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All Journal Medical Journal of Indonesia Indonesian Journal of Urology Journal of the Indonesian Medical Association : Majalah Kedokteran Indonesia Narra J JKKI : Jurnal Kedokteran dan Kesehatan Indonesia Griya Widya: Journal of Sexual and Reproductive Health Proceedings Book of International Conference and Exhibition on The Indonesian Medical Education and Research Institute
Ponco Birowo
Universitas Indonesia
Biochemistry, Genetics & Molecular Biology Education Health Professions Immunology & microbiology Medicine & Pharmacology Neuroscience Public Health Other

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ROBOTIC-ASSISTED KIDNEY TRANSPLANTATION: A REVIEW Prasetyo, Dimas Tri; Birowo, Ponco; Hamid, Agus Rizal Ardy Hariandy; Wahyudi, Irfan; Rodjani, Arry; Mochtar, Chaidir; Rasyid, Nur
Indonesian Journal of Urology Vol 25 No 1 (2018)
Publisher : Indonesian Urological Association

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.32421/juri.v25i1.394

Abstract

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.
THE USE OF RIGISCAN® EXAMINATION IN DIAGNOSING PATIENTS WITH ERECTILE DYSFUNCTION IN JAKARTA Basukarno, Ari; Birowo, Ponco; Tri Prasetyo, Dimas; Rasyid, Nur
Indonesian Journal of Urology Vol 25 No 2 (2018)
Publisher : Indonesian Urological Association

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.32421/juri.v25i2.404

Abstract

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 Widyasmara, Her Bayu; Birowo, Ponco; Rasyid, Nur
Indonesian Journal of Urology Vol 25 No 2 (2018)
Publisher : Indonesian Urological Association

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.32421/juri.v25i2.406

Abstract

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.  
USAGE OF SUPPORTING PAD FOR SUPINE PCNL: A SINGLE CENTER EXPERIENCE Hakim, Rizky Lukman; Birowo, Ponco
Indonesian Journal of Urology Vol 29 No 1 (2022)
Publisher : Indonesian Urological Association

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.32421/juri.v29i1.720

Abstract

Objective: This study aims to compare the safety, efficacy, and other surgical outcomes of supine PCNLs performed with and without the use of supporting pad. Material & Methods: We enrolled 27 patients who undergone PCNL procedure with supine position for renal stones with all sizes between January - December 2019. Divided into two groups, operated with and without supporting pad, with 13 and 14 patients respectively. Inclusion criteria are patients with renal stones, including staghorn, multiple calyx, and proximal ureteral stones. Meanwhile, pediatric patients under 12 years old, uncorrectable bleeding disorders, active urinary infection, and pregnancy are excluded. Results: Our observation showed no statistically significant difference between the two groups, although blood loss and length of stay in supporting pad showed better results. A statistically significant difference was found in stone-free-rate (P = 0.006) favoring in supine PCNL with supporting pad. Conclusion: Supine PCNL with support padding may be a safe and more effective choice to treat renal stones. Nevertheless, the patient’s anatomic variations may influence this. Thus, a prospective study with a larger population is needed to verify our outcomes.
Effect of pH and neutrophil count on the motility and persistence of spermatozoa in the vagina of candidiasis rat models Iswara, Raja AW.; Hestiantoro, Andon; Budiningsih, Yuli; Werdhani, Retno A.; Birowo, Ponco; Wuyung, Puspita E.; Afandi, Dedi
Narra J Vol. 4 No. 2 (2024): August 2024
Publisher : Narra Sains Indonesia

