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All Journal Journal of the Medical Sciences (Berkala Ilmu Kedokteran) Indonesian Journal of Urology Paediatrica Indonesiana Indonesian Journal of Cancer Indonesian Journal of Biomedicine and Clinical Sciences
Indrawarman Soeroharjo
Division Of Urology, Department Of Internal Medicine, Faculty Of Medicine, Public Health And Nursing, Universitas Gadjah Mada/Dr. Sardjito General Hospital, Yogyakarta, Indonesia
Biochemistry, Genetics & Molecular Biology Health Professions Immunology & microbiology Medicine & Pharmacology Neuroscience Public Health

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RELATIONSHIP BETWEEN P53 EXPRESSION AND PROBABILITY OF ORGAN CONFINEMENT IN PATIENTS WITH PROSTATE CANCER IN SARDJITO HOSPITAL Soeroharjo, Indrawarman; Danarto, H R
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.v18i1.68

Abstract

Objective: To determine the association between p53 expression and the probability of organ confinement in patients with prostate cancer in Sardjito Hospital, Yogyakarta. Material & method: Prostate specimens were obtained from patients with clinical  stage  T1-T2 prostatic  adenocarcinoma  in Sardjito  Hospital between January  2007 and December 2008. Samples were processed and immunohistochemically stained in the Department of Anatomical Pathology Gadjah Mada University. Probability of organ confinement was determined by updated Partin table 2007 from preoperative serum PSA level, Gleason Score, and clinical stage. Correlation  between p53 expression and probability of organ confinement were statistically analyzed by Spearman correlation test. Results: There were 28 prostate cancer patients eligible for this study. Mean age was 65,19 ± 10,9 (28 - 81) years old. Mean preoperative PSA level were 107,13 ± 165,82 (0,20  734,20) ng/ml. Mean number of p53 expression was 97,47 ± 97,27 (5 - 396)/HPF. Significant correlation was found between p53 expression and probability of organ confinement (Spearman r = -0,441; p = 0,019). Conclusion:  p53 expression was negatively correlated with the level of organ confinement in patients with prostate cancer
EVALUATION OF TENCKHOFF CATHETER INSERTION USING OPEN SURGERY IN CHRONIC RENAL FAILURE PATIENTS Nugroho, Indra Bayu; Singodimedjo, Prawito; Indrawarman, Indrawarman
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.v23i1.182

Abstract

Objective: To evaluate the dysfunction rate of Tenckhoff catheter insertion for end stage renal disease patients at Sardjito General Hospital Yogyakarta. Material & method: Data were collected from medical record retrospectively for all chronic kidney disease (CKD) patients underwent continuous ambulatory peritoneal dialysis (CAPD), by open surgery at Sardjito General Hospital Yogyakarta, from January 2010 until Desember 2013. The cause of CKD and dysfunction rate was studied. Data was analyzed using SPSS ver 18.0 (IBM corp, USA). Results: There were 43 CKD patients underwent Tenckhoff cateter placement using open surgery. Tenckhoff catheter dysfunction was found in 11.7% patients. Disfunction was caused by blockage of the catheter by omentum (6.9%) and catheter migration (4.8%). Peritonitis complication was found in 2.3% patients. The cause of CKD at Sardjito General Hospital Yogyakarta was diabetes mellitus (53.5%), hypertension (44.2%), and glomerulonefritis (2.3%). There were no correlation of dysfunction rate with gender and the cause of CKD. Conclusion: Tenckhoff catheter placement by open surgery at Sardjito General Hospital Yogyakarta have good outcome.
SUPERIOR INFERIOR CALYCES AXIS IN SAGITTAL VERSUS CORONAL PROJECTION OF NON CONTRAST ABDOMINAL MULTISLICE COMPUTED TOMOGRAPHY: AN ANATOMICAL STUDY IN SUPINE PCNL Krisna, Muhammad Sidharta; Soeroharjo, Indrawarman; Ali, Zulfikar
Indonesian Journal of Urology Vol 27 No 1 (2020)
Publisher : Indonesian Urological Association

