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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 Folia Medica Indonesiana

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

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Berat badan lahir lebih dari 4000 gram merupakan faktor risiko kejadian mikropenis pada bayi baru lahir di Denpasar tahun 2019 I Gusti Bagus Dharma Prakasa Musti; Gede Wirya Kusuma Duarsa; Tjok Gde Mahadewa; Gede Wirata
Intisari Sains Medis Vol. 10 No. 3 (2019): (Available online: 1 December 2019)
Publisher : DiscoverSys Inc.

Background: Standard values related to age for penis size can help for early diagnosis and treatment of potential diseases. Rapid changes in growth and interindividual differences can occur during infancy and puberty. Therefore, micropenis data during newborns are beneficial for clinical evaluation and prognosis.Aim: This study aims to find out whether birth weight > 4000 grams and testis size <0.52 cm are risk factors for micropenis prevalence in newborns.Methods: This study used a descriptive-analytical cohort study involving 85 research subjects, namely healthy newborn boys who did not experience hypospadias, severe chordae, ambiguous penises. Respondents contributed to physical examinations and investigations following the standard procedure in the analysis of the weight, gestational age, and size of the testis. The study also evaluated the risk factors for micropenis in the form of a history of maternal hormonal birth control.Results: The micropenis was categorised to be <1.8 cm, which was obtained from <2.5 SD mean where the size of penis length in this study was achieved with a mean of 2.08 cm. The results of the multi-variate test showed that birth weight> 4000 grams was the most dominant risk factor causing micropenis. The positive B value with a value of 5.13, which means birth weight> 4000 grams has a positive relationship with the incidence of micropenis. The newborn weight was obtained about p = 0,000 (95%CI: 11,29-2558,17) with OR 170 which mean that there was an effect of birth weight on the incidence of micropenis where birth weight> 4000 grams had a chance of micropenis by 170 times.Conclusion: Weight> 4000 grams became the most dominant risk factor for micropenis having probabilities for a micropenis approximately 170 times.

Karakteristik pasien batu ginjal dengan tatalaksana retrograde intra-renal surgery di Rumah Sakit Umum Pusat Sanglah dan Rumah Sakit Surya Husada: initial report tahun 2017-2019 I Made Nugraha Gunamanta Sabudi; Gede Wirya Kusuma Duarsa; Kadek Budi Santosa; I Wayan Yudiana; Pande Made Wisnu Tirtayasa; Ida Bagus Putra Pramana; Anak Agung Gde Oka
Intisari Sains Medis Vol. 11 No. 2 (2020): (Available online: 1 August 2020)
Publisher : DiscoverSys Inc.

