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All Journal International Journal of Integrated Health Sciences Majalah Kedokteran Bandung Althea Medical Journal Indonesian Journal of Urology Jurnal Aisyah : Jurnal Ilmu Kesehatan
Tjahjodjati
Department Of Urology Faculty Of Medicine Universitas Padjadjaran/Dr. Hasan Sadikin General Hospital, Bandung
Health Professions Medicine & Pharmacology Nursing Public Health Veterinary

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THE EFFECT OF TOPICAL GENTAMYCIN APPLICATION AT THE URETHRAL STENT TO THE URETHRAL STENT’S BACTERIAL COLONY-FORMING-UNIT COUNTS IN HYPOSPADIAS PATIENTS PERFORMED URETHROPLASTY: A PRELIMINARY STUDY Oetama, Harris; sibarani, jupiter; Tjahjodjati, Tjahjodjati; Agil, Ahmad
Indonesian Journal of Urology Vol 25 No 2 (2018)
Publisher : Indonesian Urological Association

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.32421/juri.v25i2.425

Abstract

Objective: To determine the effect of topical gentamycin application at the urethral stent to the stent’s colony-forming-unit (CFU) in hypospadias patients. Material & methods: This study is a double blind prospective randomized controlled study, conducted from November 2016 - August 2017 in Urology Department Hasan Sadikin Hospital Bandung. We include patients with distal until penoscrotal hypospadias who underwent urethroplasty for the first time. The subjects were divided into 2 groups: Group A were patients performed urethroplasty with nasogastric tube (NGT) urethral stents only. Group B were patients performed urethroplasty with NGT urethral stents that were coated with topical gentamycin. Both group were operated by a single surgeon using either Tubularized Incised Plate (TIP) or Onlay Preputial Flap technique. Both group used supra pubic urinary diversion. Both group were given the same preoperative and postoperative intravenous antibiotics and given same dressing. At post operative day 7, the stents were removed and swabbed for bacterial culture and resistance test and colony-forming-unit (CFU) counts. Demographic data is described and, among others were analyzed statistically. Other adverse events and complications were also documented. Results: There were 25 hypospadias patients who were performed urethroplasty (12 patients in Group A and 13 patients in Group B). The median age in group A was 7 ± 2.995 (years old) and the mean age in group B was 6 ± 3.178  (years old). In group A, 1 patient (8.3%) were distal shaft type, 1 patient (8.3%) were middle shaft type, 8 patients (66.7%) were penoscrotal type, 1 patient (8.3%) were proximal shaft type, and 1 patient (8.3%) were subcoronal type. In group B, 3 patients (23.1.%) were distal shaft type, 3 patients (23.1%) were middle shaft type, 5 patients (38.5%) were penoscrotal type, and 2 patients (15.7%) were proximal shaft type. In group A, 6 patients (50%) using TIP, 6 patients (50%) using onlay preputial flap. In group B, 5 patients (38.5%) using TIP, 8 patients (61.5%) using onlay preputial flap. In Group A, Staphylococus haemoliticus was the most common bacterial found in urethral stent swabbed culture (50%), followed by Pseudomonas aeroginosa (16.7%), Acinetobacter baumannii (8.3%), Enterococcus faecalis (8.3%), Morganella morgagnii (8.3%) and sterile cultures (8.3%). In Group B, 38.5% were sterile urethral stents culture, followed by Staphylococus haemoliticus (30.8%), Enterobacter cloacae (7.7%), Staphylococus warneri (7.7%), Staphylococus epidermidis (7.7%), and Moraxella catarrhalis (7.7%). The most sensitive antibiotics in both group were Amikacin, Gentamycin, Meropenem, Cotrimoxazole, and Cefepime. In group A, 11 patients (91.7%) had >100.000 CFU counts, and 1 patient (8.3%) with no colony found.  In Group B, 2 patients (15.4 %) had >100.000 CFU counts, 6 patients (46.2%) had <100.000 CFU counts, and 5 patient (38.5%) with no colony found. In group A, there were 3 patients (25%) with urethra-cutaneous fistula, 4 patients (33.3%) with hematoma, and 5 patients (38.5%) without any complications. In group B, there were 2 patients (15.4%) with urethra-cutaneous fistula, 3 patients (23.1%) with hematoma and 8 patients (61.5%) without any complication. Using Mann-Whitney U-test, we found a significant difference of CFU counts formation between the two groups (p=0.001). Statistically, the lesser CFU counts found, the lesser complication were developed (p=0.001). Conclusion: Topical gentamycin application at the urethral stents in hypospadias patients performed urethroplasty significantly reduced CFU counts found at the urethral stents and thus reduced the urethra-cutaneous fistula and hematoma formation.
UROVAGINAL FISTULA IN TERTIARY HOSPITAL OF WEST JAVA INDONESIA Karim, Muhammad Ilhamul; Tjahjodjati
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.v29i1.709

