Ferry Safriadi
Department Of Of Urology, Faculty Of Medicine Universitas Padjadjaran/Dr. Hasan Sadikin General Hospital, Bandung

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Prostatektomi Radikal: Morbiditas dan Mortalitas di RSUP dr. Hasan Sadikin, Bandung Safriadi, Ferry
Indonesian Journal of Cancer Vol 7, No 1 (2013): Jan - Mar 2013
Publisher : "Dharmais" Cancer Center Hospital

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Abstract

Kanker prostat merupakan salah satu jenis keganasan tersering pada pria. Prostatektomi radikal merupakan terapi pilihan pada kanker prostat yang masih organ confined. Tindakan ini merupakan tindakan operatif dengan derajat kesulitan tinggi, sehingga risiko morbiditas atau mortalitas harus menjadi perhatian. Tujuan penelitian ini adalah mengevaluasi morbiditas, mortalitas pasien, dan faktor yang berperan.Penelitian ini dilakukan secara retrospektif dengan mengumpulkan data dari rekam medis dan status khusus pasien kanker prostat yang telah menjalani operasi prostatektomi radikal dari 2005 sampai 2011 di RS Hasan Sadikin. Analisis univariat dilakukan dengan Chi-square untuk menilai faktor yang berperan terhadap morbiditas dan mortalitas.Sebanyak 90 pasien sebagai subjek penelitian. Usia rerata subjek 62,99 + 5,32 tahun, nilai PSA 31,89 + 29,13 ng/ml, volume prostat 53,24 + 29,13 ml, skor Gleason paling banyak ditemukan pada rentang 2-6 sebesar 58,9%. Rerata lama operasi 236,74 + 89,78 menit dengan jumlah perdarahan sebanyak 874,22 + 573,46 ml dan transfusi 318,11 ml.Morbiditas mayor ditemukan pada 8 kasus (0,08%); 6 kasus termasuk klasifikasi modikasi Clavien derajat 3 dan 2 kasus derajat 5. Analisis statistik tidak menunjukkan adanya kaitan antara usia, PSA, volume prostat, skor Gleason, dan stadium T terhadap terjadinya morbiditas dan mortalitas.Kesimpulannya, morbiditas pada penelitian ini sebesar 0,06% dan mortalitas 0,02%. Faktor usia, PSA, volume prostat, skor Gleason, dan stadium T tidak bermakna secara statistik. Penapisan pra-operasi yang baik akan mencegah terjadinya morbiditas dan mortalitas, selain faktor pengalaman operator.Kata kunci: kanker prostat, prostatektomi radikal, morbiditas, mortalitas.
Penanganan Metastasis Tulang dan Bone Loss pada Penderita Kanker Prostat SAFRIADI, FERRY
Indonesian Journal of Cancer Vol 6, No 3 (2012): Jul - Sep 2012
Publisher : "Dharmais" Cancer Center Hospital

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Abstract

Kanker prostat merupakan keganasan non-kulit terbanyak di negara barat atau keganasan keempat terbanyak pada pria setelah kanker kulit, paru, dan usus besar.Di negara maju, stadium awal ditemukan pada 75% penderita. Di Rumah Sakit Hasan Sadikin, Bandung, pada periode 2004-2010 ditemukan 57% kasus masih terbatas di organ dan locally advanced. Sedangkan sisanya, 43% termasuk stadium lanjut dari 320 kasus kanker prostat.Kanker prostat adalah keganasan di bidang urologi yang paling sering bermetastasis ke tulang sampai 70% kasus. Penyulitnya berupa nyeri hebat, fraktur patologis, sindrom kompresi tulang belakang, dan hiperkalsemia. Insidensi penyulit sekitar 46,1% mengakibatkan peningkatan biaya perawatan dan memperburuk prognosis pasien.Androgen Deprivation Therapy merupakan terapi kanker prostat yang telah bermetastasis. Terapi ini sendiri menyebabkan osteopenia atau osteoporosis.Bifosfonat merupakan obat yang paling banyak dipakai saat ini untuk terapi metastasis tulang. Bifosfonat menghambat secara langsung aktivitas osteoclast dan secara tidak langsung melalui osteoblast. Denosumab merupakan opsi terapi terkini pada kasus metastasis tulang dan lebih baik dari asam zoledronat.Kata kunci: kanker prostat, metastasis tulang, bone loss, terapi.
Upregulation of FGFR3 and HIF-1α expression in muscle invasive bladder cancer Warli, Syah Mirsya; Laksmi, Lidya Imelda; Safriadi, Ferry; Umbas, Rainy
Medical Journal of Indonesia Vol 28, No 1 (2019): March
Publisher : Faculty of Medicine Universitas Indonesia

