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Tarmono Djojodimedjo
Department Of Urology, Faculty Of Medicine, Universitas Airlangga, Dr. Soetomo Hospital, Surabaya
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TOTAL CHOLESTEROL AND C-REACTIVE PROTEIN LEVELS AS A PROGNOSTIC MARKERS OF UROSEPSIS wahyudi, septa surya; Hardjowijoto, Sunaryo; Soebadi, Doddy M; Soetojo, Soetojo; Djojodimedjo, Tarmono; Budiono, Budiono
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.v23i1.198

Abstract

Objective: To investigate whether total cholesterol and C-reactive protein levels could be use as a prognostic factor for outcome in patients with urosepsis. Material & Methods: An analytic observational study using 30 patients assigned for total cholesterol and CRP level at the day of admission, three days later, and on the last day of sepsis or on the dead day. All subjects were managed according to standard urosepsis therapy. At the 14th day of treatment, patients were evaluated with a clinical severity score. Then we classified the outcome as improve/good condition, worse, and died. The variables were statistically tested using Spearman’s rho test with software SPSS 20. P < 0.05 was consider significant. Result: From 30 subjects with urosepsis, we found 15 patients in septic condition, 14 patients had severe sepsis and one patient had septic shock. The mean of total cholesterol level in patient with died and worse was lower than that in patient with good outcome. Day-1 (63.25 mg/dl and 101.38 mg/dl vs 119.5 mg/dl), day-3 (56.0 mg/dl and 93.6 mg/dl vs 128.6 mg/dl) and last day/died day (51.0 mg/dl and 82.25 mg/dl vs 154.8 mg/dl). The mean of CRP level in patient with died and worse was higher than that in patient with good outcome. Day-1 (177.18 mg/l and 146.74 mg/l vs 88.1 mg/l), day 3 (127.1 mg/l and 148.8 mg/l vs 56.2 mg/l) and last day/died day (141.88 mg/l and 88.71 mg/l vs 31.58 mg/l). These were statistically significant between total cholesterol and CRP levels in determining the outcome of urosepsis patient. Day-1 (p 0.000 vs 0.011), day-3 (p 0.000 vs 0.002), and last day/died day (p 0.000 vs 0.000). The coefficient correlation total cholesterol was better than CRP in day-1 (rho -0.633 vs 0.459), day-3 (rho -0.755 vs 0.543), and last day/died day (rho -0.874 vs 0.686). Conclusion: Low total cholesterol and high C-reactive protein levels can be used as poor prognostic in urosepsis patients. Total cholesterol level was better than CRP as a prognostic marker.
URINARY NEUTROPHIL GELATINASE-ASSOCIATED LIPOCALIN AND CREATININE SERUM BPH PATIENTS WITH ACUTE URINE RETENTION TO DETECT KIDNEY FUNCTION DISORDERS Rahayu, Septina; Hardjowijoto, Sunaryo; Djojodimedjo, Tarmono; Soebadi, Mohammad Ayodhia
Indonesian Journal of Urology Vol 23 No 2 (2016)
Publisher : Indonesian Urological Association

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.32421/juri.v23i2.233

Abstract

Objective: The main objective of this study was to determine renal function in patients with Benign Prostate Hyperplasia (BPH) in acute urinary retention period and two weeks after catheter insertion using creatinine serum and urinary Neutrophil Gelatinase-Associated Lipocalin (NGAL) biomarker parameters.Materials & Method:This is an observational co-hort study conducted in patients with BPH with acute urinary retention who came to Soetomo General Hospital, Surabaya. All the patients underwent laboratory investigation that were urinary NGAL and creatinine serum, marker of renal function.Result: The mean creatinine serum of 31 samples when retention phase was 1.6 ± 0.9 mg/dL and it decreased after 2 weeks of urinary catheter insertion (1.46 ± 0.89 mg/dL). Mean urinary NGAL level when retention phase was 308.1 ± 244.8 ng/dL, and after 2 weeks after urinary catheter insertion it decreased to 158.5 ± 123.3 ng/dL. There was significant decreasing creatinine serum and urinary NGAL levels in patients with BPH and acute urinary retention in the retention phase 2 weeks after urinary catheter insertion, with p value < 0.006 and < 0.0001, respectively. There was no significant correlation between the duration of retention and urinary retention volume (p>0.05).Conclusion: There was a significant decreasing creatinine serum and urinary NGAL levels in patients with BPH and acute urinary retention in retention phase and two weeks after urinary catheter insertion. There was no significant correlation between the urinary NGAL and creatinine serum and the duration of retention and urinary retention volume.
BODY MASS INDEX RELATIONS WITH THE DIFFICULTIES AND COMPLICATIONS OF PERCUTANEOUS NEPHROLITHOTOMY Prapiska, Fauriski Febrian; Hardjowijoto, Sunaryo; Soebadi, Doddy M; Djojodimedjo, Tarmono
Indonesian Journal of Urology Vol 23 No 2 (2016)
Publisher : Indonesian Urological Association