Abstract

Objective: This study was conducted to find out the frequency and characteristics of urovaginal fistula patients. Material & Methods: This study design used a retrospective descriptive research design conducted at a tertiary hospital in West Java, Indonesia (Hasan Sadikin General Hospital) from 1 January 2010 to 31 December 2016. Results: Of all 22 urovaginal fistula patients, the majority in the age range of 41-50 years, and there was one patient in the age range of 61-70 years. Fourteen patients (63.6%) had defects in the bladder, and 36.5% of patients had defects in the ureters. There were nine patients (40.9%) who had urovaginal fistula after undergoing a hysterectomy procedure. The other causes were cervical carcinoma (40.9%), difficult labor (9.1%), radiotherapy (4.5%), carcinoma rectum (4.5%), cesarean section procedure (9.1%), and other gynecological procedures such as myomectomy or cystectomy (9.1%). Based on the type and location of the fistula, the majority of patients had vesicovaginal fistula/VVF (59%), ureterovaginal fistula/UVF (36%), and a combination of ureterovesicovaginal fistula (5%). The causes of VVF and UVF are different from each other. In patients with VVF, the most common cause is cervical carcinoma (35.7%). Meanwhile, the most common cause of UVF is hysterectomy (75%). Conclusion: Of the various types of urovaginal fistulas, vesicovaginal fistulas are the most frequently encountered. In general, the characteristics of urovaginal fistula patients in Hasan Sadikin General Hospital is slightly different from the literature, especially the cause of fistula. At Hasan Sadikin General Hospital, vesicovaginal fistulas are mostly caused by cervical cancer, not a hysterectomy. For ureterovaginal etiology, the characteristics of patients in Hasan Sadikin General Hospital are caused mainly by hysterectomy.
Nigella sativa Infusion as an Antioxidant Agent Against Gentamicin-Induced Kidney Damaged in Mice Hamsiah binti Halim; Achadiyani Achadiyani; Tjahjodjati Tjahjodjati
Althea Medical Journal Vol 1, No 2 (2014)
Publisher : Faculty of Medicine Universitas Padjadjaran

Show Abstract | Download Original | Original Source | Check in Google Scholar | Full PDF (290.903 KB)

