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All Journal Indonesian Journal of Urology Green Medical Journal Journal of Aafiyah Health Research (JAHR)
Krisna, Muhammad Sidharta
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Biochemistry, Genetics & Molecular Biology Health Professions Immunology & microbiology Medicine & Pharmacology Public Health

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SUPERIOR INFERIOR CALYCES AXIS IN SAGITTAL VERSUS CORONAL PROJECTION OF NON CONTRAST ABDOMINAL MULTISLICE COMPUTED TOMOGRAPHY: AN ANATOMICAL STUDY IN SUPINE PCNL Krisna, Muhammad Sidharta; Soeroharjo, Indrawarman; Ali, Zulfikar
Indonesian Journal of Urology Vol 27 No 1 (2020)
Publisher : Indonesian Urological Association

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.32421/juri.v27i1.536

Abstract

Objective: Getting the right access to the kidney calyces that has been determined is the most important part of PCNL. Less optimal access can cause an increase in operating time and a decrease in stone free rate. The use of inferior calyx as access decreases the risk of complications, but there are difficulties in reaching the superior calyx, which affects the stone free rate. The angle and depth of the puncture on PCNL can be determined by coronal and sagittal cuts in the non contrast MSCT scan of the abdomen. Material & Methods: This is an analytical study with a prospective cross-sectional method. An analysis was done to 198 samples of patients in Kardinah Tegal Hospital. Samples were taken with 16 slices non-contrast abdominal MSCT using Philips MSCT MX16 (120 kVp; 2x0.75 mm slice thickness). Samples were collected with consecutive sampling method, excluding patients who had a history of other illnesses or surgical history that resulted in anatomical changes in kidney position, age<18 year old, BMI>30 (obesity), grade 4 hydronephrosis (calyces had disappeared). Reconstruction of 3D non contrast abdominal MSCT was performed by measuring the angle of the coronal cut which was simulated as a puncture in the supination position and sagittal cut which was simulated as puncture in pronation position. An imaginary line was drawn from the imaginary point between the iliac crest and 12th rib as high as 3th to 4th lumbar to the inferior renal calyx. Axis was drawn from the inferior renal calyx towards the superior renal calyx. Results: There is significant difference (P=0.000) in the angle of the imaginary line drawn from the inferior calyx to the superior calyx between the right supination position compared to the right pronation position. The angle in the supination position is more gentle 142.8 (±9.7)/(118-165) degrees compared to 96.5 (±13.2)/(11-138) degrees. On the left side, the angle formed from inferior calyx to the superior calyx in the supination position is more gentle 143.4 (±9.6)/(119-162) degrees) compared with 97.3 (±11.2)/(76-132) degrees formed in pronation position, with a value of P=0.000. Conclusion: PCNL puncture with an inferior calyx approach to reach the superior calix on abdominal MSCT without contrast will be easier to do in the supine position. This is because the angle from the inferior calyx to the superior calyx is more gentle in the supine position so that maneuvers are easier to do.
Oligoasthenoteratozoospermia After Trial of Testicular Salvaging Surgery in Testicular Torsion: A Case Report Mahfuz, Muhammad Ainul; Suwanto; Krisna, Muhammad Sidharta
Green Medical Journal Vol 2 No 3 December (2020): Green Medical Journal
Publisher : Fakultas Kedokteran Universitas Muslim Indonesia