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.52225/narra.v4i2.823

Abstract

Sexual violence is a global issue affecting individuals regardless of their relationship to the perpetrator or the setting. Microscopic examination of spermatozoa from vaginal swabs is crucial in investigating cases of sexual intercourse to determine the time of the crime. Factors such as vaginal pH and neutrophil count influence the motility and persistence of spermatozoa in the vagina, particularly in conditions like candidiasis, highlighting the need for further research in this area. This study aimed to determine the effect of pH and neutrophil count on the motility and persistence of spermatozoa in the vagina with candidiasis. An experimental study was conducted using white rats (Rattus norvegicus) of the Wistar strain, with four male rats providing spermatozoa samples and 32 female rats receiving treatment. The female rats were divided into two groups: the normal group and the candidiasis model group. In both groups, the female rats were given vaginal insemination of spermatozoa. Variables measured included pH, neutrophil count, motility, and persistence of spermatozoa in the vagina. Data were analyzed using the Mann-Whitney test, followed by the Spearman correlation test. The findings revealed that spermatozoa motility lasted up to three minutes in normal rats, whereas in the candidiasis model, it was reduced to two minutes. Additionally, spermatozoa persistence in the vagina lasted up to six days in the normal group compared to up to three days in the candidiasis model. There were significant differences in pH, neutrophil count, motility, and persistence of spermatozoa in the vagina between the normal group and the candidiasis model (all had p<0.001). There was a correlation between pH and neutrophil count with the motility and persistence of spermatozoa in the rat’s vagina (p<0.001). In conclusion, vaginal pH and neutrophil count influence the motility and persistence of spermatozoa in the vagina of candidiasis rat models.
Stone recurrence among Indonesian kidney stone formers: a comprehensive analysis of genetic polymorphism, demographic, and clinical factors Atmoko, Widi; Savira, Missy; Fajriani, Rosalina; Wistara, Sevita Sathya; Asmarinah; Harahap, Alida Roswita; Witjaksono, Fiastuti; Werdhani, Retno Asti; Safriadi, Ferry; Hamid, Agus Rizal Ardy Hariandy; Birowo, Ponco; Rasyid, Nur; Taher, Akmal
Medical Journal of Indonesia Vol. 33 No. 3 (2024): September
Publisher : Faculty of Medicine Universitas Indonesia

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.13181/mji.oa.247596

Abstract

BACKGROUND The recurrence rate of kidney stone disease (KSD) can exceed 50% within 5 years. This study aimed to investigate factors associated with stone recurrence based on single nucleotide polymorphisms (SNPs) of the calcium-sensing receptor (CaSR) rs1801725 and rs1042636, demographic, and clinical profiles. METHODS We collected data on the demographic and clinical characteristics of 80 adult kidney stone formers from April 2021 to September 2022, including peripheral blood samples, morning and 24-hour urine, and 7-day water intake records. Real-time polymerase chain reaction was used to evaluate SNP. Comparisons were made between patients with recurrent and first-time stones. RESULTS 41% of 80 patients have experienced stone recurrence. Recurrent stone formers exhibited significantly higher 24-hour urine calcium excretion (p = 0.03) and lower serum calcium levels (p = 0.019) than first-time stone formers. Hypocitraturia (100%), low urine volume (78%), and hyperoxaluria (55%) were the main abnormalities of all patients. No significant differences were found in CaSR gene polymorphisms and other demographic, biochemical, or clinical parameters. CONCLUSIONS Recurrent stone formers had higher 24-hour urine calcium excretion and lower serum calcium levels. Other risk factors and CaSR polymorphisms may insignificantly affect KSD recurrence.
Comprehensive Histopathological Properties of Dartos Tissue Associated with Hypospadias Severity and Chordee: A Prospective Study Raharja, Putu Angga Risky; Birowo, Ponco; Rachmadi, Lisnawati; Wibowo, Heri; Kekalih, Aria; Duarsa, Gede Wirya Kusuma; Wahyudi, Irfan
Proceedings Book of International Conference and Exhibition on The Indonesian Medical Education Research Institute Vol. 8 No. - (2024): Proceedings Book of International Conference and Exhibition on The Indonesian M
Publisher : Writing Center IMERI FMUI

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.69951/proceedingsbookoficeonimeri.v8i-.243

Abstract

Background: The cause of chordee in hypospadias is not fully understood. Dartos fascia resection has been shown to correct penile curvature, suggesting its potential involvement. This study aimed to evaluate the histopathological properties of dartos tissue and their association with hypospadias severity and chordee.Methods and Materials: Dartos tissue samples were collected from 37 children with hypospadias and ten controls undergoing circumcision between March and October 2024. Histopathological analysis using hematoxylin-eosin and Masson’s trichrome staining assessed for collagen, smooth muscle, and vascular density. Assessment and quantification of all histopathological components were blinded. Results: The hypospadias group showed lower collagen density (60.85±6.75% vs. 67.31±4.61%; p=0.003) and higher smooth muscle density (7.34±4.92% vs. 2.51±2.24%; p<0.001) compared to controls, with no significant difference in vessel density. Sub-analysis showed severe chordee was linked to lower collagen density compared to mild (Mean Difference [MD] -6.24±2.41%; p=0.014) and moderate chordee (MD -5.73±2.54%; p=0.031). Conclusions: The dartos tissue in hypospadias patients exhibited lower collagen density and higher smooth muscle density, with chordee severity specifically linked to decreased collagen density.
Impact of semen insemination on the vaginal microbiome profile of candidiasis rat model: A preliminary forensic study on sexual violence evidence Iswara, Raja AFW.; Hestiantoro, Andon; Budiningsih, Yuli; Werdhani, Retno A.; Birowo, Ponco; Wuyung, Puspita E.; Fadilah, Fadilah; Afandi, Dedi
Narra J Vol. 5 No. 1 (2025): April 2025
Publisher : Narra Sains Indonesia

