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All Journal BALI MEDICAL JOURNAL (BMJ) E-Jurnal Medika Udayana E-Jurnal Udayana Medica Indonesian Journal of Urology Syntax Literate: Jurnal Ilmiah Indonesia JBN (Jurnal Bedah Nasional) ISM (Intisari Sains Medis) : Jurnal Kedokteran Neurologico Spinale Medico Chirurgico Journal of Anesthesiology and Clinical Research Journal of Global Pharma Technology Proceedings Book of International Conference and Exhibition on The Indonesian Medical Education and Research Institute E-Amal: Jurnal Pengabdian Kepada Masyarakat

Gede Wirya Kusuma Duarsa

Bagian Bedah Urologi Fakultas Kedokteran Universitas Udayana

Author-ID : 2936362

Agriculture, Biological Sciences & Forestry Humanities Biochemistry, Genetics & Molecular Biology Computer Science & IT Economics, Econometrics & Finance Education Environmental Science Health Professions Immunology & microbiology Law, Crime, Criminology & Criminal Justice Medicine & Pharmacology Neuroscience Public Health Social Sciences Other

Published : 31 Documents Claim Missing Document

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Diabetes mellitus, hipertensi, obesitas dan usia berhubungan terhadap meningkatnnya risiko terjadinya disfungsi ereksi pada pasien benign prostat hyperplasia di rumah sakit sanglah bulan Juni sampai Oktober tahun 2015 I Gusti Ayu Irma Vitriani; Gede Wirya Kusuma Duarsa
E-Jurnal Medika Udayana Vol 7 No 5 (2018): E-Jurnal Medika Udayana
Publisher : Universitas Udayana

Show Abstract | Download Original | Original Source | Check in Google Scholar | Full PDF (223.231 KB)

Benign Prostate Hyperplasia (BPH) is a degenerative disease that has complications of erectile dysfunction. Increased incidence of erectile dysfunction (ED) in cases of BPH is often accompanied by age risk factors as well as comorbid diseases such as diabetes mellitus, hypertension and obesity. This research uses cross-sectional study design. The technique of collecting samples by consecutive sampling method conducted in RSUP Sanglah Denpasar. The subjects were male patients with controlled BPH in Poly of Urology. The subjects were men who suffer Benign Prostate Hyperplasia (BPH) who visited the Poli Urology and treated at Sanglah Hospital. From this study showed that diabetes mellitus did not have a significant relationship to increase incident of ED in BPH, p=0.504. Hypertension has no significant relationship to increase incident of ED in BPH, p= 0.116. Obesity does not have a significant relationship to increase ED in BPH, p =0.058. While only age had a significant relationship to increase ED in BPH, p=0.016. The conclusion of the study is Diabetes Mellitus, Hypertension and Obesity not linked to increase incident of ED in BPH, while age has a close relationship to to increase incident of ED in BPH. Keywords: Benign Prostate Hyperplasia, ED, diabetes mellitus, hypertension, obesity, age

BENIGN PROSTATIC HYPERPLASIA Citra Gading; Gede Wirya Kusuma Duarsa
Bali Journal of Medical and Health Sciences vol 1no2 2013
Publisher : Faculty of Medicine, Udayana University

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Benign Prostatic Hyperplasia (BPH) is a nonmalignant enlargement of the prostate gland. BPH is commonly found in elderly man. The clinical manifestation include Lower Urinary Tract Syndrome (LUTS), Bladder Outlet Obstruction (BOO), acute and chronic urinary retention, urosepsis, urinary tract infection, bladder stone, and hematuria. BPH is diagnosed based on history taking, physical examintaion, rectal examination, laboratory examination, and urinary flow rate. Management of BPH based on patient symptom, include watchful waiting, medical therapy, minimally invasive therapy, and surgical therapy. Key words: Benign Prostatic Hyperplasia (BPH), Lower Urinary Tract Syndrome (LUTS), Prostate, Urethra

Rekonstruksi Penis pada Entrapped Penis setelah Perbaikan Hipospadia: Laporan Dua Kasus Gede Wirya Diptanala Putra Duarsa; Pande Made Wisnu Tirtayasa; I. B. Putra Pramana; Gede Wirya Kusuma Duarsa
JBN (Jurnal Bedah Nasional) Vol 4 No 2 (2020): JBN (Jurnal Bedah Nasional)
Publisher : Program Studi Ilmu Bedah, Fakultas Kedokteran Universitas Udayana