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.32421/juri.v23i2.255

Abstract

Objective: To identified outcomes and complications of percutaneous nephrolithotomy (PCNL) in patients of various body mass indices (BMI) to determine the safety of this procedure in patients with elevated BMI.Material & methods: The analytic observational prospective study of patients who underwent PCNL between February to July 2015 in the operating room Soetomo General Hospital Surabaya. Specifically, BMI, stone-free rates, difficulties duringsurgery, complications, and Clavien score were assessed. We evaluate the independent contribution of BMI as a predictor of outcomes. Results: There were 35 selected patients with kidney stone and planned to PCNL, 20 patients were included and 15 patients were excluded from this study. The patients consisted of 10 men (50%) and 10 women (50%). Mean age was 47.55 years (range 33-75). There were 4 patients with diabetes (20%), and 10 patients with hypertension (50%). Mean stone size was 23.30 mm. Stone location was 11 patients (55%) in the right kidney, and 9 patients (45%) in the left. There were 12 patients (60%) with a single stone, and 8 patients (40%) with multiple stones. BMI values were distributed as follows,underweight 1 patient (5%), normoweight 7 patients (35%), overweight 6 patients (30%), obesity 6 patients (30%). Mean skin to stone distance (SSD) was 87.56 mm. Stone free rate was 55%, and difficulties during surgery only seen in 1 patient (5%) bleeding profusely and open surgery was performed. Clavien score in these patients were grade I in 11 patients (55%), grade II in 7 patients (35%), and grade IIIB in 2 patients (10%). The BMI had no significant effect with Intra operative and postoperative difficulties (0.390. p <0.05. CI 95%). However the lower stone free rate had significant effect (0.040. p <0.05. CI 95%).Conclusion: BMI had no significant effect with Intraoperative and postoperative difficulties in PCNL.However, the lower stone-free rate risk associated with elevated BMI was significant.
CORRELATION BETWEEN PCAR WITH IPSS SCORE, QMAX, AND POST VOIDING RESIDUAL URINE AND ITS CUT-OFF VALUE IN DETERMINING BOO IN PATIENTS WITH BPH LUTS Nurhadi, Pradana; Hakim, Lukman; Djojodimedjo, Tarmono; Hardjowijoto, Sunaryo
Indonesian Journal of Urology Vol 24 No 1 (2017)
Publisher : Indonesian Urological Association

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.32421/juri.v24i1.263

Abstract

Objective: This study was conducted to determine the correlation between Presume Circle Area Ratio (PCAR) and IPSS score, Qmax, and post voiding residual urine (PVR) and to find PCAR cut-off value in determining the presence Bladder Outlet Obstruction (BOO) in Benign prostatic hyperplasia (BPH) Lower Urinary Tract Symptoms (LUTS). Materials & Methods: This study was observational analytic study with 30 BPH LUTS patients as subjects during the period September 2015 to January 2016. The determined variables were PCAR, IPSS score, Qmax, post voiding residual urine (PVR) and analyzed using the SPSS program v21. Results: There were 30 patients who met the inclusion and exclusion criteria with the mean age of 67.47 years. In the correlation test, there was insignificant correlation between PCAR with IPSS (r=0.138, p=0.467), a significant correlation between PCAR with Qmax (r=0.468, p=0.009), PCAR with PVR (r=0.399, p=0.029), PCAR with BOO (r=0.491, p=0.006) PCAR cutoff value is 0.65 with sensitivity of 69% and specificity of 71%. Conclusion: PCAR has a significant correlation with PVR, Qmax and BOO but no significant with IPSS score. PCAR value >0.65 indicating BOO in BPH LUTS. PCAR can be used as an alternative non-invasive examination in determining the existence of BOO.
THE EFFECT OF PERIOPERATIVE AND PROPHYLACTIC ANTIBIOTICS AGAINST THE INCIDENCE OF UTI AND SURGICAL SITE INFECTIONS AFTER HYPOSPADIAS SURGERY Kusuma, Raditya; Renaldo, Johan; Djojodimedjo, Tarmono; Hardjowijoto, Sunaryo
Indonesian Journal of Urology Vol 24 No 1 (2017)
Publisher : Indonesian Urological Association