Background: Renal stone is frequent cases that happened in the community. There are a lot of options to treat renal stone; one of them is RIRS. RIRS is an alternative procedure after ESWL and PNL for renal stone.Method: Twenty-seven samples as total sampling of all patients that were done with RIRS in Sanglah Hospital and Surya Husada Hospital from January 2017 until June 2019 retrospectively. Data were collected secondary from Medical Reports of the patients and showed a descriptive study depict how the RIRS patient characteristic in Sanglah Hospital and Surya Husada Hospital. All RIRS patients showed that the RIRS procedure is secondary due to history of ESWL, PNL, URS with insertion of DJ Stent, and or Nephrolithotomy.Results and Conclusion:Characteristic of age in this study was 52,41 years old in mean value, with male and female per cent, respectively 62,96% and 37,04%. Stone size of the study was classified to 4 cluster which are: (1) 37,04% cluster with stone size <1 cm, (2) 33,33% cluster with stone size â‰¥1cm to <2cm, (3) 3,70% cluster with stone size â‰¥2 cm, and (4) 25,93% cluster that with stone size unknown. This study also showed some similarity with two other studies about patient characteristic of RIRS treatment.Â Latar Belakang: Batu ginjal adalah kasus yang sering terjadi di masyarakat. Terdapat banyak pilihan tindakan untuk mengambil batu ginjal salah satunya adalah dengan tindakan RIRS. Tindakan RIRS masih menjadi alternatif tindakan setelah pilihan pertama PNL dan ESWL untuk batu ginjal.Metode: Penelitian ini mengambil 27 sampel pasien dari total sampling seluruh pasien yang dilakukan RIRS di Rumah Sakit Umum Pusat (RSUP) Sanglah dan Rumah Sakit (RS) Surya Husada selama Januari 2017 hingga Juni 2019 secara retrospektif. Data didapatkan dari data sekunder rekam medis pasien. Penelitian disajikan secara deskriptif memberikan gambaran karakteristik pasien yang mendapatkan tindakan RIRS. Seluruh pasien yang dilakukan RIRS di RSUP Sanglah dan RS Surya Husada merupakan pasien dengan mendapat RIRS Sekunder setelah sebelumnya memiliki riwayat pernah ESWL, PNL, URS dengan pemasangan DJ-stent, dan atau nefrolitotomi.Hasil dan Simpulan: Karakteristik usia rata-rata pada penelitian ini adalah 52,41 tahun dengan perbandingan persentase laki-laki perempuan berturut-turut 62,96% dan 37,04%. Ukuran batu pada penelitian dikelompokkan menjadi 4 kelompok dengan masing-masing kelompok: (1) 37,04% kelompok dengan ukuran batu <1 cm, (2) 33,33% kelompok dengan ukuran batu â‰¥1cm s/d <2cm, (3) 3,70% kelompok dengan ukuran batu â‰¥2 cm, (4) 25,93% kelompok yang ukuran batunya tidak tercantum.

Ginjal tapal kuda dengan hidronefrosis unilateral sekunder akibat atresia ureter: laporan kasus Putu Kurnia Darma Pratama; Gede Wirya Kusuma Duarsa; Gusti Ayu Putu Nilawati; Pande Putu Yuli Anandasari
Intisari Sains Medis Vol. 10 No. 2 (2019): (Available online: 1 August 2019)
Publisher : DiscoverSys Inc.

Background: Total prevalence of multiple congenital anomalies (MCA) was 15.8 per 10,000 births. Genitourinary anomalies were associated with MCA cases about 43.8% of the cases. The horseshoe kidney is one example of genitourinary anomalies related to the high incidence of MCA and up to one third also had hydronephrosis thought to be secondary to ureteric atresia.Case: A 10-month-old boy presented with a 5-month history of abdominal distention. On physical examination, there was a large non-tender cystic mass in the right upper abdomen extending down to the right lower abdomen. The other congenital anomalies on this patient were hydrocephalus, hypospadias, and bilateral undescended testis. Abdominal CT showed a significant right hydronephrosis with megaureter and mesenteric cyst. The horseshoe kidney was unclear. The surgical approach to the kidney was via a transverse upper abdominal transperitoneal incision. Exploration revealed a horseshoe kidney with cystic mass situated retroperitoneally on the right side, massive dilatation of renal pelvis and proximal ureter 3 cm from UPJ. The distal ureter was markedly atresia. It was decided to perform nephroureterectomy on the right side considering its thin renal cortex. The postoperative average urine production is 25 ml/hour, no bleeding from surgical wound, BUN 10.7 mg/dL, and serum creatinine 0.37 mg/dL.Conclusion: The horseshoe kidney is one example of genitourinary anomalies related to the high incidence of MCA. Up to one third with horseshoe kidney had hydronephrosis secondary to ureteric atresia, which can be managed by reconstruction surgery or nephroureterectomy considering the function of the affected side of kidney.Â

The short-term disadvantageous of tension-suture and spica cast application in exstrophy-epispadias complex reconstruction: a case report Ida Bagus Putra Pramana; Anak Agung Gde Oka; Gede Wirya Kusuma Duarsa; Kadek Budi Santosa; I Wayan Yudiana; Pande Made Wisnu Tirtayasa
Intisari Sains Medis Vol. 10 No. 3 (2019): (Available online: 1 December 2019)
Publisher : DiscoverSys Inc.