Abstract

Background: Gentamicin is one of the most common antibiotics related to nephrotoxicity. It has been proposed that the nephrotoxicity is associated with the generation of the reactive oxygen species. Thymoquinone, an active compound of Nigella sativa, shows to have an antioxidant property. The study aims to identify the possible nephroprotective action of Nigella sativa infusion against gentamicin-induced kidney damaged in mice.Methods:This experimental study was carried out in the Department of Cell Biology Laboratory, Universitas Padjadjaran, Bandung from 10th November 2012 to 14th December 2012. There were four groups, each consisting of  6 mice. Group I (control negative), group II (gentamicin 100 mg/kg), group III (3.9 mg Nigella sativa infusion+gentamicin 100mg/kg) and group IV (7.8 mg Nigella sativa infusion+gentamicin 100mg/kg). The kidneys were evaluated histopathologically by light microscope. The percentage average number of normal proximal tubules in group I and the percentage average number of proximal tubules damaged in group II, III and IV were measured.Results: The results showed the percentage average number of the proximal tubules damaged in group II, III and IV were 14.53%, 7.49% and 3.94% respectively. Significant differences were observed between group II and III, group II and IV, and group III and IV.Conclusion:Nigella sativa infusion protects against gentamicin-induced kidney damage in mice.Keywords: gentamicin, kidney, Nigella sativa infusion  Infusa Nigella sativa sebagai Antioksidan Terhadap Kerusakan Ginjal padaTikus yang Diinduksi Gentamisin   LatarBelakang: Gentamisin adalah salah satu antibiotik yang paling sering dihubungkan dengan nefrotoksisitas. Nefrotoksisitas yang terjadi berhubungan dengan pembentukan reactive oxygen species. Thymoquinone, senyawa aktif Nigella sativa, telah terbukti memiliki sifat antioksidan. Penelitian ini bertujuan untuk mengidentifikasi sifat nefroprotektif infusa Nigella sativa terhadap kerusakan ginjal pada tikus yang diinduksi gentamisin.Metode: Penelitian eksperimental ini dilakukan di Laboratorium Departemen Biologi Sel, Fakultas Kedokteran, Universitas Padjadjaran, Bandung dari 10 November 2012 –14 Desember 2012. Ada empat kelompok masing-masing terdiri atas 6 tikus. Kelompok I (control negatif), kelompok II (gentamisin 100 mg /kg), kelompok III (3,9 mg Nigella sativainfus + gentamisin 100mg/kg) dan kelompok IV (7,8 mg Nigella sativa infus + gentamisin 100mg/kg). Ginjal kemudian dievaluasi secara histopatologi dengan mikroskop cahaya. Persentase rata-rata jumlah tubulus proksimal yang normal dalam kelompok I dan persentase rata-rata jumlah tubulus proksimal rusak dalam kelompok II, III dan IV diukur.Hasil: Persentase rata-rata jumlah tubulus proksimal rusak dalam kelompok II, III dan IV adalah 14,53%, 7,49% dan 3,94%. Perbedaan signifikan yang diamati adalah pada kelompok II dengan III, kelompok II dengan  IV, serta kelompok III dan IV.Simpulan: Infusa Nigella sativa infuse melindungi terhadap kerusakan ginjal yang diinduksi gentamisin pada tikus.Kata kunci: gentamisin, ginjal, infusa Nigella sativaDOI: 10.15850/amj.v1n2.354
Urinary Tract Stones Risk Factors in Patients with Benign Prostatic Hyperplasia in West Java, Indonesia Iman Surendroputro Tjahjodjati; Bambang Sasongko Noegroho; Aaron Tigor Sihombing
Althea Medical Journal Vol 8, No 2 (2021)
Publisher : Faculty of Medicine Universitas Padjadjaran

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.15850/amj.v8n2.2257

Abstract

Background: Urinary tract stones are common in patients with benign prostatic hyperplasia (BPH); therefore, an imaging test is needed for patients who have risk factors for the formation of urinary tract stones. The purpose of this study was to explore the factors associated with the presence of urinary tract stones in patients with BPH as information to conduct imaging tests.Methods: A cross-sectional quantitative analytic study was conducted on medical records of patients with BPH, both with and without urinary tract stones, or patients with urinary tract stones registered at the Department of Urology, Dr. Hasan Sadikin General Hospital, Indonesia, from 2015 to 2018. Data on age, body mass index, hypertension, use of antihypertensive drugs, diabetes mellitus, and hyperuricemia were collected and analyzed using the Mann-Whitney, Chi-square, Fisher exact test, and multivariate logistic regression statistical test to compare variables between BPH with and without urinary tract stones.Results: In total, 235 BPH patients were registered, of whom 74 (31.5%) had urinary tract stones. The median age was 64 years old. There was a relationship between age (p=0.030), diabetes mellitus (p=0.043), and the occurrence of urinary tract stones in patients with BPH. The most dominant risk factor was diabetes mellitus (OR=3.000, 95%CI 1.03-8.69).Conclusions: Age and diabetes mellitus are the risk factors for urinary tract stones in patients with BPH. BPH patients with diabetes mellitus are at a 3-fold risk for urinary tract stones. Diabetes mellitus in BPH patients is an indication to conduct imaging tests.
Ultrasound Guided Fine Needle Aspiration Biopsy in Renal Tumors Tjahjodjati Tjahjodjati; Joko Pitoyo
International Journal of Integrated Health Sciences Vol 3, No 1 (2015)
Publisher : Faculty of Medicine Universitas Padjadjaran

