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All Journal Indonesian Journal of Urology Medika Tadulako Indonesian Journal of Biomedicine and Clinical Sciences
H R Danarto
Division Of Urology/Department Of Surgery, Faculty Of Medicine/Gadjah Mada University, Sardjito General Hospital, Yogyakarta
Biochemistry, Genetics & Molecular Biology Health Professions Immunology & microbiology Medicine & Pharmacology Neuroscience Public Health

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PARAMETER PROGNOSIS PERBAIKAN FUNGSI GINJAL PADA PASIEN OBSTRUKSI UROPATI. Aristo, Aristo; Danarto, Danarto
Medika Tadulako: Jurnal Ilmiah Kedokteran Fakultas Kedokteran dan Ilmu Kesehatan Vol 3, No 3 (2016)
Publisher : Medika Tadulako: Jurnal Ilmiah Kedokteran Fakultas Kedokteran dan Ilmu Kesehatan

Show Abstract | Download Original | Original Source | Check in Google Scholar

Abstract

Latar belakang: Obstruksi uropati merupakan suatu kegawatan dibidang urologi yang dapat meyebabkan gagal ginjal akut maupun kronik. Penanganan lebih lanjut pasien obstruksi uropati sangat ditentukan oleh fungsi ginjal. Pemeriksaan sesuai standar baku emas untuk menilai fungsi ginjal dengan renogram, akan tetapi penggunaan renogram masih sangat terbatas terkait fasilitas terbatas dengan biaya yang tinggi. Diperlukan suatu parameter untuk menilai prognosis perbaikan fungsi ginjal setelah dilakukan release obstruksi.Objektif: untuk menilai parameter yang dapat digunakan untuk menilai prognosis perbaikan fungsi ginjal pada pasien obstruksi uropati setelah dilakukan release obstruksiMetodologi: penelitian ini merupakan studi analitik retrospektif. Data diambil dari pasien pasien obstruksi uropati periode januari 2014 – desember 2015. Dilakukan analisis bivariat untuk menilai hubungan antara rasio BUN/Creatinin (<10 atau ≥10) , kadar hemoglobin (<10 g/dL atau ≥10 g/dL), kadar kalium (<5.5 atau ≥5.5), kadar gula darah (<200 atau ≥200), dan tebal parenkim ginjal(<10 mm atau ≥10 mm) dengan penururan kreatinin serum (< 2 mg/dL). Dengan analisis Chi Square dan Fisher’s Exact test diperoleh parameter prognosis perbaikan fungsi ginjal.Hasil: Tebal parenkim ginjal, kadar hemoglobin dan rasio BUN/Creatinin memiliki hubungan signifikan dengan penurunan kreatinin sehingga dapat digunakan sebagai parameter prognosis perbaikan fungsi ginjal setelah dilakukan release obstruksi. Kata kunci: Obstruksi uropati, Hiperkalemi
EFFECT OF URETHRAL DILATION ON ANTERIOR URETHRAL STRICTURE RECURRENCE AFTER INTERNAL URETHROTOMY IN MALES Hapsari, Edhi; Hamid, Agus Rizal AH; Rodjani, Arry; Firdaoessaleh, Firdaoessaleh; HR, Danarto
Indonesian Journal of Urology Vol 20 No 1 (2013)
Publisher : Indonesian Urological Association

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.32421/juri.v20i1.38

Abstract

Objective: The aim is to evaluate the effect of urethral dilation on anterior urethral stricture recurrences after direct vision internal urethrotomy (DVIU). Material & Method: Patients were classified into 2 groups after internal urethrotomy for urethral dilation or observation. All strictures included were anterior, single, and causing partial obstruction. Urethral dilation was performed using a metal sound. This procedure was performed every 1 or 2 weeks in the first and second month after operation and then once a month for 1 year or in case of voiding complaints or low flow rate (< 10 mL/s). Follow up at least until 1 year after DVIU. Results: A total of 32 cases could be reviewed, of which are 21 had urethral dilation and 11 observation only. In the urethral dilation group, we found 4 recurrences (19%) with mean time to recurrence 10,52 months. In the observation group, we found 7 recurrent cases (63,63%) with a mean time to recurrence of 8,09 months. P value is 0,02 which means urethral dilation significantly decreased the chance of stricture recurrence. By Kaplan Meier survival analysis, urethral dilation had a better and longer time to recurrence. Conclusion: In this study, regular meatal dilation is proven to prolong the time to recurrence of an anterior urethral stricture after DVIU. Keywords: Urethral dilation, anterior urethral stricture, stricture recurrence.
STONE COMPOSITION PATTERN OF KIDNEY STONE Alpendri, Aries; HR, Danarto
Indonesian Journal of Urology Vol 20 No 1 (2013)
Publisher : Indonesian Urological Association