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.32421/juri.v24i1.270

Abstract

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
CORRELATION BETWEEN S.T.O.N.E NEPHROLITHOMETRY SCORING IN PREDICTING FREE-STONE RATE AFTER PERCUTANEOUS NEPHROLITHOTOMY putri, Karinda triharyu caesari; Djojodimejo, Tarmono; Rizaldi, Fikri; Hardjowijoto, Sunaryo
Indonesian Journal of Urology Vol 24 No 1 (2017)
Publisher : Indonesian Urological Association

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.32421/juri.v24i1.281

Abstract

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.
COMPARATION OF DIAGNOSTIC VALUE B-MODE ULTRASOUND WITH COLOR DOPPLER TWINKLING ARTIFACT FOR DETECTING RESIDUAL STONE AFTER PCNL Wardhana, Sonny Andikha; Rizaldi, Fikri; Djojodimedjo, Tarmono; Hardjowijoto, Sunaryo
Indonesian Journal of Urology Vol 24 No 2 (2017)
Publisher : Indonesian Urological Association

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.32421/juri.v24i2.303

Abstract

Objective: To compare the accuracy of B-Mode US and color Doppler twinkling artifact for detecting residual stone after Percutaneous Nephrolithotomy (PCNL) with Non-contrast CT (NCCT) as the standard diagnostic. Material & methods: In this prospective study, 30 patients who underwent Percutaneous Nephrolithotomy (PCNL) were examined with US and NCCT. In US, echogenicity and posterior-shadow (PS) parameters were evaluated and compared with color-Doppler ultrasonography (CDUS) twinkling artifact and NCCT signs. The results then analyzed statistically with Kappa and McNemar tests. Results: More positive residual stone results with color Doppler twinkling artifact in 14 patients than B-Mode US in 11. NCCT detected 17 residual stone with the most location in inferior calyx. (n=10, 58.8%). The sensitivity, specificity and difference positive-negative likehood ratio of B-Mode US were 64.7%, 92.3% and 8.02, both Kappa test was significant (p=0.125) and McNemar tests was significant (p=0.002). The color Doppler twinkling artifact has 82.3%, 92.3%, and 10.5 for sensitivity, specificity and difference positive-negative likehood ratio, the Kappa test was significant (p=0.00), McNemar test was not significant (p=1.00). Conclusion: Color Doppler twinkling artifact was valid, highly sensitive and accuracy better than B-mode US in detecting residual stone after PCNL procedure.
EFIKASI TAMSULOSIN PADA BENIGN PROSTATIC HYPERPLASIA DENGAN RETENSIO URINE AKUT YANG MENJALANI TRIAL WITHOUT CATHETER Kholis, Khoirul; Soetojo, Soetojo; Djojodimedjo, Tarmono; P, Widodo J
Indonesian Journal of Urology Vol 16 No 2 (2009)
Publisher : Indonesian Urological Association

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.32421/juri.v16i2.337

Abstract

Objective: To evaluate the efficacy of tamsulosin on BPH patients with acute urinary retention on trial without catheter (TWOC). Materials & method: This study was a post test only-placebo group design comparing residual urine in BPH patients with acute urinary retention on TWOC between groups administered with tamsulosin and placebo. The efficacy of both groups with tamsulosin and placebo on the 3rd and 14th day was analyzed using Chi Square test while the efficacy of administration of tamsulosin and placebo on the 3rd and 14th day was analized using Mc Nemar test. Results: This study showed that there was still urinary retention in 7 patients (58,3%) and 4 patients (44,4%) shared recovery within 3 days of tamsulosin administration, while 5 patients (41,7%) still had urinary retention compared to 5 patients (55,6%) who showed recovery in the placebo group. The difference was insignificant with p=0,670. Patients who dropped out from TWOC on the 3rd day and given tamsulosin until the 14th day showed urinary retention in 4 patients (44,4%) and recovery in 3 patients (100%) while all samples who were given placebo showed urinary retention 5 patients (55,6%). The difference was insignificant with p=0,205. Follow up for 3 days in Tamsulosin groups which have urine retention in this study, 3 patients became free for urine retention and the other 4 patients still had urine retention. But in this study, no difference in efficacy with p=1,025. In placebo groups with urinary retention before the 3rd day of administration still showed urinary retention after the 14th day. Conclusion: There was no statistical differences on the success of TWOC, between groups administered with 0,2 mg of tamsulosin and placebo group, neither on the 3rd day nor on the 14th day. There was reduction of recatheterization because of failure of TWOC with patients who were given tamsulosin for 14 days.
PERBEDAAN ANGKA KEJADIAN FISTEL URETROKUTAN PADA PENGGUNAAN KATETER URETRA DAN KATETER SUPRAPUBIK DENGAN STENT SETELAH OPERASI HIPOSPADIA Sigumonrong, Yacobda H; Santoso, Adi; Djojodimedjo, Tarmono; P, Widodo J
Indonesian Journal of Urology Vol 16 No 2 (2009)
Publisher : Indonesian Urological Association

