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All Journal Majalah Kedokteran Bandung Indonesian Journal of Urology Folia Medica Indonesiana Indonesian Journal of Cancer JBN (Jurnal Bedah Nasional)
Sunaryo Hardjowijoto
Department Of Urology, Faculty Of Medicine, Universitas Airlangga/ Dr. Soetomo General Academic Hospital, Surabaya
Health Professions Medicine & Pharmacology Public Health Other

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ADIPOSE-DERIVED STEM CELL TRANSPLANTATION ON URETHRAL MICROVESSEL AND VOIDING FUNCTION Mahadi, Endi Prilansa; Hardjowijoto, Sunaryo; Alif, Sabilal; Purwati, Purwati; Sandhika, Willy; Budiono, Budiono
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.v22i1.101

Abstract

Objective: To examine the effects of adipose-derived stem cell (ADSC) transplantation on urethral tissue microvessel and voiding function on artificial stress urinary incontinence (SUI) in rats. Material & methods: 25 of 32 female wistar rats underwent vaginal distension as animal-SUI model. ADSCs were isolated from the peri-ovary fat, examined for stem cell properties, and labeled with PKH-2. Seven rats without vaginal distension and periurethral ADSCs injection as control. Twelve rats received periurethral injection of phosphate buffer saline as plasebo and 13 rats received periurethral injection of ADSCs. 14 and 28 days later, voided volume was meassured with voided stained on paper and microvessel density was meassured with immunohistochemical analysis (factor VIII R-Ag). Results: Voided volume analysis showed that rats in the plasebo group had abnormal voided volume compare to normal rats in day 14 (168.5 ± 119.05l vs 621.21 ± 283.85l; p < 0.05), and insignificant improvement of voided volume compare to normal rats in day 28 (852.09 ± 626.7l vs 868.49 ± 578.0l; p > 0.05). While in the ADSCs group only showed significant improvement of voided volume compare to abnormal rats in days 14 (379.35 ± 191.74l vs 228.18 ± 56.26l; p < 0.05). Immunohistochemical analysis showed that microvessel density higher in the ADSCs group compare to plasebo group in days 28 (12.86 ± 2.5 vs 9.50 ± 1.64; p < 0.05). Conclusion: ADSCs transplantation promotes improvements voided volume and urethral microvessel in the rat-SUI model. Keywords: Adipose-derived stem cell, vaginal distension, voided stained on paper, microvessel density.
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.
CHARACTERISTIC OF URINARY RETENTION IN DEPARTMENT OF UROLOGY SOETOMO GENERAL HOSPITAL SURABAYA Wardhana, Sonny Andikha; Soebadi, Moh. Ayodhia; 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.v24i1.269

Abstract

Objectives: We analyze our data of patients with urinary retention that have been managed in Soetomo general hospital to know our prevalence, causes and its management. Material & methods: We retrospectively reviewed the medical records of the patients with urinary retention who admitted on our department between January 2011 and December 2012.  Results: During 2 years between January 2011 until December 2012, a total number of urinary retention was 295 cases among 1282 urology emergency cases, with sex ratio of urinary retention in men and women was 85.7% : 14.3%. Of the study population 264 (89.5%) presented with acute urine retention while 31 (10.5%) had chronic urine retention. Most of urinary retention was caused by bladder stone (33.3%) in children, urethral stricture (26.8%) in young adult men, BPH (71.3%) in elder men and cystitis (26.3%) in women. Trial of voiding without catheter (TWOC) that performed in 60 of the BPH patients, was succeeded in 43 (71.6%) of the patients and failed in 17 (28.4%). Emergency treatment of urinary retention were urethral catheter (83.7%) and cystostomy (16.3%). Conclusion: Urinary retention is one of emergency in urology that most common occur in men. Urine retention found among the participants was mainly AUR rather than CUR. Most of urinary retention was caused by bladder stone in children, urethral stricture in young adult men, BPE in elder men and cystitis in women. The most emergency management was urethral catheter. Trial of voiding without catheter showed a high success rate, so it can be considered as definitive non-surgical therapy in selective patient.
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.
INTRATESTICULAR INJECTION OF 20% HYPERTONIC SODIUM CHLORIDE AS A NOVEL CASTRATION METHOD: A PRECLINICAL STUDY Hendry, Marta; Hardjowijoto, Sunaryo; Purnomo, Basuki B; Joewarini, Endang; Meles, Dewa Ketut; P, Widodo J
Indonesian Journal of Urology Vol 17 No 1 (2010)
Publisher : Indonesian Urological Association

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.32421/juri.v17i1.339

Abstract

Objectives: To demonstrate that intratesticular injection of 20% hypertonic sodium chloride can result in permanent castration and to evaluate serum changes in sodium chloride levels. Materials and Methods: A total of 40 Wistar rats were divided into 4 groups, consisting of bilateral orchidectomy (n=10), control (n=10) and 2 groups receiving intratesticular injections of 20% sodium chloride (n=10 in each group). Serum testosterone was measured on day 0, day 1, day 15 and day 30. Serum sodium chloride was assessed before injection, at 1 hour and 24 hours after injection. All testicles were harvested for histological examination. One way ANOVA and student t-test were used for statistical analysis. Results: Serum testosterone decreased to castrate levels in the orchidectomy and injected groups with no significant difference (p>0,05). Significant rise in serum sodium chloride was found 1 hour post injection (p<0,05) but after 1 day it decreased significantly (p<0,05). There was no significant difference in histopathological findings between the 2 injected groups after day 15 and 30 (p>0,05). Conclusion: Twenty percent hypertonic chloride injection has the same permanent castration effect with bilateral orchidectomy in rats. The serum sodium chloride changes did not reach the lethal level for rats. Therefore this treatment has a promising potential as a novel and cost-effective castration method with the additional benefit of retaining both testes.
Co-Authors A.A. Ketut Agung Cahyawan W Agung Dwi Wahyu Widodo Anak Agung Ngurah Oka Diatmika Aryati Aryati Aulia, Rifky Basuki B Purnomo, Basuki B Budiono Dimas Panca Andhika Doddy M Soebadi Doddy M. Soebadi Eddy Sunarno, Eddy Edwin Ongkorahardjo, Edwin Endang Joewarini Endi Prilansa Mahadi Fadhli Hasan Fauriski Febrian Prapiska, Fauriski Febrian Gondo Mastutik heri budiono I Wayan Yudiana I'tishom, Reny Ida Bagus Putra Pramana Johan Renaldo Juniastuti Juniastuti Kusuma, Raditya Lukman Hakim Lukman Hakim M. Andriady S. Nasution M. Asro Abdih Marta Hendry, Marta Meles, Dewa Ketut Moh. Ayodhia Soebadi Mohamad Ayodhia Soebadi Mohammad Ayodhia Soebadi Muhammad Ridha Mukti, Ade Indra Nurhadi, Pradana Purwati Purwati Purwati putri, Karinda triharyu caesari RIFKYA ULIA, RIFKYA Rizaldi, Fikri Sabilal Alif Satrya Husada, Satrya septa surya wahyudi, septa surya Septina Rahayu, Septina Soetojo Soetojo Suhartono Taat Putra Tarmono Djojodimedjo Taufik Indrawan Triyono Karmawan Sukmana Pria wahjoe djatisoesanto Wardhana, Sonny Andikha Wayan Suarsana Widjoseno Gardjito, Widjoseno Widodo J P Widodo J Pudjirahardjo Widodo J Pujiraharjo Willy Sandhika Yuanda, Rameshdo Zamroni Zamroni