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.32421/juri.v20i1.44

Abstract

Objective: The purpose of this study was to know the bacterial and sensitivity pattern towards antimicrobials on kidney stones and to know the stone composition of kidney stones. Material &Method: Data were collected from medical record in 1 year period from January until Desember 2008 with descriptive study design. Results: We found 59 patients in that period, 32 males and 27 females, the mean age was 52,5 ± 10,31 with age 31 – 75 years old, most patients came from Bantul (16,9%) and 25,4% patients were housewives. From urine analysis we found leucocyturia (44,1%), erythrocyturia (39,0%), nitrituria (3,4%) and bacteriuria (6,8%). Urine culture showed E. coli (12,5%) and Candida (12,5%) being the most common causative microorganism. No antimicrobials was sensitive to all bacteriae while all antifungal was sensitive to candida. Stone composition showed ammonium (98%), calcium oxalate (91,8%), calcium non oxalate (93,9%), carbonate (22,4%), cholesterol (14,3%), uric acid (10,2%) and phosphate acid (10,2%). Conclusion: The most common stone composition were ammonium, calcium oxalate, and calcium non oxalate. E. coli still being the most common causative microorganism.Keywords: Kidney stone, stone composition, urinary tract infection, urine analysis, urine culture.
RELATIONSHIP BETWEEN P53 EXPRESSION AND PSA SERUM Hendri, Ahmad Zulfan; HR, Danarto
Indonesian Journal of Urology Vol 19 No 2 (2012)
Publisher : Indonesian Urological Association

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.32421/juri.v19i2.56

Abstract

Objective: To know the relationship between p53 expression and prostate specific antigen (PSA) serum level in prostate cancer patients. Material & method: Specimens were studied from patients with pathological diagnosis of prostate cancer in Sardjito Hospital Yogyakarta during 2007 to 2008. The p53 expression was measured by immunohistochemical staining. The stains were done in Department of Anatomical Pathology and examined by a pathologist. The relationship between p53 mutated expression and PSA serum level were analyzed with correlation coefficient (rs). Results: There were 29 patients included in this study. The mean age was 66,34 ± 8,15 (50 - 83) years old. The mean PSA serum level was 165,98 ± 269,208 (1,4 – 1051) ng/ml. The mean number of p53 expression was 111,38 ± 94,30 (16 – 396). There was positive correlation between p53 expression and increasing PSA serum level in the prostate cancer patients (rs + 0,497; p = 0,006). Conclusion: P53 expression was positively correlated with increasing PSA serum level.Keywords: Prostate cancer, p53 expression, PSA serum level.
RELATIONSHIP BETWEEN P53 EXPRESSION AND PROBABILITY OF ORGAN CONFINEMENT IN PATIENTS WITH PROSTATE CANCER IN SARDJITO HOSPITAL Soeroharjo, Indrawarman; Danarto, H R
Indonesian Journal of Urology Vol 18 No 1 (2011)
Publisher : Indonesian Urological Association

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.32421/juri.v18i1.68

Abstract

Objective: To determine the association between p53 expression and the probability of organ confinement in patients with prostate cancer in Sardjito Hospital, Yogyakarta. Material & method: Prostate specimens were obtained from patients with clinical  stage  T1-T2 prostatic  adenocarcinoma  in Sardjito  Hospital between January  2007 and December 2008. Samples were processed and immunohistochemically stained in the Department of Anatomical Pathology Gadjah Mada University. Probability of organ confinement was determined by updated Partin table 2007 from preoperative serum PSA level, Gleason Score, and clinical stage. Correlation  between p53 expression and probability of organ confinement were statistically analyzed by Spearman correlation test. Results: There were 28 prostate cancer patients eligible for this study. Mean age was 65,19 ± 10,9 (28 - 81) years old. Mean preoperative PSA level were 107,13 ± 165,82 (0,20  734,20) ng/ml. Mean number of p53 expression was 97,47 ± 97,27 (5 - 396)/HPF. Significant correlation was found between p53 expression and probability of organ confinement (Spearman r = -0,441; p = 0,019). Conclusion:  p53 expression was negatively correlated with the level of organ confinement in patients with prostate cancer
Prognosis of obstructive nephropathy patients after percutaneous nephrostomy Sukmagara, Jefri; Danarto, H R
Indonesian Journal of Urology Vol 22 No 1 (2015)
Publisher : Indonesian Urological Association