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.32421/juri.v27i1.536

Abstract

Objective: Getting the right access to the kidney calyces that has been determined is the most important part of PCNL. Less optimal access can cause an increase in operating time and a decrease in stone free rate. The use of inferior calyx as access decreases the risk of complications, but there are difficulties in reaching the superior calyx, which affects the stone free rate. The angle and depth of the puncture on PCNL can be determined by coronal and sagittal cuts in the non contrast MSCT scan of the abdomen. Material & Methods: This is an analytical study with a prospective cross-sectional method. An analysis was done to 198 samples of patients in Kardinah Tegal Hospital. Samples were taken with 16 slices non-contrast abdominal MSCT using Philips MSCT MX16 (120 kVp; 2x0.75 mm slice thickness). Samples were collected with consecutive sampling method, excluding patients who had a history of other illnesses or surgical history that resulted in anatomical changes in kidney position, age<18 year old, BMI>30 (obesity), grade 4 hydronephrosis (calyces had disappeared). Reconstruction of 3D non contrast abdominal MSCT was performed by measuring the angle of the coronal cut which was simulated as a puncture in the supination position and sagittal cut which was simulated as puncture in pronation position. An imaginary line was drawn from the imaginary point between the iliac crest and 12th rib as high as 3th to 4th lumbar to the inferior renal calyx. Axis was drawn from the inferior renal calyx towards the superior renal calyx. Results: There is significant difference (P=0.000) in the angle of the imaginary line drawn from the inferior calyx to the superior calyx between the right supination position compared to the right pronation position. The angle in the supination position is more gentle 142.8 (±9.7)/(118-165) degrees compared to 96.5 (±13.2)/(11-138) degrees. On the left side, the angle formed from inferior calyx to the superior calyx in the supination position is more gentle 143.4 (±9.6)/(119-162) degrees) compared with 97.3 (±11.2)/(76-132) degrees formed in pronation position, with a value of P=0.000. Conclusion: PCNL puncture with an inferior calyx approach to reach the superior calix on abdominal MSCT without contrast will be easier to do in the supine position. This is because the angle from the inferior calyx to the superior calyx is more gentle in the supine position so that maneuvers are easier to do.
THE ROLE OF CYP17A1 IN ADENOCARCINOMA OF THE PROSTATE AT SARDJITO GENERAL HOSPITAL Prayogo, Dwi; Soeroharjo, Indrawarman
Indonesian Journal of Urology Vol 27 No 1 (2020)
Publisher : Indonesian Urological Association

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.32421/juri.v27i1.550

Abstract

Objective: The purpose of this study is to determine the relationship and role of CYP17A1 gene expression to androgen biosynthesis activity in prostate cancer patients. Material & Methods: The samples of this study are patients diagnosed with prostate adenocarcinoma based on histopathology examination who underwent TURP surgery at Sardjito General Hospital. A total of 30 samples were examined for PCR to determine the presence and absence of CYP17A1 gene expression. CYP17A1 gene expression was analyzed with the patient’s age, stage, organ metastasis, Gleason score, and PSA value. Results: Analysed using Chi-Square Tests, p=0.784 was obtained on expression of CYP17A1 gene with patient’s age, p=0.469 on expression of CYP17A1 gene with staging tumor, p=0.855 on expression of CYP17A1 gene with presence or absence of organ metastasis, p=0.059 on expression of CYP17A1 gene expression with total Gleason score, p=0.895 on expression of CYP17A1 gene with PSA value. Conclusion: There was no association between CYP17A1 gene expression and intratumoral androgen biosynthesis activity based on the patient’s age, patient’s clinical stage, organ metastasis, Gleason score, and PSA value.
AN EXPERIENCE OF SUPINE PCNL ON BILATERAL STAGHORN AUTOSOMAL DOMINANT POLYCYSTIC KIDNEY DISEASE Zulfiqqar, Andy; Soeroharjo, Indrawarman
Indonesian Journal of Urology Vol 27 No 2 (2020)
Publisher : Indonesian Urological Association

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.32421/juri.v27i2.562

Abstract

Objective: The aim of this article was to reports our experiences PCNL on ADPKD patients. Case(s) Presentation: We report the case of a 38-year-old male with autosomal dominant polycystic kidney disease associated with bilateral staghorn diseases. We performed a supine PCNL on left kidney. Discussion: ADPKD may arise sporadically, the developmental abnormality that resulting in multiple cysts, hypertension, hematuria, polyuria, plank pain, and are prone to reccurent urinary tract infection and renal stones. ADPKD is one most commonly genetics disorder than frequently results in End Stage Renal Disease (ESRD). Population of ADPKD has a higher risk to have a nephrolithiasis, thus it may hastened the onset of ESRD. Open surgeries was one of treatment of choices of ADPKD with staghorn stones, but considering of high rates of morbidity. Recently there’s consistent switching the trend on minimal invasive treatment such as ESWL and PCNL. Conclusion: PCNL may considered as an effective and safe procedure in managing nephrolithiasis in ADPKD, further studies with larger sample and longer periods observation is needed to confirmed role of PCNL in preserving kidney on ADPKD with staghorn kidney.
AN EXPERIENCE OF SUPINE PCNL ON BILATERAL STAGHORN AUTOSOMAL DOMINANT POLYCYSTIC KIDNEY DISEASE Zulfiqqar, Andy; Soeroharjo, Indrawarman
Indonesian Journal of Urology Vol 27 No 2 (2020)
Publisher : Indonesian Urological Association