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.33096/gmj.v2i3.64

Abstract

Testicular torsion (TT) is an emergency in urology that happens because of the spermatic cord’s rotation. Decreased of overall sperm parameters after TT often happens in which can endanger the patient’s fertility status. Approach on how to salvage the testicle and to prevent unwanted complications remains as the doctor’s greatest priority. We report a case of oligoasthenoteratozoospermia after surgical detorsion without orchidectomy in testicular torsion. A 19-year-old male, presenting with sudden, progressive, and continuous pain in the right testicle for 4 hours. The right testicle was larger in volume on physical examination, there were a negative phren sign and negative cremasteric reflex. Gray scale ultrasound without Doppler showed changes suggestive of testicular torsion. Emergency surgery revealed a dark-bluish right testicle with a 360o rotation of the spermatic cord. Detorsion without orchidectomy was performed with clinical judgment hoping for the restoration of testicular viability. Sperm analysis was done after one month and oligoasthenoteratozoospermia was found. Although some patients experience decreased overall sperm parameters after TT that perhaps making them infertile, interestingly there is no difference in pregnancy rates among couples with TT men when compared to the general population. The best testicular salvage surgery method to prevent testicular atrophy also has not been determined yet. Thus, the patient should be carefully counseled about the good outcome of pregnancy rate and the chance for testicular atrophy, regardless of what is the surgical choice.
A Critical Appraisal of Global Guidelines on Obturator Nerve Block in TURP: Urological and Anesthetic Collaboration: Penilaian Kritis terhadap Pedoman Global tentang Blok Saraf Obturator pada TURP: Kolaborasi Urologi dan Anestesi Supardi, Alif Zulfikar; Reza, Muhammad Alfi; Krisna, Muhammad Sidharta; Wirawan, Nur Surya
Journal of Aafiyah Health Research (JAHR) Vol. 6 No. 1 (2025): JANUARY-JUNE
Publisher : Postgraduate Program in Public Health, Universitas Muslim Indonesia

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.52103/jahr.v6i1.2010

Abstract

ABSTRACT Background: Obturator nerve block (ONB) is increasingly recognized as a crucial component in transurethral resection of the prostate (TURP) to prevent complications such as the obturator reflex, which can lead to intraoperative risks including bladder perforation. While ONB has been incorporated into various global clinical guidelines, its implementation remains inconsistent. Objective: This study critically examines the role of ONB in TURP by analyzing global guidelines, comparing different ONB techniques, and evaluating the integration of ONB with other surgical modalities to improve patient safety and procedural outcomes. Method: A comprehensive review of literature and clinical guidelines was conducted to assess the effectiveness, safety, and best practices related to ONB in TURP. Key parameters examined include the efficacy of ultrasound-guided ONB, multimodal approaches combining ONB with bipolar energy or laser techniques, and the impact of training programs for anesthesiologists. Results: Global guidelines from major urological and anesthesiology associations recommend ONB as a beneficial but non-mandatory procedure in TURP, particularly for high-risk patients. Evidence suggests that ultrasound-guided ONB improves procedural success rates and reduces complications. The combination of ONB with newer surgical modalities offers enhanced safety, and structured training programs can further facilitate its adoption in clinical practice. Conclusion: Although ONB is not universally required for TURP, its application significantly improves intraoperative safety. Standardizing protocols, expanding training programs, and integrating ONB with advanced surgical techniques can enhance the efficacy and reliability of TURP globally. Future research should focus on long-term outcomes and cost-effectiveness to refine clinical recommendations.
The Role of Clusterin (CLU) in the Pathogenesis of Benign Prostatic Hyperplasia: Mechanisms and Potential as a Biomarker: Peran Clusterin (CLU) dalam Patogenesis Hiperplasia Prostat Jinak: Mekanisme dan Potensi sebagai Biomarker Reza, Muhammad Alfi; Krisna, Muhammad Sidharta; Diennillah, Fathannia Rizky; Putri, Jihan Asma; Yulianto, Andy
Journal of Aafiyah Health Research (JAHR) Vol. 5 No. 1 (2024): JANUARY-JUNE
Publisher : Postgraduate Program in Public Health, Universitas Muslim Indonesia