Background: Exstrophy-epispadias complex (EEC) represents a spectrum of genitourinary malformations and associated with another congenital anomaly. EEC is a rare congenital disability. EEC affects the genitourinary system, anterior abdominal wall, musculoskeletal system, spine and anus. The surgical outcome has a lot of potential complications in patient with EEC. The decision to first approach is important for the next step. Herein, we reported a case of EEC with several anomalies. Case Description: A new-born male was born with section cesarean at 38 weeks of gestation from 34-year-old mother, and this is from the second pregnancy. The weight was 3300 grams, and the height was 48 centimetres. There was an abdominal wall defect with an exposed evaginated bladder plate with urine draining from the defect. A complete dorsally opened urethral plate was seen from the bladder neck down to the glandular grove. The patient was diagnosed with Exstrophy-epispadias complex (EEC). A 2 stage repair was conducted in this patient. After 10 days post-operation, the wound became dehiscence and got sepsis postoperatively as well as lead to die in the day 20.Conclusion: Wound dehiscence following reconstruction is very critical inpatient with EEC. Tension suture and spica cast application can be disadvantageous inpatient with EEC.

Interval waktu iskemia, derajat iskemia, dan sindrom kompartemen merupakan faktor risiko amputasi pada pasien acute limb ischemia yang dilakukan tindakan trombektomi terbuka di RSUP Sanglah Denpasar Dea Emmanuel; Ketut Putu Yasa; Ida Bagus Putra Manuaba; I Nyoman Semadi; Ketut Widiana; Gede Wirya Kusuma Duarsa
Intisari Sains Medis Vol. 11 No. 2 (2020): (Available online: 1 August 2020)
Publisher : DiscoverSys Inc.

Introduction: Acute Limb Ischemia (ALI) is a sudden decrease in perfusion in the extremities that causes the threat of tissue viability and is still one of the causes of disability. The purpose of this study was to determine the factors that influence amputation in patients with acute limb ischemia who undergo thrombectomy.Methods: This was a retrospective observational study with case-control studies. As many as 40 patients with acute limb ischemia who underwent thrombectomy were seen as an outcome of amputation. Matching was done based on age and sex in the case (amputation) and control (without amputation) groups. Data collection is based on medical records from 2014 to 2019. Bivariate analysis uses Chi-Square or Fisher's Test while multivariate analysis uses logistic regression.Results: In this study we found that the time interval of ischemia and the degree of ischemia is a risk factor of amputation in person with ALI (p<0.05) but compartment syndrome was not significantly related to amputation in ALI. Multivariate analysis shows degree of Rutherford IIB / III ischemia to be a the most dominant factor for amputation (OR = 6.84; 95% CI = 1.19-39.35; p = 0.03).Conclusion: The time interval of ischemia and the degree of ischemia are factors that influence amputation in patients with acute limb ischemia who undergo thrombectomy. The degree of ischemia is the most dominant risk factor affecting amputation.Â Latar Belakang: Acute Limb Ischemia (ALI) adalah penurunan secara tiba-tiba perfusi di ekstremitas sehingga menyebabkan ancaman viabilitas jaringan dan masih menjadi salah satu penyebab disabilitas Tujuan dari penelitian ini adalah untuk mengetahui faktor faktor yang mempengaruhi amputasi pada pasien acute limb ischemia yang dilakukan trombektomi.Metode: Penelitian ini merupakan penelitian observasional retrospektif dengan studi kasus kontrol. Sebanyak 40 pasien acute limb ischemia yang dilakukan trombektomi dilihat outcomenya dari amputasi. Dilakukan matching berdasarkan usia dan jenis kelamin pada kelompok kasus (amputasi) dan kontrol (tanpa amputasi). Pengambilan data berdasarkan catatan medis dari tahun 2014 hingga 2019. Analisa bivariat menggunakan Chi-Square atau Uji Fisher sedangkan analisa multivariat menggunakan regresi logistik.Hasil: Berdasarkan analisa statistik didapatkan didapatkan interval waktu iskemia dan derajat iskemia mempengaruhi amputasi (p<0,05) namun sindrom kompartemen tidak berhubungan secara signifikan. Hasil multivariat dengan regresi logistik ditemukan derajat iskemia Rutherford IIB/III menjadi faktor dominan terjadinya amputasi (OR = 6.84; IK 95% = 1,19-39,35; p = 0,03).Simpulan: Interval waktu iskemia dan derajat iskemia merupakan faktor yang mempengaruhi amputasi pada pasien acute limb ischemia yang dilakukan trombektomi. Derajat iskemia merupakan faktor risiko yang paling dominan mempengaruhi amputasi.