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.32421/juri.v27i2.562

Abstract

Objective: The aim of this article was to reports our experiences PCNL on ADPKD patients. Case(s) Presentation: We report the case of a 38-year-old male with autosomal dominant polycystic kidney disease associated with bilateral staghorn diseases. We performed a supine PCNL on left kidney. Discussion: ADPKD may arise sporadically, the developmental abnormality that resulting in multiple cysts, hypertension, hematuria, polyuria, plank pain, and are prone to reccurent urinary tract infection and renal stones. ADPKD is one most commonly genetics disorder than frequently results in End Stage Renal Disease (ESRD). Population of ADPKD has a higher risk to have a nephrolithiasis, thus it may hastened the onset of ESRD. Open surgeries was one of treatment of choices of ADPKD with staghorn stones, but considering of high rates of morbidity. Recently there’s consistent switching the trend on minimal invasive treatment such as ESWL and PCNL. Conclusion: PCNL may considered as an effective and safe procedure in managing nephrolithiasis in ADPKD, further studies with larger sample and longer periods observation is needed to confirmed role of PCNL in preserving kidney on ADPKD with staghorn kidney.
NEEDLE RENAL LIFTING TECHNIQUE IN MANAGEMENT OF COMPLICATED PROXIMAL URETERAL LITHOTRIPSY: A CASE REPORT Risan, Muhammad; Soeroharjo, Indrawarman; Danarto, Raden; Yuri, Prahara
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.v28i2.715

Abstract

Objective: To described a needle renal lifting technique using an 18-gauge needle to adjunct ureterorenoscopy (URS) in the management of complicated proximal ureteral stones. Case(s) Presentation: A 46 years old man presented with right flank pain for 1 month. This patient was diagnosed with ureteral stone and ureteral kinking that prohibits access to the proximal side of the ureter. Due to difficult access to the proximal ureter, we perform a needle renal lifting technique which is initialized by puncturing the middle renal calyx with 18-gauge needle. Then, the proximal end of the needle was pushed to the caudal direction to move the kidney to the cephalic direction and straighten the kinked ureter. After that procedure, the URS sheat can easily enter the proximal ureter to the stone site. Discussion: The success rate of this procedure is based on the operator skills to access the calyx and perform URS simultaneously. Like a previous technique, needle renal lifting is effective only when the kidney is mobile. Conclusion: The needle renal lifting technique can be used to adjunct URS in the management of complicated ureteral stones which prohibited access to the proximal ureter.
COMPARISON OF ILEAL CONDUIT AND TUUC: A 4 YEARS STUDY Soerohardjo, Indrawarman; Zulfiqqar, Andy; Yuri, Prahara; Hendri, Ahmad Z.
Indonesian Journal of Urology Vol 29 No 1 (2022)
Publisher : Indonesian Urological Association

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.32421/juri.v29i1.681

Abstract

Objective: This study aims to compare 4 years of experience of IC and TUUC in the same period and among similar experienced surgeons. Material & Methods: Between January 2016 and August 2019, 44 radical cystectomies were performed, but 4 patients were excluded due to incomplete data or who underwent neo-bladder procedures. The primary endpoint was 30 days of complication rate and intraoperative complications. Bowel movement, ambulation, and length of stay (LOS) postoperatively were followed-up over a period of 30-day postoperatively. Results: 12 male patients underwent TUUC and 24 male patients IC, while only 4 female patients underwent IC. The mean of LOS of IC was 12.72 8.6 and 10.08 3.5 for TUUC; there were no significant differences between arms. However, TUUC had lower intra-operatively bleeding (779.17 441.15 ml) compared to IC (1328.57 810.40 ml). There was no difference in early complications between arms. Conclusion: Our results suggest that TUU with UC diversion may be used as a viable option of urinary diversion in radical cystectomy. This technique provides similar safety both surgically and oncologically.
mRNA expression of CYP17A1, CYP11A1, CYP19A1, HSD3B1 and AKR1C2 in metastatic and non-metastatic prostate cancer patients Indrawarman Soerohardjo; Muhammad Puteh Mauny; Alharsya Franklyn Ruckle; Ahmad Zulfan; Raden Danarto; Didik Setyo Heriyanto
Journal of the Medical Sciences (Berkala Ilmu Kedokteran) Vol 50, No 4 (2018)
Publisher : Journal of the Medical Sciences (Berkala Ilmu Kedokteran)

Show Abstract | Download Original | Original Source | Check in Google Scholar | Full PDF (484.129 KB) | DOI: 10.19106/JMedScie/005004201808