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.32421/juri.v16i2.338

Abstract

Objectives: To study rate of urethrocutaneous fistula formation associated with usage of indwelling urethral catheter compared to suprapubic catheter with stent after hypospadias repair. Materials and methods: Twenty patients with primary hypospadias of penile shaft and posterior type underwent reconstruction with onlay technique by a single operator. Urinary diversion in 10 patients utilised a urethral catheter, while the remainder used a silicone suprapubic catheter with stent. Results: Seven urethrocutaneous fistula were observed (35%) with 4 fistulas in the group with suprapubic catheter and stent, and 3 fistulas in the group with urethral catheters. Fisher exact test value was 0,001 with significance level of 1,000 (p>0,05). Conclusion: There was no difference in rate of urethrocutaneous fistula with use of urethral catheter and suprapubic catheterisation with stent after hypospadias repair.
HAEMATURIA AND COLIC CORRELATION AS CLINICAL PREDICTORS IN URETERAL STONES PATIENTS AT UROLOGY OUTPATIENT UNIT SOETOMO HOSPITAL WITHIN JANUARY 2011 - DECEMBER 2015 PERIOD Laksmana, Wisnu; Renaldo, Johan; Djojodimedjo, Tarmono
Indonesian Journal of Urology Vol 24 No 2 (2017)
Publisher : Indonesian Urological Association

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.32421/juri.v24i2.385

Abstract

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.
Co-Authors A.A. Ketut Agung Cahyawan W Addin, Sofyan Rais Aditya, Dimas Visa Agung Dwi Wahyu Widodo Ahmad Fajrial Fajrial Ahmad Nadhir Ahmad Nadhir Andri Kustono Anny Setijo Rahaju, Anny Setijo Anny Setijo Rahayu Askandar Tjokroprawiro Aulia Nur Fadila Bambang Soeprijanto Benny Kristyantoro Doddy M Soebadi Doddy M. Soebadi Doddy M. Soebadi Doddy M. Soebadi Dyah Erawati, Dyah Efendi, Ferdyan Rachmat Fauriski Febrian Prapiska, Fauriski Febrian heri budiono Heru Nurdianto I Dewa Gede Reza Sanjaya Ida Bagus Putra Pramana Johan Renaldo Khoirul Kholis, Khoirul Kustono, Andri Kusuma, Raditya Laksmana, Wisnu Lukman Hakim Lumbangaol, Arifai Moh Ayodhia Soebadi Moh. Ayodhia Soebadi Mohammad Ayodhia Soebadi Muhammad Fawzi Zulfikar Muhammad Reza Gautama Muhammad Wahyu Ali Muhammad Yamin S Nanang Sasmita Nurhadi, Pradana Ogi Bahaurini Gumilar Paksi Satyagraha Permana, Wien Pranoto, Indrianto W. putri, Karinda triharyu caesari Rahaju, Anny S. Ramadhan, Ido Putra Ramandita Duta Dewangga Reza Kurniawan Rizaldi, Fikri S.Pd. M Kes I Ketut Sudiana . Sabilal Alif Sawal, Zuhri Sawal, Zuhri septa surya wahyudi, septa surya Septina Rahayu, Septina Soebadi , Mohammad A. Soetojo Soetojo Subkhan Subkhan Sunaryo Hardjowijoto Suryatmana, Anggana wahjoe djatisoesanto Wardhana, Sonny Andikha Widodo J P Widodo J Pudjirahardjo Widodo Pudjirahardjo Wien Permana Yacobda H Sigumonrong, Yacobda H Yufi Aulia Azmi Zulfikar, Muhammad Fawzi