Non-Ischemic Priapism In Patients With Spinal Cord Injury Cervical 2-6 Accompanied By Spinal Shock Pramana, Ida Bagus Putra; Wisnu Tirtayasa, Pande Made; Yudiana, I Wayan; Santosa, Kadek Budi; Wirya Kusuma Duarsa, I Gede; Gde Oka, A A
Syntax Literate Jurnal Ilmiah Indonesia
Publisher : CV. Ridwan Publisher

Priapismus yang terjadi pada pasien dengan spinal cord Injury (SCI) merupakan kasus yang jarang terjadi. Priapismus pada pasien dengan SCI dapat terjadi karena penurunan fungsi dari sistem saraf simpatis dan peningkatan fungsi dari sistem saraf parasimpatis yang menyebabkan aliran arterial pada ruang sinusoidal penis. Pasien SCI biasanya datang dengan grade A American Spinal Injury Association. Penulis melaporkan pasien dengan Non-Ischemic Priapismus yang diakibatkan Spinal Cord Injury Cervical 2 -6 yang disertai dengan Spinal Syok

Perioperative outcome between open renal stone-removal surgery and PCNL in patients with staghorn stones Gede Wirya Kusuma Duarsa
Journal of Global Pharma Technology Volume 11 Issue 01.
Publisher : Journal of Global Pharma Technology

Show Abstract | Download Original | Original Source | Check in Google Scholar | Full PDF (368.381 KB)

Background: Percutaneous nephrolithotomy (PCNL) has become the treatment of choice for staghorn stones, replacing open stone surgery. However, in a developing country, open stone surgery is still the treatment of choice due to its nature for not requiring endourology devices, it can be performed by a general surgeon, and it is financially acceptable.Objective: This study aims to compare the cost-related outcome between PCNL and open renal stone surgery in patients with staghorn stones.Method: Data were collected retrospectively, taken from patients’ medical records who underwent PCNL and open stone surgery in three hospitals from 2016-2017. Seventy-eight patients were divided equally into PCNL group and open surgery group. Data of the hospital length of stay, the volume of blood loss during surgery, stone-free rate, and post-operative additional procedures were recorded.Outcome Measurements and Statistical Analysis: The data were analyzed using SPSS version 23.0 for Windows.Results: The hospital length of stay was shorter in PCNL compared to open stone surgery (3 vs. 4 days, p<0.001). The post-operative stone-free rate was lower in PCNL compared to open stone surgery (48.7 vs. 92.3%, p<0.001). More post-operative additional procedures were found in PCNL compared to open stone surgery (p<0.001). There was no significant difference in the amount of blood loss during surgery in both groups (p=0.102).Conclusions: PCNL is a minimally invasive procedure that is effective and safe for treating staghorn stones. Nevertheless, in places where PCNL is unavailable, open stone surgery can still be a choice for treatment.

Correlation among Transforming Growth Factor , Tumour Necrosis Factor- , Prostate Specific Antigen, and Testosterone with Prostate Stromal to Epithelial Ratio in Benign Prostate Hyperplasia Gede Wirya Kusuma Duarsa
Journal of Global Pharma Technology Volume 11 Issue 08 (2019) Aug. 2019
Publisher : Journal of Global Pharma Technology

Show Abstract | Download Original | Original Source | Check in Google Scholar | Full PDF (448.409 KB)