Abstract

The progression of prostate cancer (PCa) mainly occurs caused by androgens. There is a linkbetween intratumoral steroidogenesis and castration-resistant prostate cancer. This studyaimed to determine the mRNA expression of various steroidogenic enzymes (CYP17A1,CYP11A1, CYP19A1, HSD3B1, and AKR1C2) in metastatic and non-metastatic prostatecancer patients. This study was conducted at the Anatomical Pathology Laboratory andUrologi Division, Department of Surgery, Faculty of Medicine, Public Health and Nursing,Universitas Gadjah Mada/Dr. Sardjito General Hospital, Yogyakarta from September-November 2017. Samples were taken from 30 paraffin blocks with adenocarcinoma ofprostate, stained with hematoxylin-eosin (HE) and then classified into metastatic and nonmetastaticgroups. Samples then underwent deparaffinization procedure and examinationof mRNA expression of CYP17A1, CYP11A1, CYP19A1, HSD3B1, AKR1C2 genes usingReal-Time PCR. The mean mRNA expressions of CYP11A1, CYP17A1, CYP19A1,HSD3B1, and AKR1C2 genes in the metastatic adenocarcinoma prostate group were 7.08,10.11, 3.94, 4.84 and 3.58, respectively. In the non-metastatic group, the mean mRNAexpressions of CYP11A1, CYP17A1, CYP19A1, HSD3B1, and AKR1C2 genes were 4.62,9.45, 3.46, 2.68 and 4.92, respectively. The mean of mRNA expression of CYP11A1,CYP17A1, CYP19A1, and HSD3B1 genes were higher in the metastatic group than nonmetastaticadenocarcinoma prostate group. However, it was not statistically significant(p>0.05). The highest mRNA expression of steroidogenic enzymes was the CYP17A1gene. In conclusion, the mRNA expressions of CYP17A1, CYP11A1, CYP19A1, HSD3B1were higher in the metastatic prostate cancer patients compared to that in non-metastaticprostate cancer patients but statistically not significant.
Diagnosis value of prostate specific antigen density (PSAD) and prostate specific antigen (PSA) in bone metastases of prostate cancer among Indonesian population Ahmad Zulfan Hendri; Andy Zulfiqqar; Indrawarman soeharjo; Raden Danarto
Journal of the Medical Sciences (Berkala Ilmu Kedokteran) Vol 52, No 2 (2020)
Publisher : Journal of the Medical Sciences (Berkala Ilmu Kedokteran)

Show Abstract | Download Original | Original Source | Check in Google Scholar | Full PDF (250.553 KB) | DOI: 10.19106/JMedSci005202202005

Abstract

Cancer prostate (PCa) is currently reported as the most diagnosed cancer in males. Bone metastases in PCa indicate poor prognosis and the major cause of pain and death. Early diagnosis of metastases is important in PCa management. Prostate specific antigen (PSA) velocity was used to predict overall survival and metastasis-free survival. However, this test should be conducted 2 times, for at least 4 weeks apart. Therefore, a cross-sectional test with higher positive probability value is needed. This study aimed to compare PSA density (PSAD) and PSA level to evaluate patients at risk of bone metastases in Yogyakarta, Indonesia. Aretrospective study with a total subject of 106 patients with (n = 31) and without (n = 75) bone metastases were analyzed. The initial PSA measurement, as well as bone scan and prostate volume, were evaluated in all patients. Bone survey found to be positive in 31/106 (29.2%) patients. The total of 50(47.2%), 10(9.4%) and 46(43.4%) patients had PSA level <50, 50-100 and >100ng/mL, respectively. Furthermore, receiver operating characteristic (ROC) area under the curve of PSAD (0.75) was higher that that ofPSA (0.65).PSAD more than 0.15 indicated sensitivity of 93% and specificity of 38%, while PSA more than 20 ng/mL shown sensitivity 82% and specificity 21%. In conclusion, PSAD level more than 0.15 shows high sensitivity and specificity in causing potential skeletal metastases. Using this PSAD cut-off value, unnecessary investigation canbe avoided. 
Co-Authors Ahmad Zulfan Ahmad Zulfan Hendri Alharsya Franklyn Ruckle Andy Zulfiqqar Andy Zulfiqqar Brodjonegoro, Sakti R Danarto, Raden Didik Setyo Heriyanto Ery Kus Dwianingsih Frannata, Lucky H R Danarto Hariwibowo, Rinto Hendri, Ahmad Z Hendri, Ahmad Z. Indah S. Widyahening Indra Bayu Nugroho, Indra Bayu Krisna, Muhammad Sidharta Lydia Kristianti Muhammad Puteh Mauny Nur Rasyid Ponco Birowo Prahara Yuri Prakoso, Ragil Unggul Prawito Singodimedjo Prayogo, Dwi Raden Danarto Risan, Muhammad Sabdo Waloejo Sangundo, Muhammad Faham Soelatin Winarno Sumadi Lukman Anwar Yurisal Akhmad Dany Yurisal Akhmad Dany Zulfikar Ali, Zulfikar Zulfiqqar, Andy