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.52103/jahr.v5i1.2036

Abstract

ABSTRACT Background: Benign Prostatic Hyperplasia (BPH) is a common urological condition characterized by excessive proliferation of prostate epithelial and stromal cells, leading to lower urinary tract symptoms. Clusterin (CLU), a multifunctional glycoprotein, has been implicated in various cellular processes, including apoptosis regulation, inflammation, and autophagy. However, its exact role in BPH pathogenesis remains unclear. Objective: This study aims to analyze the role of CLU in the molecular mechanisms underlying BPH and evaluate its potential as a biomarker for disease progression. Method: A comprehensive analysis of recent literature was conducted to examine CLU expression in BPH tissues and its interactions with inflammatory pathways, hormonal regulation, and cellular homeostasis mechanisms such as apoptosis and autophagy. The study also reviewed CLU’s involvement in epithelial-stromal interactions and its correlation with disease severity. Results: Increased CLU expression in hyperplastic prostate tissues is associated with chronic inflammation, contributing to aberrant cell proliferation and apoptosis resistance. CLU interacts with inflammatory markers such as TNF-α and IL-6, promoting a microenvironment conducive to disease progression. Additionally, CLU is involved in autophagy dysregulation, which may further sustain cellular survival and resistance to apoptosis. Evidence suggests that hormonal factors, particularly androgens and estrogens, regulate CLU expression, linking it to prostate tissue remodeling. These findings highlight CLU as a potential biomarker for assessing BPH severity and progression. Conclusion: CLU plays a critical role in BPH pathogenesis by modulating inflammatory responses, apoptosis, and cellular homeostasis. Its increased expression in hyperplastic prostate tissues suggests that it may serve as a novel biomarker for disease progression. However, further studies are needed to validate its clinical applicability and explore targeted therapies aimed at CLU modulation to improve BPH management.
The Long-Term Urological Consequences of Anabolic Steroid Abuse: A Narrative Review: Konsekuensi Urologi Jangka Panjang dari Penyalahgunaan Steroid Anabolik: Sebuah Narasi Reza, Muhammad Alfi; Krisna, Muhammad Sidharta; Diennillah, Fathannia Rizky; S. , Suriani; Yulianto, Andy
Journal of Aafiyah Health Research (JAHR) Vol. 5 No. 2 (2024): JULY-DECEMBER
Publisher : Postgraduate Program in Public Health, Universitas Muslim Indonesia

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.52103/jahr.v5i2.2037

Abstract

ABSTRACT Background: Anabolic-Androgenic Steroids (AAS) have been widely used to enhance muscle mass and physical performance. However, their prolonged use has been associated with various adverse effects on urological health, including hypogonadism, infertility, erectile dysfunction (ED), and benign prostatic hyperplasia (BPH). Suppression of the hypothalamic-pituitary-gonadal (HPG) axis due to AAS leads to significant hormonal imbalances and long-term reproductive consequences. Objective: This study aims to review the urological effects of AAS, focusing on their impact on testosterone levels, spermatogenesis, erectile function, and prostate health. The review highlights potential risks and clinical implications for individuals using AAS. Method: A narrative review was conducted by analyzing relevant studies from PubMed, Scopus, and Science Direct published between 2014-2024. Articles were selected based on their relevance to the impact of AAS on urological health, particularly hypogonadism, infertility, ED, and BPH. Data from clinical trials, cohort studies, and systematic reviews were synthesized to provide a comprehensive analysis. Results: Chronic AAS use significantly reduces endogenous testosterone production, leading to hypogonadism and associated symptoms such as fatigue, decreased libido, and mood disturbances. Studies indicate a strong correlation between AAS use and impaired spermatogenesis, with some cases resulting in irreversible infertility. Moreover, AAS users have a higher prevalence of ED compared to non-users due to hormonal imbalances and psychological factors. Excessive androgen stimulation is also linked to an increased risk of prostate enlargement, potentially leading to urinary complications. Conclusion: The long-term use of AAS poses substantial risks to urological health, necessitating awareness and early intervention. Regular medical monitoring and cessation strategies are essential to mitigate these adverse effects. Further research is needed to develop effective rehabilitation and treatment options for individuals experiencing AAS-related urological complications.
Co-Authors Diennillah, Fathannia Rizky Indrawarman Soeroharjo Mahfuz, Muhammad Ainul Putri, Jihan Asma Reza, Muhammad Alfi S. , Suriani Supardi, Alif Zulfikar Suwanto Wirawan, Nur Surya Yulianto, Andy Zulfikar Ali, Zulfikar