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All Journal E-Jurnal Medika Udayana Medical Journal of Indonesia Indonesian Journal of Urology Syntax Literate: Jurnal Ilmiah Indonesia JBN (Jurnal Bedah Nasional) ISM (Intisari Sains Medis) : Jurnal Kedokteran Neurologico Spinale Medico Chirurgico E-Amal: Jurnal Pengabdian Kepada Masyarakat

Pande Made Wisnu Tirtayasa

Divisi Urologi, Departemen Bedah, Fakultas Kedokteran Universitas Udayana

Author-ID : 403802

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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A survey on the management of overactive bladder by Indonesian urologists Tirtayasa, Pande M.W.; Rahardjo, Harrina E.
Medical Journal of Indonesia Vol 24, No 2 (2015): June
Publisher : Faculty of Medicine Universitas Indonesia

Background: Overactive bladder (OAB) is a clinical syndrome consisting of symptom complex of urgency, with or without incontinence which has significant effects on quality of life and has to be managed properly. The aim of this study was to review the management of OAB by Indonesian urologists.Methods: A self-constructed questionnaires containing diagnostic and treatment options of OAB patients were distributed to Indonesian urologists. This was a cross-sectional study and descriptive analysis method was used to analyze the data.Results: 129 Indonesian urologists participated in this study. Most of them faced more than 20 OAB cases per year with the most common type was OAB without incontinence or dry OAB (57.4%). Most urologists (34.1%) ordered at least three diagnostic tools to determine OAB. They were bladder diary, urinalysis and scoring system. The most used scoring system (48.9%) was the overactive bladder symptoms score (OABSS). Thirty-five point seven percents (35.7%) of urologists used antimuscarinic and behavioral therapy as initial therapy. Solifenacin 5 mg/day was the most common antimuscarinic prescribed as the first line therapy (48%). Most common items commonly evaluated for follow-up: symptoms (96.9%), bladder diary (72.9%); and drugâs side effect (58.1%). When initial therapy had failed, most of the urologists (54.3%) chose to increase the dose of antimuscarinic. None of them chose bladder botulinum toxin injection as their additional therapy.Conclusion: OAB is a frequent disorder which remains a challenge for urologists. The management of patients with OAB by Indonesian urologists has been suitable with the previous studies and guidelines.

Prediction of mortality rate of trauma patients in emergency room at Cipto Mangunkusumo Hospital by several scoring systems Tirtayasa, Pande M.W.; Philippi, Benny
Medical Journal of Indonesia Vol 22, No 4 (2013): November
Publisher : Faculty of Medicine Universitas Indonesia

Background: Trauma management is well recognized as one of the main challenges in modern health care. Easy-to-use trauma scoring systems inform physicians of the severity of trauma and help them to decide the course of trauma management. The aim of this study was to find the most applicable trauma scoring system which can be used by physicians by comparing prediction of the mortality rate using: 1)triage-revised trauma score (T-RTS); 2) mechanism, Glasgow coma scale (GCS), age, and arterial pressure (MGAP); and GCS, age, and systolic blood pressure (GAP) scoring system on trauma patients in emergency room (ER) at Cipto Mangunkusumo Hospital.Methods: The data were collected retrospectively from medical records of trauma patients who came to the resuscitation area in ER at Cipto Mangunkusumo Hospital throughout 2011. As many as 185 patients were managed. The inclusion criteria were all trauma patients who came to the resuscitation area in ER. All referred patients, patients under eighteen, and uncompleted data were excluded. The data were calculated based on each scoring system. The outcome (death or alive) was collected on first 24 hours following admission.Results: There were 124 cases analyzed, with mean of age of 32.4 years and total mortality rate up to 23 cases (18.5%). The mortality rate of low risk group on T-RTS, MGAP, and GAP was 5%, 1.3%, and 1.4% respectively (p = 1.000). The mortality rate of intermediate risk group on T-RTS, MGAP, and GAP was 39.4%, 32.1%, and 36.3%, respectively (p = 0.841). Mortality rate of high risk group on T-RTS, MGAP, and GAP was 100%, 72.2%, and 85.7% respectively (p = 0.782).Conclusion: There was no difference on T-RTS, MGAP, and GAP scoring system in predicting mortality rate. T-RTS is the most applicable trauma scoring system since it does not differ the age and mechanism of trauma. (Med J Indones. 2013;22:227-31. doi: 10.13181/mji.v22i4.603) Keywords: GAP, MGAP, T-RTS, Trauma scoring system

Progressive sperm motility is associated with spontaneous pregnancy after varicocelectomy Duarsa, Gede W.K.; Krishna, I Komang O.; Tirtayasa, Pande M.W.; Yudiana, I Wayan; Santosa, Kadek B.; Mahadewa, Tjokorda G.B.; Oka, Anak A.G.
Medical Journal of Indonesia Vol 27, No 4 (2018): December
Publisher : Faculty of Medicine Universitas Indonesia

