revealed a 5 kg (22 x 25 x 18 cm, with total volume of 9.900 cm3) encapsulated neoplasm. Histophatological examination revealed a clear cell type renal cell carcinoma (RCC) with positive margin and Fuhrmann grade 2. In Asia, a giant chromophobe RCC exceeding 10 kg in weight was reported in 2009. As for previously reported giant clear cell RCC, we found out the data to be very limited. Conclusion: Giant RCC is rare, especially clear cell type in histophatological result. The size of the tumor reported in this article is considered as the largest-sized giant clear cell RCC ever reported in Asia. The size of the tumor in this case presented several challenges in the operative settings. However, the outcome and six months post-operative follow-up of the patient was satisfying in which there was no presence of single symptom within the six-month follow-up period.
SURVIVAL ANALYSIS OF CONTINUOUS AMBULATORY PERITONEAL DIALYSIS ON PATIENTS WITH END STAGE RENAL DISEASE IN SARDJITO HOSPITAL PERIOD 2007-2011
Authors: Kohar Moch. Abdul , Danarto H R
Published: August 2019

Objective: This study was aimed to analyze the survival rate on End Stage Renal Disease (ESRD) patients and underwent Continuous Ambulatory Peritoneal Dialysis (CAPD) insertion surgery. Materials & Methods: The subjects of this study were 58 people diagnosed as chronic renal failure and underwent CAPD insertion surgery. This type of research is retrospective, using medical record data in Sardjito Hospital, and then we performed patient survival analysis with CAPD procedure performed on end stage renal disease patient. Results: In survival test performed on patients who underwent CAPD insertion without considering other factors, the mean survival rate was 40.26 months. Kaplan Meier curve obtained 3 and 5 years survival rate of 62% and 45% respectively. Furthermore, the survival test is done by dividing into two group diabetes mellitus (DM) and non-diabetes mellitus (non-DM). In CAPD-attached patients with DM, has a lower mean survival time compared to non-DM. Mean survival time of CAPD patients with comorbid of DM 36.05 months while non-DM 43.43 months. In this study, the Hazard Ratio was 1.44 (0.69-2.99) DM: Non DM. In the survival test by dividing into two age groups, age group ≥ 55 years and <55 years. The results obtained mean survival time for age group ≥ 55 years 36.02 months and for age group <55 years 43.08 months. Conclusion: Patients with kidney failure who underwent CAPD with comorbid DM had lower survival compared with non-DM. The younger the age of the patient that underwent CAPD insertion, the survival rate increase.
THE USE OF RIGISCAN® EXAMINATION IN DIAGNOSING PATIENTS WITH ERECTILE DYSFUNCTION IN JAKARTA
Authors: Basukarno Ari , Birowo Ponco , Tri Prasetyo Dimas , Rasyid Nur
Published: August 2019

Objective: The aim of this study is to describe the characteristic of patients with Erectile Dysfunction (ED) and results of Nocturnal penile tumescence and rigidity (NPTR) based on Rigiscan® examination in patients with ED in Jakarta. Material & Methods: Descriptive-prospective study of patients with ED in Cipto Mangunkusumo Referral Hospital, Bunda General Hospital Jakarta, and ASRI-Siloam Urology Hospital are recorded during 2015. Patients’ age (in years), marital status (yes/no), duration of ED (in months), and International Index of Erectile Function-5 (IIEF-5) were recorded. NPTR examination were performed while patients were sleeping. Number of events, duration of each event (in minutes) as well as the rigidity (in percentage) and tumescence (in cm) were recorded. The elevation of tip and base penile circumference (in cm) during erection were also noted. Results: There were 34 patients who agreed to perform NPTR test. Most patients were married with the average age of 40.94 ± 10.81 years old. The duration of ED were varied from 5 to 96 months with average duration of 33.7 ± 44.34 months and IIEF-5 score was 6.38 ± 5.14. In general number of erections was 4 ± 3 with 23.4% of them had normal erection. The comparison between organic and psychogenic ED showed that the increment of circumference was significantly less in organic ED patients. Other parameters showed insignificant difference in statistical results. Conclusion: NPTR examination is an objective, effective, and easy-to-use measurement in order to differentiate between organic and psychogenic ED. One third of patients who complained with ED suffered from psychogenic ED and needed referral to other specialists.
URINARY STONE COMPOSITION ANALYSIS IN INDONESIAN POPULATION: A SINGLE MAJOR CENTRE ANALYSIS
Authors: Widyasmara Her Bayu , Birowo Ponco , Rasyid Nur
Published: August 2019