Latar belakang: Entrapped penis adalah bentuk concealed penis yang didapat, disebabkan oleh jaringan sikatrik tebal yang terdapat pada penis. Jaringan sikatrik tersebut dapat disebabkan oleh sirkumsisi, operasi hipospadia atau trauma. Kasus: Kami melaporkan dua kasus entrapped penis yang muncul setelah operasi rekonstruksi pada hipospadia. Kasus pertama adalah laki-laki 13 tahun dan kasus kedua adalah anak laki-laki berusia 8 tahun, kedua pasien datang dengan keluhan entrapped penis. Kedua pasien lahir dengan kelainan hipospadia dan sudah menjalani beberapa kali operasi rekonstruksi untuk keluhan hipospadia yang dialami. Setelah operasi, kedua pasien mengeluhkan kondisi entrapped penis. Pada pemeriksaan fisik didapatkan kondisi entrapped penis, dengan ukuran penis yang normal saat diretraksi. Tidak terdapat keluhan kesulitan miksi, nyeri saat miksi maupun nyeri suprapubik. Pada pasien dilakukan operasi rekonstruksi untuk membebaskan jaringan ikat pada penis dan skin flap. Pada pasien dilakukan pemasangan kateter foley 12 Fr dan pembebatan penis selama 5 hari. Pasien juga diberikan antibiotika dan analgesik. Kedua pasien dipulangkan tanpa komplikasi. Simpulan: Entrapped penis merupakan suatu komplikasi yang sering terjadi pada operasi rekonstruksi hipospadia maupun sirkumsisi. Penanganan rekonstruksi terdiri dari pembebasan jaringan ikat pada penis, skin flap dan operasi lain yang diperlukan sesuai kondisi pasien.

Tata Laksana Buried Penis di RSUP Sanglah Gede Wirya Diptanala Putra Duarsa; I Nengah Wiadi; Pande Made Wisnu Tirtayasa; Gede Wirya Kusuma Duarsa
JBN (Jurnal Bedah Nasional) Vol 4 No 1 (2020): JBN (Jurnal Bedah Nasional)
Publisher : Program Studi Ilmu Bedah, Fakultas Kedokteran Universitas Udayana

Tujuan: Untuk mengetahui tata laksana Buried penis di RSUP Sanglah. Metode: Delapan sampel dengan buried penis yang menjalani operasi rekonstruksi di RSUP Sanglah dikumpulkan dari Januari sampai Desember 2018. Pengumpulan data dilakukan sebelum operasi sampai 3 bulan setelah operasi. Hasil: Delapan pasien yang termasuk dalam penelitian ini memiliki rentang usia dari 5 sampai 15 tahun. Mayoritas berat badan pasien berada diatas persentil 50. Panjang penis sebelum operasi memiliki rentang 0,0-3,0 cm. Dilakukan degloving penis, eksisi lapisan dartos yang inelastis dan penutupan kulit dengan skin flap. Panjang penis setelah operasi meningkat menjadi 4,3-13,5 cm dimana merupakan ukuran penis normal sesuai usia pasien. Pemeriksaan histologi menunjukkan kolagen yang tebal seperti pasien hipospadia dan berbeda dengan pasien normal. Simpulan: Buried penis merupakan suatu abnormalitas penis kongenital. Terdapat pendekatan dan teknik operasi yang bervariasi sesuai kondisi pasien dan keahlian masing-masing dokter bedah. Ukuran penis meningkat setelah rekonstruksi.

Factors that influence peritonitis events on patients with continuous ambulatory peritoneal dialysis in Sanglah General Hospital, Denpasar-Bali, Indonesia Gede Wirya Kusuma Duarsa; Oka Udrayana; Yeni Kandarini; Raka Widiana; Marleen
Neurologico Spinale Medico Chirurgico Vol 3 No 3 (2020)
Publisher : Indoscholar