Show Abstract | Download Original | Original Source | Check in Google Scholar | Full PDF (79.433 KB)

Abstract

Objective: To assess the sensitivity and specificity of ultrasound guided fine needle aspiration biopsy (FNAB) in renal tumors.Methods: A diagnostic study was performed on 23 patients with renal tumors who visited the Urology Division, Department of Surgery, Dr. Hasan Sadikin General Hospital from January 2011 to August 2012. First time ultrasound guided was performed to the patients before nephrectomy. Renal tissues that were obtained from both procedures were examined histopathologically, and the result from nephrectomy was used as the gold standard. Analysis was conducted by measuring the sensitivity, specificity, positive predictive value (PPV), and negative predictive value (NPV) of the ultrasound guided FNAB. Results: The results showed that the sensitivity value of ultrasound guided FNAB was 85.71%, with 50% specificity, 94.74% PPV and 25% NPV. From 23 patients, only 2 patients had hematoma. Conclusions: Ultrasound guided FNAB is sufficiently sensitive with a fair specificity for diagnosing renal tumors and is safe for patients.Keywords: Renal tumor, sensitivity, specificity, ultasound guided FNAB DOI: 10.15850/ijihs.v3n1.401
Characteristics of Enterovesical Fistula Patients Visiting the Urology Department of Dr. Hasan Sadikin General Hospital Bandung, Indonesia, from 2015 to 2019 Daniel Saputra; Tjahjodjati Tjahjodjati
Majalah Kedokteran Bandung Vol 53, No 3 (2021)
Publisher : Faculty of Medicine, Universitas Padjadjaran

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.15395/mkb.v53n3.2353

Abstract

Enterovesical fistula (EVF) represents an abnormal channel between the intestine and the bladder. The EVF is a complication of inflammatory or neoplastic diseases and injuries. Diagnosis of EVF can be challenging and often delayed up to several months after the onset of the symptoms. This study aimed to determine the characteristics of patients with enterovesical fistula visiting Dr. Hasan Sadikin General Hospital Bandung, Indonesia. This retrospective descriptive study used the medical records of EVF patients treated in the urology department of Dr. Hasan Sadikin General Hospital from 2015 to 2019 as the secondary data to be analyzed. A total of 58 patients with EVF were enrolled in this study. By gender, that more than half of the patients were male patients (n=30, 51.7%) and 45% of patients were between 41 and 50 years old. The most common symptoms of EVF were pneumaturia and fecaluria which were seen in 30 (51.7%) and 20 (34.5%) patients, respectively. Twenty-nine (50%) patients experienced malnutrition and 18 (31.1%) patients had diabetes mellitus as a comorbid. The most common type of fistula was rectovesical fistula (n=45, 77.6%) and 26 (66.6%) patients suffered from rectosigmoid cancer and malignancy (68.95) had become the most predominant etiology. Escherichia coli was found in 42 (72.4%) urine cultures collected from the patients and cystoscopy with fistula biopsy was found in 43.1% of cases, followed by fistula repair (29.3%) and urethral catheter drainage (15.5%). Hence, malignancy and rectosigmoid cancer become the most common etiology of EVF while cystoscopy with fistula biopsy is the most frequently performed procedure. 
Microbial Culture Characteristics and Antimicrobial Susceptibility Patterns Associated with Vesicovaginal Fistula Gugum Indra Firdaus; Tjahjodjati Tjahjodjati
Majalah Kedokteran Bandung Vol 54, No 2 (2022)
Publisher : Faculty of Medicine, Universitas Padjadjaran