Objective: To evaluate the urinary stone composition of Indonesian population. Material & Methods: This is a retrospective study analyzing total 277 urinary stone, obtained from urinary stone patient that underwent treatment in Cipto Mangunkusumo Hospital Jakarta in period 2000-2013. Results: Urinary stone disease is more common in male, with male : female ratio 1.8 : 1, with both in male and female patient, the incidence are highest at 51-60 years old. Calcium containing stone is predominant in this study with calcium oxalate as the most frequent stone with 61% overall, 43.7% in male and 17.3% in female and founded most frequent in 51-60 years old. Uric acid become the second most common stone after calcium containing stone with 9.0% overall, 6.5% in male and 2.5% in female. Infection associated stone such as struvite is 5.8% and Amonium urate 0.7%. In our study, struvite is founded more in male 3.6% than in female 2.2%. Cystine is a rare stone which is only founded 0.7%, in young age at 21-30 years old. Conclusion: Calcium oxalate is the most frequently stone type in our country as it is worldwide. This study revealed  information of stone composition in Indonesian population, that could be beneficial for strategies and management to prevent urinary stone disease and recurrence.
THE INCIDENCE AND CORRELATION OF CHRONIC PROSTATITIS WITH PSA IN BPH PATIENT
Authors: Krisna Daniel Mahendra , Hariatmoko Hariatmoko , Pinzon R
Published: August 2019

Objective: The aim of this study is to determine the incidence of incidental chronic prostatitis proven by biopsy in prostate enlargement patients and to correlate with Prostate Specific Antigen (PSA) level serum. Material & Methods: This was a retrospective study with cross-sectional method. All of the prostate enlargement subjects with urinary retention and treated by surgical therapy were taken into inclusion criteria. The patient with acute prostatitis proven by biopsy and uncompleted medical records were excluded. Statistical analysis used Spearman correlation test. Results: The mean values of age and PSA were 70.24 years and 27.2 ng/mL. The patients characteristic such as surgery waiting time were 81 patients in 1-3 days, the most common length of stay were 3 patients (4%) for 1-3 days. The most common biopsy result was Benign Prostatic Hyperplasia (BPH) in 55 patients (61.5%). 64 patients (70.3%) were treated by Trans Urethral Resection of Prostate (TURP) and 14 patients (9.9%) had secondary surgery. There was a correlation between chronic prostatitis with PSA levels in BPH patients (p=0.000). Conclusion: Chronic prostatitis is often found incidentally in BPH patients and affecting PSA serum level. The existence of chronic prostatitis in BPH may predict the progress of prostate growth.
METASTASIS AND LOCAL INVASION PATTERN OF BLADDER CANCER IN HASAN SADIKIN HOSPITAL
Authors: Mustafa Akhmad , Safriadi Ferry
Published: August 2019

Objective: The aim of this study is to provide database about local invasion and metastasis pattern, as well as the disease characteristics of bladder cancer in Hasan Sadikin Hospital, Bandung. Material & Methods: Between January 2011 and December 2016 there were 321 cases of bladder cancer recorded in our hospital. Of all cases, 106 patients included in this study, with evident of local invasion or distant metastasis either radiologically (contrast abdominal pelvic CT scan) or pathologically. Results: The study group consist of 106 patients (86 men [81.7%], 20 women [28.3%]); with mean age of 56.78 ± 13.19 (4-76) years old. Histopathology findings of transitional cell carcinoma (TCC) consist of 82 (77.3%) patients and the atypical histology features group of 24 (22.7%) patients. Local invasion was found in 99 patients of 321 (30.8%), with the most common organ invasion to the prostate in male (n=38 [35.8%]). Lymph node metastasis were found in 47 patients (44.3%), with the most common nodal metastasis to obturator lymph nodes (n=21 [19.8%]). Distant metastasis was found in 24 patients (22.6%) with the most common site for distant metastasis was the liver (n=12 [11.3%]). In TCC group, 12 patients (63.1%) had a distant organ metastasis with nodal metastasis, whereas in atypical group, majority of the patients with distant organ metastasis (n=5 [83.3%]) had no lymph node involvement. Moreover, in transitional cell group, not all patient (n=17 [73.1%]) had local invasion of the tumor, while all patients with distant organ metastasis in atypical group (n=6 [100%]) had abdominal or pelvic wall invasion (cT4b). Conclusion: TCC is the most common pathology findings and with Prostate is the most common site for local tumor invasion. Obturator lymph nodes is the most common nodal metastasis and liver is the most common site for distant metastasis in bladder cancer.
THE EFFECT OF DEXAMETHASONE ON SPERMATOGONIUM AND SERTOLI CELL OF IPSILATERAL TESTIS IN UNILATERAL TESTICULAR TORSION WISTAR RAT
Authors: Efendi Ferdyan Rachmat , Renaldo Johan , Djojodimedjo Tarmono
Published: August 2019