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.36444/nsmc.v3i3.105

Background. To determine risk factors that influence peritonitis event on patients with Continuous Ambulatory Peritoneal Dialysis (CAPD) in Sanglah Hospital, thus, we can prevent the occurrence of peritonitis in CRF patients with CAPD. Methods. This is a retrospective cohort study, which was conducted at the Sanglah Hospital in Denpasar from August to September 2016. All data are processed using SPSS 17.0 for Windows, data analysis by using the Kaplan Meier (K-M) curves, hypothesis using the log-rank test, while for the survival is by using the median or mean survival. The significance is determined by the value of p < 0.05 with 95% CI. Results. A total of 78 people (46 men and 32 women) who meet the inclusion criteria of this study. Thirteen people (16.7%) are experiencing peritonitis. K-M Survival Curves between in CRF patients with CAPD, with Age ≥ 50 years (51.36 months survival rates, 95% CI 44.79 until 57.93) with < 50 years (56.1 months Survival rates, 95% CI 51.41 until 60.78) with RR 2.54 log-rank p 0.084. K-M Survival Curves between in CRF patients with CAPD, with DM (mean 52.63 months survival rates, 95% CI 47.21 until 58.06) with No DM (56.88 months survival rates, 95% CI 52.89 until 60.88) with RR 4.16 and 0.037 log-rank p. Conclusion. There is a correlation between DM and the incidence of peritonitis in CRF patients with CAPD at Sanglah Hospital. However, age and education level are not related.

Scrotal Hypospadias with Severe Chordee, Micropenis, and Bifid Scrotum in A Child Treated with Multi Stage Repair and Hormonal Therapy Paulina Magdalena; Gede Wirya Kusuma Duarsa
Neurologico Spinale Medico Chirurgico Vol 2 No 3 (2019)
Publisher : Indoscholar

Proximal hypospadias, include proximal penile, penoscrotal, scrotal and perineal types, are a less common occurrence and correspond to 20% of total hypospadias. Surgical reconstruction is the only possible therapeutic option for hypospadias. The primary objectives of the reconstruction are to create a vertically slit orthotopic meatus, straighten the penis and establish good cosmetic results that include a conically shaped glans. Other important aspects for the reconstruction are to avoid shortening the penis and optimal skin coverage. A 9 years old male presented with abnormal spraying during urination. The parents said that the opening of his urethra is located under the penis. Everytime he urinates, the urine flowing along the thighs. In physical examination, the opening of urethra is in the scrotum. The penis was uncircumcised while the scrotum was bifid in the normal position, and bilateral testes were fully descended in the well-developed scrotum. Repair of proximal hypospadias involves correction of several components of the hypospadias complex with the intent of optimizing long-term functional and cosmetic outcomes. These components include ventral penile curvature, proximal location of the urethral meatus, ventral skin deficiency, glans morphology abnormality, abnormal division of the corpus spongiosum, penile torsion and penoscrotal transposition. Surgical correction of several components divide into five sequential steps. Severe forms of hypospadia are typically accompanied by an abnormal ventral curvature of the penis (chordee). Surgical correction of both chordee and hypospadias is recommended. When properly corrected, it does not cause long-term problems, and a natural appearance of the penis is usually restored.

A False Route Case of Primary Excision Anastomosis (EPA) Procedure in The Treatment of Traumatic Bulbar Urethral Stricture I Gusti Ayu Putri Purwanthi; Gede Wirya Kusuma Duarsa; Tjokorda Gde Agung Senapathi
Neurologico Spinale Medico Chirurgico Vol 2 No 3 (2019)
Publisher : Indoscholar

The bulbar urethra stricture is the most common form of anterior urethral stricture. The treatment of urethral strictures are varies and remains a challenging field in urology. Excision Primary Anastomosis (EPA) described as the most effective intervention for traumatic urethral stricture cases with a long-term success rate. This case report described male, 42 years old with history of pelvic injury. He had underwent cystostomy and conservative management for his pelvic injury. After EPA and pubectomy procedure in September 2019, he was still unable to void from his urethra. Radiologic evaluation with BVUC was done on October 2019, showing total obstruction of urethral as high as superior aspects of pars bulbosa, unfavourable anastomosed and displaced urethra. Acquired urethral stricture or fistula is an unexpected result of urethral reconstruction and leads to much inconvenience as well as psychological problem for the patient. This condition is avoidable by operation that was performed by experienced urologist and using a flexible cystoscopy as a guidance.