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.15395/mkb.v54n2.2511

Abstract

Vesicovaginal fistula (VVF) is commonly linked with recurrent urinary tract infection (UTI). Thus, the patterns of the pathogenic microorganism becomes important consideration in the management of this disease. This study aimed to describe patient profiles, disease etiology, and antimicrobial susceptibility patterns of microorganisms in VVF patients. This retrospective study was conducted on 49 medical records of vesicovaginal fistula patients seen from January 2016 to December 2020. The most prevalent age group of the patients was 40-50 years old. Analysis demonstrated that the leading etiology for VVF among these patients was malignancy (73.47%). The antimicrobial susceptibility was tested using the disc diffusion method and Escherichia coli (44.90%) and Proteus mirabilis (14.29%) were identified as the bacterial pathogens most frequently isolated from urine samples. Of the 39 patients with significant growth of organism cases, 29 (74.35%) had symptomatic UTIs. The isolated gram-negative bacteria had excellent sensitivity to aztreonam, ertapenem, and meropenem, with a more than 90% susceptibility rate, while the  gram-positive bacteria had good sensitivity to amikacin, cefepime, tigecycline, aztreonam, ertapenem, and meropenem, with a more than 90% susceptibility. In conclusion,  bacterial culture and antibiotic susceptibility test (AST) remains an essential part of managing VVF and their results can be used as a reference for empirical therapy. Amikacin, cefepime, tigecycline, aztreonam, ertapenem, and meropenem should be considered for treatment of UTIs associated with VVF.
Relationship between BMI and Urine pH in Nephrolithiasis Cases in Indonesia Abdurrahman, Fauzan; Tjahjodjati, Tjahjodjati
Majalah Kedokteran Bandung Vol 56, No 4 (2024)
Publisher : Faculty of Medicine, Universitas Padjadjaran

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.15395/mkb.v56.3755

Abstract

In nephrolithiasis/urolithiasis, urine pH is thought to modulate kidney stone formation at various stages, including crystallization, growth, aggregation, and retention. Moreover, numerous studies have demonstrated that an increase in Body Mass Index (BMI) correlates with a decrease in urine pH. This study aimed to determine the relationship between BMI and urine pH in cases of nephrolithiasis at Dr. Hasan Sadikin General Hospital Bandung. This was analytical observational study with a cross-sectional design, followed by correlation analysis is carried out. A total of 100 patients from January 2021 to December 2022 have met the inclusion criteria. From the results of the analysis, it was discovered that of the 21 patients with acidic urine pH, 42.11% had normal BMI, 26.32% were grade 1 obese, 15.79% were grade 2 obese, 10.53% were overweight, and 5.26% were underweight. The majority of patients who had normal urine pH also had a normal BMI (34.18%), followed by 30.38% with grade 1 obesity, 21.52% with grade 1 obesity, and 13.92% with grade 2 obesity. Of the 2 patients with  alkaline urine pH, one person had a normal BMI and another had an overweight BMI. The results of the chi-square test presented a p value of >0.05, thus no significant relationship is observed between urine pH and BMI in nephrolithiasis patients.
Continuous Ambulatory Peritoneal Dialysis Cost-Effectiveness in National Health Insurance Era of Indonesia Tjahjodjati, Tjahjodjati; Kuddah, Yasser; Wijayanti, Zola
Majalah Kedokteran Bandung Vol 55, No 4 (2023)
Publisher : Faculty of Medicine, Universitas Padjadjaran