Background: Varicocelectomy is performed on patients with clinical varicocele associated with abnormal sperm parameters. The goal of this procedure is to improve men’s sperm parameters and pregnancy rates of their partners. The objective of our study was to assess the factors that were associated with spontaneous pregnancy in female partners after varicocelectomy.Methods: A retrospective case-control study was conducted to review several factors that are associated with spontaneous pregnancy after varicocelectomy. The data were taken from medical records at Sanglah General Hospital and three private hospitals in Denpasar from January 2015 to June 2016. Case subjects (n=38) include varicocele patients with abnormal sperm parameters whose partner had a spontaneous pregnancy following varicocelectomy and a control group (n=38) whose partner did not have a spontaneous pregnancy following varicocelectomy.Results: Progressive sperm motility (≥37.5%) before varicocelectomy was 2.7 times more likely to result in a spontaneous pregnancy (odds ratio: 2.7; 95% confidence interval: 1.04–6.96; p=0.04). No statistical significance was found between age at varicocelectomy, grade of varicocele, body mass index, infertility duration, smoking habit, sperm concentration, normal sperm morphology before varicocelectomy, and spontaneous pregnancy.Conclusion: Progressive sperm motility before varicocelectomy is a significant factor for the occurrence of spontaneous pregnancy after varicocelectomy.

PERCUTANEOUS NEPHROLITOTOMY ON THE MANAGEMENT OF CALYX INFERIOR STONES Tirtayasa, Pande Made Wisnu; Birowo, Ponco; Rasyid, Nur
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.v21i2.37

Objectives: To compare the stone free rates of inferior calyceal stones with stone burden < 20 mm, 21-30 mm, and > 30 mm on post-percutaneous nephrolithotomy (PCNL) patients in Cipto Mangunkusumo Hospital. Material & method: The data was collected retrospectively from PCNL medical records in Cipto Mangunkusumo Hospital between January 2000 until May 2012. Patients were followed-up with plain abdominal radiography (BNO) or renal ultrasonography (USG). Stone free status was defined as no residual fragments on radiography or USG. Results: As many as 88 patients with inferior calyceal stones who underwent PCNL were included. Forty-three cases had stone burden < 20 mm, 34 cases with stone burden 21-30 mm, and 11 cases with stone burden > 30 mm. Overall, 81 (92%) cases were defined as stone free. On group < 20 mm, 21-30 mm, and > 30 mm; 41 (95%), 32 (94%), and 8 (73%) cases defined as stone free respectively (p = 0.485). Conclusion: PCNL is the primary modalityon the management of calyx inferior stones with high stone free rate. The stone free rate of these three groups showed no statistically significant difference.Keywords: Percutaneous nephrolithotomy, inferior calyx stone, stone free rate.

COMPARISON OF STONE FREE RATE OF STAGHORN STONE, RENAL PELVIC STONE, AND INFERIOR CALYX STONE FOLLOWING PCNL Tirtayasa, Pande Made Wisnu; Birowo, Ponco; Rasyid, Nur
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.v23i1.207

Objective: To compare the stone free rates on patients with staghorn, renal pelvic, and inferior calyx stones with stone burden < 20 mm, 21-30 mm, and > 30 mm following percutaneous nephrolithotomy (PCNL) in Cipto Mangunkusumo General Hospital Jakarta. Material & methods: The data were collected retrospectively from PCNL medical records in Cipto Mangunkusumo General Hospital Jakarta between January 2000 and March 2011. Six hundred and twenty-three patients with 651 kidney stones underwent PCNL. The inclusion criteria were staghorn stones, renal pelvic stone, and inferior calyx stone. All cases outside these three criteria and incomplete data were excluded. Stone free status was defined as no residual fragment on radiography or ultrasonography. Results: As many as 364 kidney stones from 344 patients were included, with 47.8% cases of staghorn stones, 31.9% cases of renal pelvic stones, and 20.3% cases of inferior calyx stones. Overall, 273 (75%) cases were defined as stone free. In group < 20 mm, 4 staghorn stones (100%), 18 renal pelvic stones (81.8%), and 34 inferior calyx stones (94.4%) were cleared (p = 0.811). In group 21-30 mm, 20 staghorn stones (95.2%), 52 renal pelvic stones (91.2%), and 26 inferior calyx stones (92.9%) were cleared (p = 1.000). In group > 30 mm, 83 staghorn stones (55.7%), 28 renal pelvic stones (75.7%), and 8 inferior calyx stones (80%) were cleared (p = 0.037). Conclusion: PCNL is an important tool for treating various kinds and sizes of kidney stones with high stone free rate.