Show Abstract | Download Original | Original Source | Check in Google Scholar | Full PDF (4742.124 KB) | DOI: 10.13181/mji.v28i1.2396

Abstract

BACKGROUND The major risks in patients diagnosed with non-muscle invasive bladder cancer (NMIBC) are recurrence, progression of muscle invasive bladder cancer (MIBC), and metastasis. Biological markers such as fibroblast growth factor receptor-3 (FGFR3) and hypoxia-inducible factor-1α (HIF-1α) are related to muscle invasiveness of bladder cancer. This study was aimed to analyze the expression of FGFR3 and HIF-1α to predict muscle invasiveness in bladder cancer patients.METHODS This was an observational study with a case-control design. Sixty patients with bladder cancer, who underwent histopathology examinations at the Department of Pathology, Faculty of Medicine, Universitas Sumatera Utara/H. Adam Malik Hospital from January 2012 to December 2015, were included in this study. Samples were then classified into 30 NMIBC and 30 MIBC groups. All samples were analyzed with an immunohistochemistry assay for FGFR3 and HIF-1α. H-scores were used to determine the relationships between each group.RESULTS FGFR3 was expressed in 29 (96.7%) patients of the NMIBC group, and 23 (76.7%) patients of the MIBC group (p=0.026, OR=8.8; 95% CI=1.01–76.96). HIF-1α was expressed in only 1 (3.33%) patient of the NMIBC group, and 15 (50%) patients of the MIBC group (p<0.001, OR=29; 95% CI=3.49–241.13).CONCLUSIONS There was a difference in upregulation of FGFR3 and HIF-1α expression in both the NMIBC and MIBC groups.
PERIPROSTATIC NERVE BLOCK AND INTRAPROSTATIC INFILTRATION ON TRUS-P GUIDED BIOPSY Rachman, Wendi; Safriadi, Ferry
Indonesian Journal of Urology Vol 20 No 2 (2013)
Publisher : Indonesian Urological Association

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.32421/juri.v20i2.6

Abstract

Objective: This study is aimed to determine the effectiveness and complications of periprostatic block and intraprostatic infiltration anesthesia for transrectal prostate biopsy. Material & Method: Two consecutive group of patients, periprostatic block (group A) and intraprostatic infiltration (group B), underwent transrectal ultrasound (TRUS) guided prostate biopsy were entered into the study. Exclusion criteria were severe systemic infection, local infection (prostatitis, proctitis, anorectal abscess, and fissure), hemorrhoid (external and/or internal), and chronic pelvic pain (bladder pain syndrome (BPS) or other pelvic disease. Each group enrolled 58 patients. The patients were requested to choose indicate degree of pain on visual analog score (VAS) 3 times, during probe insertion (VAS1), during anesthesia (VAS2), and during the biopsy (VAS3). Complications from the procedures were recorded. The data were analyzed using Mann-Whitney and independent t-test. Results: There were no significant difference in average age of groups, 65,69 ± 7,019 years for group A and 65,34 ± 7,633 years for group B (p = 0,647). The VAS3 score of group B 5,17 ± 0,653 was significantly lower than group A 5,9 ± 0,612 (p < 0,001). The change in VAS score (VAS3-VAS2) in group B 0,55 ± 0,535 also significantly lower than group A 1,00 ± 0,530 (p = 0,004). The average days with pain were not significant on both group, group A 1,16 ± 0,362 day and group B 1,12 ± 0,329 day (p = 0,594). The duration of bleeding was significantly higher on group B 1,32 ± 0,562 day than group A 1,10 ± 0,307 day (p = 0,026). Conclusion: Intraprostatic infiltration resulted in less pain during prostate biopsy, but also reported more bleeding after the procedure than the periprostatic block.Keywords: Intraprostatic infiltration, periprostatic nerve block, transrectal ultrasound guided prostate biopsy.
TERAZOSIN EVALUATION AS MALE LUTS TREATMENT USING IPSS SUB-SCORING RATIO Tanggo, Christian Ronald K.; Safriadi, Ferry
Indonesian Journal of Urology Vol 20 No 2 (2013)
Publisher : Indonesian Urological Association