Correlation of total ischemic time to creatinine serum level and resistive index value in kidney transplant Putu Astri Novianti; Gede Wirya Kusuma Duarsa; Gede Andi Aditya; Anak Agung Gde Oka; Kadek Budi Santosa; I Wayan Yudiana; Pande Made Wisnu Tirtayasa; Ida Bagus Putra Pramana; Yenny Kandarini; Wayan Sudana; Djodi Sidartha; Raka Widiana
Neurologico Spinale Medico Chirurgico Vol 3 No 2 (2020)
Publisher : Indoscholar

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.36444/nsmc.v3i2.109

Background: The transient period when the kidney donor was extracted until being anastomosed (total ischemic time) will aggravate many putative molecular ischemic-reperfusion injury mechanisms. Several studies have reported the risk of delayed graft function development, which can be reflected by creatinine serum (Cr) level and resistive index (RI) value. This study aims to determine the correlation of total ischemic time to Cr levels reduction in one-month post-transplantation and RI value. Methods: This was a cross-sectional retrospective study involving subjects who underwent kidney transplantation in Sanglah General Hospital. In this study, the primary parameters were total ischemic time, Cr level, and RI value. The total ischemic time is calculated using a stopwatch intraoperatively. Cr level was obtained from blood examination, and RI value was obtained from the ultrasonography test. Data analysis was analyzed statistically using SPSS 24.0, and p < 0.05 was considered significant. Results: About 17 kidney transplant subjects were included in this study. The mean total ischemic time was 105 minutes and 43 seconds. There was an insignificant negative correlation between Cr level reduction and total ischemia time (r = -0.36; p = 0.89). An analysis of the correlation of total ischemic time and RI value, there was a linear correlation, but statistically insignificant (r = 0.11; p = 0.66). Conclusion: Total ischemic time has a negative correlation with post-transplant creatinine serum level and a positive correlation with the post-transplant resistive index value, but these results are not statistically significant.

Treatment of panurethral strictures using one side dissection dorsal onlay buccal mucosal graft urethroplasty Gede Wirya Diptanala Putra Duarsa; Gede Wirya Kusuma Duarsa; Ida Bagus Putra Pramana; Paksi Satyagraha
Neurologico Spinale Medico Chirurgico Vol 4 No 2 (2021)
Publisher : Indoscholar

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.36444/nsmc.v4i2.133

The management of panurethral stricture was still challenging and controversial. We presented a case of pan urethral strictures management by using a one-sided dissection of dorsal onlay buccal mucosal graft (BMG) urethroplasty (Kulkarni technique). A 53-years old man admitted with panurethral stricture who had previously undergone several procedures. Bipolar micturition cystourethrography procedure revealed 17 cm stricture length. One-sided dissection dorsal onlay buccal mucosal graft urethroplasty was performed. No drain was placed. The Foley catheter was removed four weeks after surgery, and the results of the micturition were favourable. No fistulae were found at a straight erection and meatus at a normal position. The postoperative flow rate (Qmax) was 24.9 ml/second. As a conclusion Kulkarni technique urethroplasty gained good outcome for panurethral stricture in our case.

Sistem tunggal ureter ektopik dengan ginjal multikistik displastik di RSUP Sanglah, Bali, Indonesia: laporan kasus Donny Oktavius; Gede Wirya Kusuma Duarsa
Intisari Sains Medis Vol. 11 No. 1 (2020): (Available online: 1 April 2020)
Publisher : DiscoverSys Inc.