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.32421/juri.v22i1.88

Abstract

Background: Percutaneous nephrostomy is a life-saving procedure for the treatment of obstructive uropathy associated with septicaemia and uraemia. It is regarded as a temporary interventional procedure before definitive treatment. Several factors can affect recovery of renal function after nephrostomy, such as patient age, duration of obstruction, function of the contralateral kidney, pyelolymphatic backflow and compliance of the ureter and renal pelvis.Objective: To determine factors that can predict the decrease in creatinine levels after percutaneous nephrostomy (< 2mg/dl).Methods: This is a retrospective analysis descriptive study. All patients previously performed nephrostomy at Sardjito General Hospital Yogyakarta, from January 2009 to December 2012 were identified. The data were analyzed to evaluate the relationship between reduction of serum creatinine level and following variables including: etiology, nephrostomy (unilateral or bilateral), symptom duration (≤14 days or >14 days), comorbid disease (hypertension, diabetes melitus, heart disease) and degree of hydronephrosis (mild, moderate and severe). The data were analyzed with Chi-Square test and multiple logistic regression to obtain predictive factor and predictive scoring equation to measure the possibility of recoverability of renal function after nephrostomy.Results: We analyzed 117 patients that previously treated by percutaneous nephrostomy. It showed the relationship between reduction of serum creatinine level and the following variables:  nephrostomy (unilateral or bilateral) (p=0,000), symptom duration (p=0,000), hypertension (p=0,004) and degree of hydronephrosis (p=0,000). Whereas etiology of urinary obstruction and other comorbid diseases showed no relationship. Predictive equation result: P= 1/(1+ey), where y= -0,271 + 1,636 (degree of hydronephrosis) + ((-2,216) unilateral or bilateral nephrostomy) + 1,694 (symptom duration) + ((-0,862) hypertension), with sensitivity 74,3% and specificity 70,7% in predicting renal function recoverability.Conclusions: Bilateral or unilateral nephrostomy, symptom duration, hypertension and degree of hydronephrosis are factors affecting the decrease in serum creatinine level. They role as independent predictor to predict recoverability of renal function can be considered. Key words: obstructive uropathy, percutaneous nephrostomy, multiple logistic regression.
CORRELATION BETWEEN ALDEHYDE DEHYDROGENASE 1A1 LEVEL AND BONE METASTASIS IN PROSTATE CANCER Moeljono, Abraham; Danarto, Danarto
Indonesian Journal of Urology Vol 22 No 2 (2015)
Publisher : Indonesian Urological Association

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.32421/juri.v22i2.190

Abstract

Objective: To determine the association between Aldehyde Dehydrogenase 1A1 (ALDH1) expression and metastasis in prostate cancer. Material & methods: This study was a prospectivestudy in 45 patients diagnosed with prostate cancer in Sardjito General hospital. Patient characteristics and patient clinical data were recorded. Paraffin blocks of 45 patient surgery results were performed with immunohistochemical staining with monoclonal antibody of anti ALDH1A1 (EP1933Y, Biocare, dilution 1: 200). ALDH1 expression differences between prostate cancer without metastases and prostate cancer with metastasis was compared and analyzed with Chi-square. Results: This study involved 45 prostate cancer patients with median of age of 74 years. A high Gleason scores was found in 25 (55.6%) patients with prostate cancer and 24 (53.3%) patients had metastasis to the bone. The high expression of ALDH1 was found in 30 (66.7%) patients. The incidence of bone metastasis in patients with prostate cancer was associated with high levels of ALDH1 (p < 0.001, OR, 95% CI 17.88 (3.28-97.83) and was not associated with Gleason score (p = 0.316). Conclusion: Prostate cancer cells with high ALDH1A1 level increased the risk of the incidence of bone metastasis. ALDH1A1 level in prostate cancer cells can be considered as a predictor factor of the bone metastasis in prostate cancer.
EVALUATION OF SIGN AND SYMPTOMS RELATED TO INDWELLING URETERAL STENTS suryawan, joko anom; Danarto, H R; Budiyono, Nur
Indonesian Journal of Urology Vol 23 No 1 (2016)
Publisher : Indonesian Urological Association