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.32421/juri.v20i2.12

Abstract

Objective: To evaluate the improvement of Lower Urinary Tract Symptoms (LUTS) in males treated with terazosin based on sub scoring ratio of the International Prostatic Symptoms Score (IPSS). Material & Method: Sixty eight male with LUTS subjected to terazosin 1 mg daily and divided into two groups based on IPSS sub scoring ratio. After 3 months improvement of the symptoms were evaluated using the IPSS. Data analysis was done using paired T-test. The conclusion was based on significance level p<0,05. Results: The IPSS score was improving on both failure to void group (IPSS- v/s >1) and failure to store group (IPSS- v/s ≤1) after 3 months of Terazosin therapy (mean= 9,56 versus 6,94). Statistically superior improvement was observed on failure to voiding group (p=0,0003) (95CI:1,30-3,93). Conclusion: Terazosin is best given to male LUTS with IPSS- v/s >1 although both groups respond well.Keywords:International prostatic symptoms score, sub score, failure to voiding, failure to storage, male, lower urinary tract symptoms.
SENSITIVITY AND SPECIFICITY OF PROSTATIC BIOPSY RESULT BASED ON PROSTATE VOLUME Pitoyo, Joko; Safriadi, Ferry
Indonesian Journal of Urology Vol 21 No 2 (2014)
Publisher : Indonesian Urological Association

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.32421/juri.v21i2.32

Abstract

Objective: To compare the sensitivity and specificity of both types of prostate biopsies, between 6 core biopsy/sextant biopsy with volume based biopsy prostate. Material & method: The subjects were patients that have been performed prostate biopsy in Hasan Sadikin Hospital in 2006 – 2010. The data was divided into two groups, the group A (before 2009) 327 patients had performed 6 cores biopsy, group B (after 2009), the biopsy was performed based on prostate volume (volume < 40 cc : 8 cores, volume 40-60 cc : 10 coresand volume > 60 cc : 12 cores). Biopsy results confirmed by definitive results from surgery, then analyzed specificity and sensitivity between two groups. The analytical statistic test using unpaired T test and Levene’s test. Results: There were 654 patients divided in two groups. The data in both groups were similar based on analytical statistic test using unpaired t test (p = 0.28) and the data was in normal distribution (Levene’s test = p > 0.05). The group A, mean age 67.4 years, mean prostate volume 32.53 cc and mean PSA levels 29.89 ng/dl and at group B, mean age 66.7 years, mean prostate volume 30.89 cc and mean PSA levels 16.92 ng/dl. Volume based cores method in prostate biopsy have higher sensitivity and specificity compared with 6 core biopsy (97.5% vs 94.0%) and (92.2% vs 77.8%). Conclusion: The sensitivity and specificity of prostate biopsy was increased in volume based cores compared to 6 cores biopsy. Keywords: Prostate biopsy, volume based.
COMPARISON BETWEEN GLYCOGEN LEVEL OF KIDNEY TUBULAR CELLS IN DIABETIC KIDNEY STONE PATIENTS AND NON DIABETIC KIDNEY STONE PATIENTS Ramadhan, Ken; Sugandi, Suwandi; Noegroho, Bambang S; Tjahjodjati, Tjahjodjati; Safriadi, Ferry; Siregar, Safendra; Adriansjah, Ricky; Adi, Kuncoro; Sihombing, Aaron Tigor; Yusuf, Makmuri
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.v18i1.76

Abstract

Objective: To compare glycogen level of kidney tubular cells in diabetic kidney stone patients with nondiabetic kidney stone patients. Material & method: We reviewed kidney stone patients who underwent nephrectomy in Hasan Sadikin Hospital from February 2008 to January 2009. Age, gender, type of DM, and urine pH were recorded. Glycogen level of kidney tubular cells were evaluated histochemically using HE, PAS, and PAS diastase. The results were categorized into 3 grades, based on the staining appearance compared to liver cells as controls. The results of diabetic group were compared to non diabetic patients. Results: There were 30 patients eligible for this study, 15 in diabetic group and 15 non diabetic patients. In the diabetic group, there were 10 patients with urine pH < 6 and 5 patients with a pH of 6,5. In the non diabetic group all urine pH were > 6,5. Examination revealed that glycogen level of kidney tubular cells in diabetic group was higher than in non diabetic group. Conclusion: Glycogen level of kidney tubular cells in diabetic kidney stone patients was higher than in non diabetic kidney stone patients. Keywords: Tubular cell, kidney stone, diabetes mellitus.
THE INSIDENCE OF BLADDER SQUAMOUS CELL CARCINOMA IN LARGE BLADDER STONE CASES Pitoyo, Joko; Safriadi, Ferry
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.v22i1.102