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.52225/narra.v5i1.1256

Abstract

Sexual violence, including sexual intercourse, can occur in women experiencing vaginal discharge, particularly in cases of vaginal candidiasis. In candidiasis, the vaginal microbiome undergoes changes that could serve as a diagnostic indicator or as evidence of sexual activity.  The aim of this study was to assess the effects of semen insemination on the vaginal microbiome profile of candidiasis rats and to determine its forensic investigations in cases of sexual violence.  An experimental study was carried out using Wistar strain rats (Rattus norvegicus), consisting of four male rats (for spermatozoa donors) and twenty-four female rats. The female rats were divided into four groups: normal condition (control), normal condition post-semen insemination, candidiasis rats, and candidiasis rat post-semen insemination. Vaginal microbiome profiles were examined for each group, using alpha diversity (Chao 1, Shannon, Simpson, and Faith PD indices) and beta diversity (Bray Curtis, Jaccard, Unweighted Unifrac and Weighted Unifrac indices). Data were analyzed using the Kruskal-Wallis test for alpha diversity and the PERMANOVA test for beta diversity. The vaginal microbiome profiles of normal and candidiasis rats showed no significant differences (p>0.05). In candidiasis rats, the microbiome predominantly consisted of the Eukaryota kingdom, particularly Candida albicans. Semen insemination did not significantly affect the vaginal microbiome profile of candidiasis rats in the short term (p>0.05). However, the study highlights that the presence of Eschericia-Shigella, Roseomonas, and Archaea in the vaginal microbiome post-semen insemination potentially serves as an indicator of infection or sexual activity in forensic contexts.
Comparing anastomosis techniques on ischemia time in multi-arterial kidney grafts: a systematic review and meta-analysis Hernawan Rahmat Muharia, Bayu; Situmorang, Gerhard Reinaldi; Rasyid, Nur; Rodjani, Arry; Birowo, Ponco
Medical Journal of Indonesia Vol. 34 No. 1 (2025): March
Publisher : Faculty of Medicine Universitas Indonesia

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.13181/mji.oa.257527

Abstract

BACKGROUND Kidney transplants with multiple renal arteries (MRAs) address donor shortages but carry higher vascular risks than single renal arteries. This study aimed to evaluate how different anastomosis techniques affect outcomes in kidney transplants with MRAs through meta-analysis and systematic review, concluding the continuous discussion about the best reconstructive strategy. METHODS A comprehensive search across 5 databases (PubMed, ScienceDirect, Cochrane Library, Web of Science, and the Cumulative Index to Nursing and Allied Health Literature) was conducted until December 17, 2024, to find studies comparing anastomoses technique in MRA grafts. Meta-analysis was performed using Review Manager software version 5.4, generating pooled effect estimates for mean difference (MD) and risk ratio (RR), two-sided p-values, and 95% confidence intervals (CIs). RESULTS Two retrospective cohort studies were included in the meta-analysis. There was no significant difference between end-to-side and side-to-side anastomosis in warm ischemia time (MD = 15.64, 95% CI: −6.82−38.10, p = 0.17) or cold ischemia time (MD = −16.74, 95% CI: −105.61−72.14, p = 0.71). The complication rate showed no significant variation between side-to-side and end-to-side anastomosis (RR = 2.38, 95% CI: 0.41−13.70, p = 0.33). Meta-analysis on graft function and rejection was impossible due to differences in measurements and the small number of studies. CONCLUSIONS Different anastomosis techniques for MRA grafts did not result in longer ischemia times or higher complication rates. Graft function and rejection rates were comparable between side-to-side and end-to-side anastomosis, suggesting both were equally feasible for renal transplants with MRAs. Further studies are required to verify these findings.
Urinary calcium and matrix Gla protein levels in the kidney stones: a case-control study Ali, Zulfikar; Selanno, Fradelino Esau; Gunawan, I Putu Gde Fredy; Sulchan, Mohammad; Birowo, Ponco; Winarni, Tri Indah
Medical Journal of Indonesia Vol. 34 No. 1 (2025): March
Publisher : Faculty of Medicine Universitas Indonesia