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.32421/juri.v23i1.200

Abstract

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.
HOLMIUM LASER: YAG LITHOTRIPSY IN URETERAL CALCULI MANAGEMENT Sunaryo, Juhadi; Ali, Zulfikar; Danarto, H R
Indonesian Journal of Urology Vol 23 No 1 (2016)
Publisher : Indonesian Urological Association

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.32421/juri.v23i1.206

Abstract

Objective: To know predictive factors for success of holmium laser: YAG lithotripsy in ureteral calculi management. Materials & Methods: This prospective cohort study was conducted in January 2013 to May 2015 at Kardinah Tegal Hospital Central Java. Patients diagnosed with proximal and distal stones were included. Pediatric, obesity, pregnancy, ureteral anomaly, and ureteroscopy (URS) cannot reach ureteral level of stone were excluded. We used semirigid URS (Wolf) 6/7.5F, monitor video, and holmium laser: YAG litotriptor (Versa Pulse, Lumenis, Germany), with wavelength 2100 nm, output 1-60 watt, fiber length 365 μm, laser power 2.5-10 watt with energy 0.5-1 Joule/5-15 Hz. Results: Of 50 ureteral stone patients, consisted proximal 13 (26%) and distal 37 (74%) were included in this study. Mean age 42.94 ± 11.31 years, with 28 male (56%) and 22 female (44%). Mean stone burden was 88.10 ± 57.41 mm2. There were 6 (12%) patients with multiple stones. This procedure consumed energy 1079.02 ± 1624.00 joule and duration of operation was 19.02 ± 21.17 minutes. We inserted DJ stent after the procedure in 41 patients (82%). There were 2 failure (4%), which were stone migration to kidney and conversion to open surgery. There were significant differences of stone burden (p 0.013), duration of operation (p 0.038), and stone number (p 0.000) with stone free rate, but not in age, sex, stone location and energy. Stone free rate of this procedure was 90%. Conclusion: Stone burden, duration of operation, and stone number were predictive factors for success of holmium laser: YAG lithotripsy in ureteral calculi management.
THE VALUE OF URINARY CYTOLOGY AND HYDRONEPHROSIS TO PREDICT MUSCLE INVASIVE BLADDER CANCER ardiansyah, ferdi; Danarto, H R
Indonesian Journal of Urology Vol 23 No 1 (2016)
Publisher : Indonesian Urological Association

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.32421/juri.v23i1.215

Abstract

Objective: We evaluated the value of urinary cytology, and presence of hydronephrosis to predict muscle invasive bladder cancer. Material & methods: We retrospectively analyzed data of 167 patients that diagnosed bladder cancer from medical record at Sardjito General Hospital Yogyakarta, between 2004-2011. Preoperative parameters were evaluated including age, gender, number and location of bladder cancer, urinary cytology, as well as presence of hydronephrosis. The outcome was muscle invasive bladder cancer. Results: A total of 96 (57.5%) patients had positive urinary cytology, 80 (47.9%) had hydronephrosis, most location of tumor were in trigone 43 (25.7%). The youngest patient was 26 years and the oldest was 84 years old, male was most affected in 145 (86.8%). On bivariate analysis, positive urinary cytology and hydronephrosis were associated with muscle invasive bladder cancer (OR 0.08 CI 0.038–0.167; OR 30.24 CI 12.72–71.89, respectively, each p < 0.05). Combination urinary cytology and hydronephrosis incrementally improved prediction of muscle invasive bladder cancer with positive and negative predictive value were 93.9% and 71.4%, respectively. Presence of hydronephrosis was associated with tumor location in trigone (p < 0.05). Conclusion: Urinary cytology and hydronephrosis were associated with muscle invasive bladder cancer, and can be used to predict muscle invasive bladder cancer.
Co-Authors A.A. Ketut Agung Cahyawan W Abraham Moeljono, Abraham Agus Rizal Ardy Hariandy Hamid, Agus Rizal Ardy Hariandy Akhada Maulana, Akhada Aries Alpendri Aristo Aristo, Aristo Arry Rodjani Bundu, Aristo Edhi Hapsari Ery Kus Dwianingsih ferdi ardiansyah, ferdi Firdaoessaleh Firdaoessaleh Hadibrata, Exsa Indrawarman Indrawarman Soeroharjo Jefri Sukmagara joko anom suryawan, joko anom Juhadi Sunaryo, Juhadi Kohar, Moch. Abdul Lubis, Anggiat Pratama Nur Budiyono, Nur Pratama, I Gede Andre Arda Yanuar Wicaksana Sumasta, Yanuar Wicaksana Yurisal Akhmad Dany Zulfikar Ali, Zulfikar