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.15395/mkb.v55n4.2372

Abstract

Essential treatments for patients with end-stage renal disease include Renal Replacement Therapy (RRT) consisting of hemodialysis, peritoneal dialysis, and kidney transplantation. In 2014, dialysis coverage in Indonesia was more than 1.5 trillion, making it the second highest expense in the National Health Insurance (BPJS) expenses. This study compared the cost-effectiveness between Continuous Ambulatory Peritoneal Dialysis (CAPD) and Hemodialysis (HD) in  patients treated in Dr. Hasan Sadikin General Hospital. Data were collected from the Urology Department from 2014 to 2017. This was a retrospective observational study on 3 groups of patients: patients with effective CAPD each year as the first group; patients who had experienced repair of CAPD and continued to use it as the second group; and patients who discontinued CAPD due to complications and returned to hemodialysis as the third group. Each group expense was calculated with standard cost insurance for one year in  the hospital. The expense was then be compared to the expense of hemodialysis for one year. A total of 89 patients in the CAPD program from 2014–2017 were treated at the department. When compared to HD, the first, second, and third group of CAPD patients experienced a cost reduction of IDR 23.227.857/person, IDR 18.127.857/person, and IDR 1.661.972.000, respectively. Total savings from the CAPD program in the hospital was IDR 1.661.972.000 from 2014. It is then concluded that CAPD could reduce the burden of government insurance in a cost-effective manner and is considered a treatment of choice in the National Health Insurance Era.
Impact of Covid-19 Pandemics on Urology Practices and Residency Training in an Indonesian Tertiary Hospital Kusumajaya, Christopher; Tjahjodjati, Tjahjodjati
Majalah Kedokteran Bandung Vol 56, No 1 (2024)
Publisher : Faculty of Medicine, Universitas Padjadjaran

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.15395/mkb.v56.2657

Abstract

The World Health Organization (WHO) declared Covid-19 as a global pandemic on March 11, 2020. Alterations in health service provisions must be applied to maintain prime services and decrease the number of healthcare workers exposure to Covid-19 by reducing the number of patients and workload, as well as cancelling elective surgeries. This study aimed to describe the urological services and residency training program during a Covid-19 year at Dr. Hasan Sadikin General Hospital, Bandung, which is a tertiary health center and teaching hospital in Indonesia. This was a comparative retrospective study conducted from January 2019 to December 2020 that compared the number of patients in inpatient and outpatient settings and emergency department, as well as surgical procedures performed before and during Covid-19 pandemic. Data were obtained from the administration department of the hospital, showing a reduction of 40,94%, 7.39%, 32.3%, and 53.89% of total inpatients, outpatients, emergency cases, and surgical procedures, respectively, in the urology department of the hospital when compared to the previous year. The number of surgeries that could be performed by residents was reduced by 30-60%. This current study showed the decreased number of patients and urological operative procedures during COVID-19 pandemic. This is assumed to give negative impacts to the urological residency training due to the limited exposure to variety of cases and surgical skill procedures.
Co-Authors Aaron T Sihombing, Aaron T Aaron Tigor Sihombing Abdurrahman, Fauzan Abu Surur, Abu Achadiyani Ahmad Agil Bambang S Noegroho Bambang Sasongko Noegroho Betthy S Hernowo, Betthy S Caesar Khairul Wallad, Caesar Khairul Daniel Saputra Ferry Safriadi Galuh Richata, Galuh Gugum Indra Firdaus Hamsiah binti Halim Hamsiah binti Halim Helmi, Kiki Isdianto Septiadi, Isdianto Joko Pitoyo Jumadi Santoso Jupiter Sibarani Karim, Muhammad Ilhamul Ken Ramadhan Kuddah, Yasser Kuncoro Adi Kurniawan, Aninditho Dimas Kusumajaya, Christopher Makmuri Yusuf Muhammad Rivai Mumuh M E, Mumuh M Oetama, Harris Ricky Adriansjah Rizki, Dhika Ari Safendra Siregar Sawkar V Pramod, Sawkar V Suwandi Sugandi Wahyudi, Yuvi Zola Wijayanti, Zola Zulhardi Haroen, Zulhardi