Doddy M. Soebadi
Department of Urology, Faculty of Medicine/Airlangga University, Soetomo Hospital, Surabaya, Indonesia.

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COMPARATIVE EFFICACY OF COMBINED LOW-INTENSITY EXTRACORPOREAL SHOCKWAVE THERAPY AND ORAL THERAPY VS ORAL THERAPY ALONE FOR CHRONIC PELVIC PAIN SYNDROME: A META-ANALYSIS OF RANDOMIZED CONTROLLED TRIAL Nurakbariansyah, Rocky; Soebadi, Doddy M.; Djatisoesanto, Wahjoe; Renaldo, Johan
Indonesian Journal of Urology Vol 28 No 2 (2021)
Publisher : Indonesian Urological Association

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.32421/juri.v28i2.741

Abstract

Objective: This study aimed to compare the efficacy of Low-Intensity Extracorporeal Shockwave Therapy (Li-ESWT) and oral therapy combination compared to sole oral therapy for reducing symptoms in CP/CPPS patients. Material & Methods: A systematic search was conducted from the electronic database including PubMed, Clinicaltrial.gov, and Cochrane Library, published up to July 2020 following the PRISMA guideline. We screened RCTs with the inclusion criteria and assessed the quality with the Cochrane Risk of Bias tool. The primary outcome was the National Institute of Health Chronic Prostatitis Symptom Index (NIH-CPSI) and subgroup analysis for triple therapy users was conducted to improve interpretability. The analysis was performed using Review Manager 5.3. Results: A total of 2 RCTs consisted of 91 CP/CPPS patients were analyzed. Pooled analysis showed that compared to the oral therapy only group, combination therapy had a significant lower NIH-CPSI total score at the endpoint of the treatment (MD -7.46, 95% CI -9.85 to -5.07, p<0.001) and NIH-CPSI component pain score (MD -3.48, 95% CI -5.04 to -1.93, p<0.0001), urinary symptoms score (MD -0.96, 95% CI -1.47 to -0.45, p<0.001), and quality of life (QoL) impact score (MD -2.94; 95% CI -3.68 to -2.20, p=<0.001). Conclusion: This review revealed that patients undergoing combination Li-ESWT therapy have lower total NIH-CPSI scores than patients receiving oral therapy alone, this finding is consistent with each component of the score: pain, urinary symptoms, and impact on QoL.
THE EFFECTIVENESS OF ULTRASONIC LITHOTRIPTOR COMPARED TO COMBINED ULTRASONIC AND PNEUMATIC LITHOTRIPTOR IN PERCUTANEOUS NEPHROLITHOTOMY (PCNL) SURGERY: A SYSTEMATIC REVIEW AND META-ANALYSIS Suryatmana, Anggana; Soebadi, Doddy M.; Djojodimedjo, Tarmono
Indonesian Journal of Urology Vol 28 No 2 (2021)
Publisher : Indonesian Urological Association

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.32421/juri.v28i2.742

Abstract

Objective: To evaluate the effectiveness of the ultrasonic lithotriptor compared to the combined ultrasonic-pneumatic lithotriptor in percutaneous nephrolithotomy (PCNL). Material & Methods: A systematic search was conducted focusing on studies evaluating nephrolithiasis patients who underwent PCNL using pneumatic, ultrasonic, ultrasonic-pneumatic, or laser lithotriptor. The search was conducted in the PUBMED and Science-direct databases from early to September 2020. Results: There were 406 journals in the initial search. On further selection, 3 randomized controlled trials (RCT) were obtained, with a total of 251 patients. The stone-free rate of three studies had low heterogeneity, I2=0% (P=0.34), so a fixed effect statistical model was used. There was no significant difference (P=0.44) between the stone-free rates from the ultrasonic lithotriptor group and the combination with an odds ratio of 1.26 (95% CI = 0.70-2.26). High heterogeneity was obtained with I2=71% (P=0.03) for the mean fragmentation time, so random effect statistical model was used. There was no significant difference (P=0.56) between the mean fragmentation time of the ultrasonic lithotriptor and combination group with a mean difference of -3.69 (95% CI = -16.09-8.71). Conclusion: The ultrasonic lithotriptor did not have a significant difference in stone-free rate, and mean fragmentation time compared to the combined ultrasonic-pneumatic lithotriptor in PCNL. More RCT studies are needed.
Prostate-Specific Antigen and Time to PSA Nadir as Prognostic Significance in Castration-Resistant Prostate Cancer Pranata, Firmantya Hadi; Djatisoesanto, Wahjoe; Soebadi, Doddy M.
Folia Medica Indonesiana Vol. 58, No. 1
Publisher : Folia Medica Indonesiana