Abstract

Objective: To determine the incidence of squamous cell carcinoma (SCC) in patients with large bladder stone (> 40 mm). Material & method: This is a descriptive retrospective cross-sectional study, data was collected from medical record on patients with a diagnosis of large bladder stone (> 40 mm) that have been performed surgical removal of stone (vesicolithotomy) and bladder mucosa biopsy in Hasan Sadikin Hospital Bandung during 2006-2010. Furthermore, the data are classified according to pathology. Results: This study found cases of large bladder stone (> 40 mm) of 47 cases during the period 2006-2010, and of these 47 cases, there were 76.7% and 23.3% non-malignancy of a malignancy in 2 cases (4.3%) with anatomical pathology picture of SCC. Based on the age group of patients aged 31-40 years obtained 25.5%, 41-50 years 21.3%, 51-60 years 21.3% and > 60 years 23.4%, whereas for ages below 30 years 8.5%. Based on sex, male 95.7% and 4.3% of women. Based on the size, found a stone the size of 40 mm (48.9%), stone size of 50 mm (10.6%), stone size 60 mm and 70 mm respectively (8.5%), stone size 80 mm (12.8%), stone size > 80 mm (4.3%) and 6.4% with multiple bladder stones. Conclusion: There were only two cases of bladder SCC from 47 cases patients with large bladder stone (> 40 mm) in Hasan Sadikin Hospital Bandung during 2006-2010. Keywords: Bladder Stone, bladder carcinoma, squamous cell carcinoma.
RETROPERITONEAL VS TRANSPERITONEAL LAPAROSCOPIC URETEROLITHOTOMY Putra, Rosadi; Safriadi, Ferry; Pramod, Sawkar Vijay
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.v22i2.193

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Objective: To compare retroperitoneal versus transperitoneal laparoscopic ureterolithotomy in effectivity, pain scale and early complications. Material & methods: In this prospective comparison study from January 2013 to June 2014, 32 patients with proximal and mid ureteral stones underwent retroperitoneal laparoscopic ureterolithotomy or transperitoneal laparoscopic ureterolithotomy. The randomization occured on consecutive sampling on a 1 : 1 basis. Group 1 and 2 consisted of patients who underwent retroperitoneal laparoscopic ureterolithotomy and transperitoneal laparoscopic ureterolithotomy, respectively. Demographic and clinical variable, operative time, length of stay, ureteral suturing, pain scale according to visual analog scale (VAS) and early complications data were collected and analyzed. Statistical analysis was performed with SPSS® version 17.0 using student T-test and Mann-Whitney U tests with p value < 0.05 considered statistically significant. Results:VAS on day 1 between the 2 groups was statistically significant, and was higher in group 2 (p < 0.05). According to the Clavien-Dindo classification of surgical complication all the patients were in grade 1 classification. The differences in operative time, length of stay, ureteral suturing, visual pain analog score on day 3, and early complications between the 2 groups were not statistically significant.Conclusion: Transperitoneal laparoscopic ureterolithotomy is significantly associated with pain than retroperitoneal laparoscopic ureterolithotomy in first day after surgery. Successful stone removal remains the same in both groups.
CUT-OFF POINT OF PSA AND PSA DENSITY IN PROSTATE CANCER SUSPECTED PATIENTS Simanjuntak, Daniel; Safriadi, Ferry
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.v23i1.203

Abstract

Objective: In Hasan Sadikin General Hospital Bandung prostate biopsy is recommended for patients with prostate specific antigen (PSA) levels above 10 ng/mL or PSA density (PSAD) above 0.15 if PSA in between 4–10 ng/mL. However, there were other factors beside of prostate cancer (PCa) that could influence PSA value, such as racial differences and prostatitis. Thus, the optimal cut-off point for PSA is still debatable in national level. This research aimed to determine PSA and PSAD cut-off point for patient suspected of PCa in Hasan Sadikin Hospital Bandung. Material & Methods: A total of 502 patients underwent prostate biopsy for suspicion PCa from 2010–2014. The cut-off point of PSA and PSAD is generated from receiver operating characteristic (ROC) curve. Results: The cut-off point for PSA was 14.6 ng/mL (sensitivity 81.4%, specificity 29.8%). The cut-off point for PSAD was 0.23 (sensitivity 81.4%, specificity 34.8%). Positive predictive value (PPV) for this new cut-off point of PSA and PSAD were 41.1% and 37.6% respectively. Conclusion: PSA and PSAD cut-off point for patients in our center was 14.6 ng/mL and 0.23 respectively. This value is relatively higher compared to the Indonesian consensus. The difference might occur due to high rate of urinary tract infection in patients attending Hasan Sadikin General Hospital Bandung.