Introduction: Benign Prostatic Hyperplasia (BPH) occurs due to an imbalance between cell proliferation and the apoptotic process. Many factors influence the growth of the prostate. This study aims to determine which factors among TGF-b, TNF-a,, PSA, testosterone, correlate the most the stromal-to-epithelial ratio of the prostate. Methods: The study was conducted in 83 BPH subjects in several hospitals in Denpasar. From all subjects, blood was taken for PSA and testosterone examination. TGF-b and TNF-a were examined from the histopathological examination of prostate tissue specimens. Data were collected, then statistical analysis was done with SPSS 22.0. Results: From all parameters, only PSA was significantly negatively related to stromal-to-epithelial ratio, although the strength was negatively weak (r -0.28). Multivariate analysis showed that the combination of PSA and TGF- levels had an effect of 10.8% on the epithelial-stromal ratio. Conclusion: PSA showed a significant association with the ratio of prostate epithelial stroma and had an effect value of 10.8% when combined with TGF-bKeywords: Prostate enlargement, Epithelial-stromal ratio, TNF-α, TGF-β, PSA, Testosterone.

Overview of Acute Kidney Injury (AKI) in the Intensive Care Unit: Observational Study at Prof. Dr. I.G.N.G Ngoerah General Hospital, Denpasar, Indonesia Pontisomaya Parami; Tjokorda Gde Agung Senapathi; Gede Wirya Kusuma Duarsa; Pramana, Putu Bagus Gin Gin
Journal of Anesthesiology and Clinical Research Vol. 5 No. 3 (2024): Journal of Anesthesiology and Clinical Research
Publisher : HM Publisher

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.37275/jacr.v5i3.555

Introduction: Acute kidney injury (AKI) is a serious clinical syndrome with complications that can be life-threatening. AKI is associated with increased length of stay and mortality in patients in the intensive care unit (ICU). This study aims to determine the incidence and characteristics of AKI in ICU patients at Prof. Dr. I.G.N.G Ngoerah General Hospital Denpasar. Methods: This descriptive observational research was conducted by collecting data from medical records of ICU patients for three months. Data were analyzed to determine the incidence of AKI, stage of severity, and mortality rate. Results: Of the 388 patients treated in the ICU, 87 (22.37%) experienced AKI. The mortality rate in AKI patients was 12.9% (n=50). A total of 11.05% (n=25) of AKI patients were classified as stage 1, 5.91% (n=17) as stage 2, and 5.40% (n=8) as stage 3. Conclusion: The incidence of AKI in the ICU of Prof. Dr. I.G.N.G Ngoerah General Hospital Denpasar. is quite high (22.37%). AKI is associated with a significant mortality rate (12.9%). This study provides a preliminary description of the incidence and characteristics of AKI in the ICU of this hospital, which may be useful for improving the quality of patient care and prevention of AKI.

PENGABDIAN MASYARAKAT OLEH DEPARTEMEN UROLOGI FAKULTAS KEDOKTERAN UNIVERSITAS UDAYANA BERUPA PENYULUHAN DAN SKRINING BATU GINJAL DAN PEMBESARAN PROSTAT DI KELURAHAN SESETAN DENPASAR Tirtayasa, Pande Made Wisnu; Prayudi, I Nyoman Gede; Pramana, Ida Bagus Putra; Yudiana, I Wayan; Santosa, Kadek Budi; Duarsa, Gede Wirya Kusuma
E-Amal: Jurnal Pengabdian Kepada Masyarakat Vol 4 No 3: September-Desember 2024
Publisher : LP2M STP Mataram

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.47492/eamal.v4i3.3563

The two most common diseases in the field of urology are prostate enlargement and kidney stone disease. The main principles of health promotion and treatment are preventive and curative actions. To reduce the incidence of kidney stones and prostate enlargement, preventive measures include providing education and health screening to the community. In addition to education on kidney stones and prostate enlargement diseases, this community service activity will conduct screenings for kidney stones and prostate enlargement using ultrasound equipment. The targeted outcomes include increasing public knowledge about kidney stone disease and prostate enlargement, as well as screening for kidney stones and prostate enlargement.

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 Niryana 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 Putra, Bismantara Aditya 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 Suryawisesa, Ida Bagus Made 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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