DELAYED GRAFT FUNCTION FOLLOWING LAPAROSCOPIC LIVE DONOR NEPHRECTOMY: A MULTIVARIATE ANALYSIS Tirtayasa, Pande Made Wisnu; Situmorang, Gerhard Reinaldi; Rodjani, Arry; Rasyid, Nur
Indonesian Journal of Urology Vol 23 No 2 (2016)
Publisher : Indonesian Urological Association

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.32421/juri.v23i2.208

Objective: This study was performed to define and investigate the incidence, risk factors, and clinical characteristics of delayed graft function (DGF) in laparoscopic live donor nephrectomy (LDN). Material & methods: We retrospectively analyzed the medical records of donor and recipient from our first 100 cases of laparoscopic LDN in Cipto Mangunkusumo General Hospital Jakarta, from November 2011 to February 2014. The criteria used to define DGF were the requirement for dialysis in postoperative week 1 and/or serum creatinine greater than 2.5 mg/dl at postoperative day 7. Patients who did not match any of these criteria were define as having normal renal allograft function. Results: The overall prevalence of DGF was 14%. Recipients body mass index, cold ischemia time, vascular anastomosis time, and total ischemia time were higher among the delayed graft function group, but no risk factors for DGF were significantly associated after multivariate analysis. Conclusion: The incidence of DGF in our study was in the range of that observed in previous studies. The factors that previously reported and believed as risk factors of DGF in laparoscopic LDN were not significantly associated with the development of DGF in our study.

THE CORRELATION BETWEEN SERUM PSA LEVEL AND PROSTATE HISTOLOGIC AGGRESSIVENESS WITH PROSTATIC VOLUME IN BPH PATIENTS Duarsa, Gede Wirya Kusuma; Oka, AA Gde; Santosa, Kadek Budi; Yudiana, Wayan; Tirtayasa, Pande Wisnu; Udiyana, Nyoman Dwi Maha; Mahadewa, Tjok Gede Bagus
Indonesian Journal of Urology Vol 26 No 1 (2019)
Publisher : Indonesian Urological Association

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.32421/juri.v26i1.465

Objective: Prostate inflammation is one of pathophysiology of prostate hyperplasia in benign prostatic hyperplasia (BPH). There are several factor that involved in prostatic inflammation, such as prostate specific antigen (PSA) that play a role as an autoantigen. The objective of this study was to assess the correlation between free PSA level with prostate histologic aggressiveness, and also the correlation between prostate histologic aggressiveness with prostatic volume in BPH patients. Material & Methods: The design of this study was cross-sectional analytic observational study to determine correlation between serum PSA level with prostatic aggressiveness, and prostatic volume with prostatic aggressiveness. This study was performed from June to November 2016 in Sanglah Public Hospital, Surya Husadha, Balimed, Bhakti Rahayu, and Ganesa Hospital. Eighty three patients with BPH undergoing transurethral resection of the prostate (TURP) were recruited. Results: The result of gamma correlation analysis using Chi-square of PSA level with aggressiveness (p=0.000) and aggressiveness with prostatic volume (p=0.012). Conclusion: Serum PSA level were correlated with prostatic aggressiveness. Prostatic aggressiveness also correlated with prostatic volume.

DAMPAK PANDEMI COVID-19 PADA PELAYANAN EXTRACORPOREAL SHOCK WAVE LITHOTRIPSY (ESWL) DI RS SURYA HUSADHA DENPASAR Gede Wirya Kusuma Duarsa; Gede Wirya Diptanala Putra Duarsa; Pande Made Wisnu Tirtayasa
E-Jurnal Medika Udayana Vol 10 No 9 (2021): Vol 10 No 09(2021): E-Jurnal Medika Udayana
Publisher : Universitas Udayana

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.24843/MU.2021.V10.i9.P03

Pandemi COVID-19 telah membuat suatu gangguan pada sistem pelayanan kesehatan yang telah berjalan sekian lama. Hal ini bisa menjadi suatu hambatan namun dapat pula menjadi suatu tantangan, khususnya di bidang pelayanan kesehatan pasien dengan batu saluran kemih. Penyakit batu saluran kemih dapat terjadi di sepanjang traktus urinarius contohnya di ginjal. Terdapat beberapa metode penanganan batu ginjal, salah satunya adalah dengan tindakan extracorporeal shock wave lithotripsy (ESWL). Penelitian ini bertujuan untuk melihat apakah pandemi COVID-19 berdampak terhadap jumlah pelayanan ESWL di salah satu pelayanan kesehatan di Denpasar. Studi observasional deskriptif dilakukan di RS Surya Husadha Denpasar dengan menggunakan data sekunder yaitu data rekam medis pasien yang dilakukan tindakan ESWL. Data dibagi menjadi dua grup yaitu data sebelum pandemi COVID-19 (November 2019 – Januari 2020) dan data saat pandemi COVID-19 berlangsung (Februari 2020 – Mei 2020). Total data yang dikumpulkan sebanyak 1109 kasus yaitu terdiri dari 499 kasus sebelum pandemi dan 610 kasus saat pandemi COVID-19. Rerata jumlah pasien yang dilakukan ESWL sebelum dan saat pandemi adalah 166,3 kasus/bulan dan 152,5 kasus/bulan. Terdapat penurunan rerata jumlah pasien yang dilakukan ESWL saat pandemi yaitu sebanyak 8,2% dibandingkan sebelum pandemi COVID-19. Sebagian besar kasus adalah berjenis kelamin laki-laki pada kedua grup dan kelompok umur terbanyak pada kedua grup adalah kelompok umur >50 tahun. Penurunan angka tindakan ESWL saat pandemi pada studi ini dilatarbelakangi oleh faktor pada pelayanan kesehatan dan faktor dari pasien sendiri. Prioritas utama diberikan kepada pasien batu saluran kemih dengan potensi risiko yang lebih besar.