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Abstract

Highlight: • Assessing the survival rate in castration-resistant prostate cancer was descriptived. • PSA level between survivor and non survivor was significant but not for PSA nadir level, TTN and TTC. • Initial PSA level can predict survival prognosis rate of castration-resistant prostate cancer patients. Abstract: High mortality rates was often found in castration-resistant prostate cancer (CRPC). Our aim on this research was to assess the PSA level and time to PSA nadir as a prognostic tool for survival in CRPC patients. Several factors are considered to be useful as prognostic marker in CRPC patients. This study was a descriptive study assessing the survival rate in castration-resistant prostate cancer. Evaluation data included sex, age, initial PSA level, final PSA level, time to PSA nadir (TTN), time to CRPC progression (TTC), and survival status. A total of 24 patients with CRPC were evaluated in this study. There was significant difference found of initial PSA level between survivor (445.7 + 165.6 ng/mL) and non-survivor (200.7 + 144.9 ng/mL). There were no significant differences were also found in PSA nadir level, TTN and TTC between survivor and non-survivor groups. This study revealed that there was association between initial PSA level on survival rate of CRPC patients. Initial PSA level could be used to predict survival prognosis in CRPC patients.
Percutaneous Nephrolithotomy (PCNL) in Older and Younger Patients at a Tertiary Hospital in Surabaya, Indonesia Ali, Muhammad Wahyu; Azmi, Yufi Aulia; , Tarmono; Soebadi, Doddy M.
Folia Medica Indonesiana Vol. 59, No. 1
Publisher : Folia Medica Indonesiana

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Abstract

Highlights: • Percutaneous nephrolithotomy (PCNL) in older patients is as effective and safe as in younger patients. • It is a viable option for managing renal stones in older patients with indications, although blood transfusions are frequently required. Abstract: Percutaneous nephrolithotomy (PCNL) for renal and proximal ureteral stone treatment among the elder population is considered challenging due to the complication risk associated with comorbidity and lower functional reserve. Patients older and younger than 60 years old were compared for efficacy and safety in following PCNL procedures. Consecutive patients who underwent PCNL from 2019-2021 in a single center were divided into patients aged at least 60 years (group I) and patients aged under 60 years (group II). Single stage fluoroscopic-guided PCNL were used for the entire study population. Patients' habitus, stone-related, and operative characteristics were compared. The two groups' PCNL success and complication rates were evaluated. A total of 245 patients, comprising 65 in group I and 180 in group II, were included for analysis. Diabetes mellitus prevalence was higher in group I (30.8% vs 18.9%). However, the study population did not show a significant difference in regard to comorbidity. Operative time, success rate (80% vs 74.4%), and complication rate (16.9% vs 15.6%) did not statistically differ (p>0.05). Transfusion rate was higher among patients aged at least 60 years (p=0.018). Based on the multivariate analysis, stones located in the renal pelvis was the factor which contributed to the success rate. In conclusion, percutaneous nephrolithotomy is a safe and effective procedure for treating renal and proximal ureteral stones in the older population. Blood transfusions are more frequently given, in part, due to bleeding risk among older patients.