Background:Â Ectopic ureter is a condition when the ureter does not enter the bladder properly. The occurrence of the ectopic ureter is 1:2.000 - 1:4.000 in general population with gender ratio 6:1 in favour of females. More than 80% of cases of ectopic ureters are generally associated with complete duplication of the pelvic-ureteric system. Still, the ectopic ureter can also occur in a single pelvic-ureteric system, which is typically dysplastic or poorly functioning, such as in multicystic dysplastic kidney. This study aims to evaluate the current management of a single ectopic ureteral system with dysplastic multicystic kidneys at Sanglah General Hospital, Bali, Indonesia.Case Description:Â A 3-year-old girl was referred to the urology clinic of Sanglah General Hospital with chief complaint cloudy urinary since 1,5 years ago. Past medical history, the patient had a recurrent urinary tract infection with fever. Physical examination and laboratory findings were normal. However, an abdominal ultrasound showed a multicystic dysplastic kidney. VCUG showed vesicoureteral reflux grade V and ectopic ureter. Cystoscopy with retrograde pyelography and ureterorenoscopy showed an ectopic ureter opening was located in the proximal urethra above the external sphincter. Nephroureterectomy was performed. After the surgical procedure, the patient was treated and had no complaint. The patient was discharged from the hospital four days after surgery.Â Conclusion:Â The management of ectopic ureteral cases varies for each case. In this regard, the nephroureterectomy surgery performed in the case has provided good outcomes.Latar Belakang: Ureter ektopik merupakan suatu kondisi dimana ureter tidak masuk ke buli-buli pada tempat yang seharusnya. Insiden ureter ektopik 1:2.000 - 1:4.000 kelahiran pada populasi secara umum dengan perbandingan jenis kelamin perempuan lebih banyak daripada laki-laki, yaitu 6:1. Lebih dari 80% kasus ureter ektopik umumnya berhubungan dengan duplikasi sistem pelvis-ureter yang lengkap. Tetapi ureter ektopik juga dapat terjadi pada sistem pelvis-ureter tunggal, yang pada umumnya displastik atau fungsinya buruk, seperti pada keadaan ginjal multikistik displastik. Studi ini bertujuan untuk mengevaluasi manajemen terkini pada sistem tunggal ureter ektopik dengan ginjal multikistik displastik di RSUP Sanglah, Bali, Indonesia.Deskripsi Kasus: Seorang anak perempuan berusia 3 tahun dirujuk ke poliklinik urologi Rumah Sakit Sanglah dengan keluhan buang air kecil keruh sejak 1,5 tahun lalu. Riwayat penyakit dahulu, penderita mengalami infeksi saluran kemih berulang disertai demam. Hasil pemeriksaan fisik dan laboratorium normal. Hasil USG abdomen menunjukkan gambaran ginjal multikistik displastik, VCUG menunjukkan vesikoureteral refluks grade V dan ureter ektopik. Sistoskopi dengan retrograde pyelografi dan ureterorenoskopi menunjukkan muara ureter ektopik terletak di uretra proksimal di atas sfingter uretra eksterna. Lalu dilakukan tindakan nefroureterektomi. Setelah dioperasi, selama perawatan, pasien tidak memiliki keluhan. Pasien dipulangkan setelah empat hari perawatan.Kesimpulan: Tatalaksana pada kasus ureter ektopik bervariasi untuk setiap kasus. Berkaitan dengan hal tersebut maka tindakan pembedahan nefrouretektomi yangÂ dilakukan pada kasus tersebut telah memberikan luaran yang baik.

Co-Authors Anak Agung Gde Oka Aria Kekalih Bramastha A Rosadi, Bramastha A Cita Rosita Sigit Prakoeswa Citra Gading Dea Emmanuel Djodi Sidartha Donny Oktavius Gde Oka, A A Gede Andi Aditya Gede Wirata Gede Wirya Diptanala Putra Duarsa Gede Wirya Diptanala Putra Duarsa Gede Wirya Diptanala Putra Duarsa Gede Wirya Diptanala Putra Duarsa Gusti Ayu Putu Nilawati Heri Wibowo I Gde Raka Widiana I Gusti Ayu Irma Vitriani I Gusti Ayu Putri Purwanthi I Gusti Bagus Dharma Prakasa Musti I Ketut Widiana I Made Nugraha Gunamanta Sabudi I Nengah Wiadi I Nyoman Semadi I Wayan Yudiana I.G. Darma-Kusuma Ida Bagus Putra Manuaba Ida Bagus Putra Pramana Irfan Wahyudi Kadek Budi Santosa Ketut Putu Yasa Krishna, I Komang O. Lisnawati Rachmadi Marleen Nurhaen - Nyoman Golden Nyoman Khrisna Dharmawan Oka Udrayana Oka, AA Gde Oka, Anak A.G. Paksi Satyagraha Pande Made Wisnu Tirtayasa Pande Putu Yuli Anandasari Paulina Magdalena Ponco Birowo Pontisomaya Parami Pradiptha, I Nyoman Tri Pramana, Putu Bagus Gin Gin Prayudi, I Nyoman Gede Putu Astri Novianti Putu Kurnia Darma Pratama Putu Primeriana Nugiaswari Raharja, Putu Angga Risky Rika Lesmana, Rika S. F. Laura, S. F. Sri Maliawan Sugianto, Ronald Teguh Dwi Nugroho, Teguh Dwi Tjokorda Gde Agung Senapathi Tjokorda Gde Bagus Mahadewa Udiyana, Nyoman Dwi Maha Wayan Sudana Yenny Kandarini

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