Objective: To investigate the effect of dexamethasone on spermatogonium and sertoli cell of ipsilateral testis in unilateral testicular torsion strain wistar rat. Material & Method: Experimental study with post-test only control group design. The present  study was conducted on 30 Wistar male rats aged 10 – 12 weeks grouped into 5 groups. Group I was the normal/sham operation group (KN), group II was left testicular torsion for 4 hours group and followed  by manual detorsion  (K1), group III was left testicular torsion for 10 hours group and followed  by manual detorsion (K2),  group IV was left testicular torsion for 4 hours group and given dexamethasone 10 mg/kg body weight subcutaneously 30 minutes before manual etorsion (D1), and group V was left testicular torsion for 10 hours group and  given dexamethasone 10 mg/kg body weight subcutaneously 30 minutes before manual detorsion. All rats had left orchidectomy 4 hours after detorsion. The number of spermatogonium and sertoli cells were counted in histological seminiferous tubular testis that have obtained Haematoxylin Eosin staining. Data were analyzed by ANNOVA followed by Post Hoc Tukey for spermatogonium and Kruskal Wallis followed by Mann Whitney test for sertoli cell. Differences were considered significant at p <0.05. Results: There was significant difference in the mean number of spermatogonium between K1 & D1 group. Otherwise, there was no significant difference in the mean number of spermatogonium between K2 & D2. There was significant difference in the mean number of Sertoli cells between K1 & D1 group, likewise that between K2 & D2 group. Conclusion: These results suggest that dexamethasone has protective effect in spermatogonium and sertoli cell in testicular torsion for 4 hours.
PREOPERATIVE INTRAVENOUS TRAMADOL FOR PERCUTANEOUS NEPHROSTOMY TO REDUCE INTRAOPERATIVE PAIN
Authors: Oetama Harris , Sihombing Aaron Tigor
Published: August 2019

Objective: To evaluate the effect of additional preoperative intravenous tramadol for reducing intraoperative pain. Material & Methods: This study was a double blind randomized controlled study from April - June 2017 in Urology Department in Hasan Sadikin Hospital. Inclusion criteria were cervical cancer patients who were performed percutaneous nephrostomy. Exclusion criteria were patients with infection and pain before the procedure. Written informed consent was obtained from each patient and the study protocol was approved by the local human ethics committee. The subjects were randomly divided into 2 groups. Group A were given 100 ml dripped normal saline 1 hour before the procedure and intraoperative local anesthesia with lidocaine 2% and group B were given preoperative intravenous tramadol 100 mg dripped within 100 ml of normal saline 1 hour before the procedure and intraoperative lidocaine 2%. Visual Analogue Score (VAS) were used to evaluate the pain score. All calculation were done using SPSS version 20. Results: There were 60 cervical cancer patients who were performed percutaneous nephrostomy (29 patients in Group A and 31 patients in Group B). The mean age in group A was 48.86 ± 8.524 (years old) and the mean age in group B was 51.90 ± 6.76 (years old). The median VAS score in group A was 4, with the minimum score was 2.00, maximum score was 6.00. The median VAS score in group B was 2, with the minimum score was 0.00, maximum score was 4.00. In group A, 11 patients (18.3%) were mild pain, 16 patients (26.7%) were moderate pain, 2 patients (3.3%) were severe pain. In group B, 29 patients (48.3%) were mild pain, 2 patients (3.3%) were moderate pain, 0 patients (0.0%) were severe pain. Based on Mann-Whitney U test, there was a significant pain score reduction in group B compared to group A (p=0.0001). There were no significant differences in the prevalence or proportion of patients with nausea and vomiting in group A and B (10% and 12%, respectively). There were no other adverse events and other complications observed in both groups. Conclusion: Preoperative intravenous tramadol significantly reduced intraoperative pain in cervical patients who were performed percutaneous nephrostomy compare to those who were only given intraoperative local anesthesia.