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.13181/mji.oa.257748

Abstract

BACKGROUND Kidney stones are a global issue with varying prevalence. The most common metabolic risk factor is hypercalciuria, a condition where excess calcium in the urine promotes stone formation. Matrix Gla protein (MGP) inhibits stone formation by preventing crystal growth. This study aimed to analyze the correlation between urinary calcium and MGP levels in kidney stone formation. METHODS A case-control study at Kardinah Hospital, Indonesia, included 64 patients with kidney stone and 64 healthy controls. Exclusion criteria included renal failure, stroke, kidney tumor, heart failure, and hemodialysis. Urinary calcium and MGP were measured using the 5’-nitro-5’-methyl-BAPTA method and enzyme-linked immunosorbent assay. Cut-off values were determined via receiver operating characteristic analysis. RESULTS Among 128 participants (mean age: 51.6), the optimal cut-off for urinary MGP was 1,405 ng/l (p = 0.00024) with 62.5% sensitivity and 72% specificity. Urinary calcium cut-off was 72.5 mg/24 hours with 81.3% sensitivity and 62.5% specificity. Higher urinary calcium and MGP levels were linked to kidney stones (OR: 7.22; 95% CI: 3.23–16.18 and OR: 4.26; 95% CI: 2.03–8.96, respectively). A significant association was found between urinary calcium and MGP (OR: 5.11; 95% CI: 2.31–11.29, p = 0.00006) that hypercalciuria and increased MGP levels are predictors of kidney stone formation. CONCLUSIONS Urinary calcium and MGP levels are associated with kidney stones. Elevated urinary calcium (>1,405 ng/l) increases MGP levels more than 5-fold. Depending on their levels, urinary calcium and MGP act as both promoters and inhibitors of stone formation.
Co-Authors Achmadsyah, Armand Adianti Khadijah, Adianti Agus Rizal Ardy Hariandy Hamid, Agus Rizal Ardy Hariandy Akmal Taher Andon Hestiantoro Ari Astram, Ari Ari Basukarno, Ari Aria Kekalih Ariyati, Ira Arry Rodjani Asmarinah Biddulth Sujana, Biddulth Brodjonegoro, Sakti R Budi Wiweko C Susilo, C Chaidir A. Mochtar CHAIDIR MOCHTAR, CHAIDIR charles johanes, charles Danarto, Raden Dedi Afandi Djoko Rahardjo donny eka putra, donny eka Dyandra Parikesit, Dyandra Endrika Noviandrini, Endrika Fadilah Fadilah, Fadilah Fajriani, Rosalina Fakhri Rahman, Fakhri Febriyani Ferry Safriadi Fiastuti Witjaksono Gede Wirya Kusuma Duarsa Gerhard Reinaldi Situmorang, Gerhard Reinaldi Gunawan, I Putu Gde Fredy Hakim, Rizky Lukman Harahap, Alida Roswita Hariwibowo, Rinto Hendri, Ahmad Z Heri Wibowo Hernawan Rahmat Muharia, Bayu Hery Tiera I Putu Gde Sanjaya, I Putu Ikhlas A. Bramono, Ikhlas A. Indah S. Widyahening Indrawarman Soeroharjo Irfan Wahyudi Isaac A. Deswanto, Isaac A. Iswara, Raja AFW. Iswara, Raja AW. Ivan Rizal Sini, Ivan Rizal Joedo Prihartono Levina S. Pakasi Lisnawati Rachmadi Meilinda, Astrid Mewahyu Dewi, Mewahyu Michelle Eva Mohammad Sulchan Namira Kesuma Jelita Nur Rasyid Nur Rasyid P Pryambodho, P Pakpahan, Karimul Abdi Pande Made Wisnu Tirtayasa Prahara Yuri Prasetyo, Dimas Tri Pudji Sari Puji Sari Purba, Herdiman Bernard Puspita E. Wuyung Putra, Donny E. Raharja, Putu Angga Risky Rahmad Mulyadi, Rahmad Retno A. Werdhani Retno Asti Werdhani Savira, Missy Savitri, Ary Indriana Selanno, Fradelino Esau Siti Setiati Siti T.K. Gardian Surya Putra, Abdul Hafiidh Suryoadji, Kemal Akbar Sutisna Himawan Tommie Prasetyo Tommie Prasetyo, Tommie Tri Indah Winarni Tri Prasetyo, Dimas Uiterwaal, Cuno Vinny Verdini Widi Atmoko Widyasmara, Her Bayu Wistara, Sevita Sathya Yopie Tjandradiguna Satyawan Yuli Budiningsih Zulfikar Ali Zulfikar Ali, Zulfikar