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.

Evaluasi Ureteroskopi dengan Laser Holmium: Yttrium-Aluminum-Garnet untuk Penatalaksanaan Batu Ureter di Rumah Sakit Persekutuan Gereja Indonesia Cikini Tahun 2010-2012 Octoveryal Aslim; Pande Made Wisnu Tirtayasa; Adi Bachtiar Tambah; Frendy Wihono; Winner Winner; Egi Edward Manuputty; David Manuputty
JBN (Jurnal Bedah Nasional) Vol 1 No 1 (2017): JBN (Jurnal Bedah Nasional)
Publisher : Program Studi Ilmu Bedah, Fakultas Kedokteran Universitas Udayana

Tujuan: untuk mengetahui efektivitas ureterorenoscopy (URS) menggunakan laser Holmium: Yttrium-Aluminum-Garnet (Ho: YAG) untuk pengelolaan batu ureter di Rumah Sakit Persekutuan Gereja Indonesia (PGI) Cikini sepanjang tahun 2010 hingga 2012. Metode: data dikumpulkan retrospektif dari catatan medis pasien di Rumah Sakit PGI Cikini dari 1 Januari 2010 sampai 31 Desember 2012 yang menjalani URS dengan Ho: YAG lithotripter laser untuk mengobati penyakit batu saluran kemih. Kriteria inklusi pada semua pasien dengan batu saluran kemih dilakukan URS menggunakan laser Ho: YAG. Hasil: sebanyak 205 penyakit batu ureter dari 182 pasien yang mendapat pengobatan URS dengan Ho: YAG laser litotriptor di Rumah Sakit PGI Cikini, terdiri dari 143 laki-laki dan 39 wanita dengan rata-rata umur 45,69 tahun (19-76). Terdiri dari 115 batu ureter kanan dan 90 kiri, dengan 128 batu ureter proksimal dan 77 distal. Komorbititas yang paling sering muncul adalah hydronephrosis sejumlah 169 (88,5%) dan 155 (75,6%) komorbiditas dari kasus lainya. Komplikasi post operatif ditemukan pada 11 pasien (5,8%). Rata-rata waktu operasi 55,19 menit dan rata-rata lama rawat inap pasien paska operasi adalah 3,31 hari. Angka bebas batu secara keseluruhan adalah 88,3%. Dimana angka bebas batu pada ureter proksimal adalah 85,9%, sedangkan ureter distal 89,6%, dengan angka bebas batu secara keseluruhan yaitu 88,3%. Simpulan: URS memakai laser Ho: YAG merupakan prosedur yang aman dan efektif untuk pasien dengan batu ureter terlepas dari lokasi batu pada ureter.

Co-Authors Adi Bachtiar Tambah Anak Agung Gde Oka Arry Rodjani Benny Philippi David Manuputty Djodi Sidartha Egi Edward Manuputty Frendy Wihono Gde Oka, A A Gede Andi Aditya Gede Wirya Diptanala Putra Duarsa Gede Wirya Diptanala Putra Duarsa Gede Wirya Diptanala Putra Duarsa Gede Wirya Kusuma Duarsa Gerhard Reinaldi Situmorang, Gerhard Reinaldi Harrina E. Rahardjo I Gde Raka Widiana I Made Nugraha Gunamanta Sabudi I Nengah Wiadi I Wayan Yudiana Ida Bagus Putra Pramana Kadek Budi Santosa Krishna, I Komang O. Nur Rasyid Octoveryal Aslim Oka, AA Gde Oka, Anak A.G. Ponco Birowo Prayudi, I Nyoman Gede Putu Astri Novianti Tjokorda Gde Bagus Mahadewa Udiyana, Nyoman Dwi Maha Wayan Sudana Winner Winner Yenny Kandarini

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