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All Journal Jurnal Kedokteran Brawijaya Indonesian Journal of Urology Neurologico Spinale Medico Chirurgico Jurnal Klinik dan Riset Kesehatan Indonesian Andrology and Biomedical Journal Brawijaya Journal of Urology
Paksi Satyagraha
Department Of Urology, Faculty Of Medicine, Brawijaya University, Saiful Anwar General Hospital Malang, East Java
Biochemistry, Genetics & Molecular Biology Health Professions Immunology & microbiology Medicine & Pharmacology Neuroscience Nursing Public Health

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RELATIONSHIP BETWEEN TZI AND TZV WITH IPSS, QMAX, AND BOO Satyagraha, Paksi; Djojodimedjo, Tarmono; Wirjopranoto, Soetojo; Budiono, Budiono
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.v20i2.15

Abstract

Objective: This study evaluate the relationship between the IPSS score, Qmax,  and degree of bladder outlet obstruction with transitional zone volume (TZV) and transitional zone index (TZI) in clinical BPH patient. Material & Methods: This is an observational cross sectional study which 26 patients included with clinical BPH between September 2011 until January 2012. General information and other variables are recorded (total prostate volume, TZV, TZI, IPSS score, Qmax and degree of bladder outlet obstruction (BOO) according to Schaefer normogram. The data will be descriptive and analytically analyzed. Results: 26 patients with clinical BPH are included in this study, with average age is 64,7 (± 5,98) years. The average volume of the total prostate volume and TZV are 30,35 (± 15,35) gram and 15,31 (± 11,77) gram. Meanwhile the average of TZI is 0,4 (± 0,13). After the normal distribution test was performed, all data is analyzed with Pearson correlation test. A strong correlation was found between IPSS and total prostate volume (r = 0,526, p = 0,006), TZV (r = 0,671, p = 0,000) and TZI (r = 0,812, p = 0,000). A strong correlation is also found between TZI and BOO (r = 0,560, p = 0,003). Meanwhile weak correlation is found between Qmax and total prostate volume (r = -0,105, p = 0,608), TZV (r = -0,103, p = 0,616) and TZI (r = - 0,084, p = 0,734). Another weak correlation is shown between total prostate volume (r = 0,233, p = 0,253) and TZV (r = 0,37, p = 0,062) with degree of BOO according to Schaefer nomogram. Conclusion: TZV has significant correlation with IPSS score, but no significant correlation with Qmax and degree of BOO in patients with clinical BPH. Meanwhile TZI has a significant correlation with IPSS and degree of BOO in patients with clinical BPH. TZI could be performed as a single non invasive procedure to determine BOO in patients with clinical BPH.Keywords: Prostatic hyperplasia, transition zone, ultrasonography, urodynamics.
IPP AS PREDICTIVE FACTOR FOR ACUTE URINARY RETENTION IN BPH PATIENTS Budaya, Taufiq Nur; Purnomo, Basuki B.; Daryanto, Besut; Seputra, Kurnia Penta; Satyagraha, Paksi
Indonesian Journal of Urology Vol 21 No 1 (2014)
Publisher : Indonesian Urological Association

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.32421/juri.v21i1.26

Abstract

Objective: To demonstrate usefulness of Intra Prostatic Protrusion (IPP) as Predictive Factor for Acute Urinary Retention (AUR) in Benign Prostate Hyperplasia (BPH) Patients. Material & methods: Cross sectional retrospective study of case records from January to July 2012 of BPH patients at Saiful Anwar General Hospital (SAGH) Malang was carried out. The data were collected from the Medical Record Division in SAGH Malang. We noted age, prostate volume, IPP, IPSS and urinary retention status. The patients were classified by IPP degree < 5 mm (group A), 5-10 mm (group B), 10 -15mm (group C), > 15mm (group D) and we compared all parameters that we noticed. Results: Eighty patients, mean age was 66.32 years were enrolled. Transabdominal ultrasound determined the mean IPP was 13.5 mm, and prostatic volume 95 cc. IPP values were distributed as follows: group A 10 (12.5%), group B 25 (31.25%), group C 24 (30%), group D 21 (26.25%), with AUR incidence in group A 20%, group B 36%, group C 79%, and group D 81%. The IPP showed a significant correlation with urinary retention (r = 0.8, p < 0.05, OR = 15) and IPSS (r = 0.6, p < 0.05). Conclusion: IPP can be used as predictive factor for the incidence of acute urinary retention in BPH Patients.Keywords: Intra Prostatic Protrusion, Acute Urinary Retention, Benign Prostate Hyperplasia.
Treatment of panurethral strictures using one side dissection dorsal onlay buccal mucosal graft urethroplasty Gede Wirya Diptanala Putra Duarsa; Gede Wirya Kusuma Duarsa; Ida Bagus Putra Pramana; Paksi Satyagraha
Neurologico Spinale Medico Chirurgico Vol 4 No 2 (2021)
Publisher : Indoscholar

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.36444/nsmc.v4i2.133

Abstract

The management of panurethral stricture was still challenging and controversial. We presented a case of pan urethral strictures management by using a one-sided dissection of dorsal onlay buccal mucosal graft (BMG) urethroplasty (Kulkarni technique). A 53-years old man admitted with panurethral stricture who had previously undergone several procedures. Bipolar micturition cystourethrography procedure revealed 17 cm stricture length. One-sided dissection dorsal onlay buccal mucosal graft urethroplasty was performed. No drain was placed. The Foley catheter was removed four weeks after surgery, and the results of the micturition were favourable. No fistulae were found at a straight erection and meatus at a normal position. The postoperative flow rate (Qmax) was 24.9 ml/second. As a conclusion Kulkarni technique urethroplasty gained good outcome for panurethral stricture in our case.
46 XX Congenital Adrenal Hyperplasia (CAH) after Clitoroplasty, Labioplasty, and Vaginoplasty Rahmat Husein; Besut Daryanto; Paksi Satyagraha; Pradana Nurhadi
Jurnal Kedokteran Brawijaya Vol. 32 No. 2 (2022)
Publisher : Fakultas Kedokteran Universitas Brawijaya

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.21776/ub.jkb.2022.032.02.9

Abstract

Congenital adrenal hyperplasia (CAH) is the most common cause (60%) of Disorder of Sex Development (DSD), which causes three problems: symptoms and conditions arising due to adrenal endocrine disorders, long-term treatment, and quality of life due to genital ambiguity. An 18-year-old female patient was diagnosed with simple virilizing CAH and had genital ambiguity from birth. The patient was raised as a male. Overall, the examination results indicated a female. Physical examination before surgery showed virilization, such as external genital pigmentation, precocious pubic hair, and bilateral impalpable testis. The karyotype genetic examination confirmed female: 46, XX. Eventually, the patient decided as a female and underwent surgical management consisting of clitoroplasty, labioplasty, and vaginoplasty, followed by long-term corticosteroid therapy. Observations were made for three years after surgery to see the progress of the patient's condition. After undergoing glucocorticoid therapy and surgery, the patient had not experienced menstruation. Her breasts did not enlarge, and mustache and beard were still growing on her face. The patient was concerned about her condition, especially about the risk of infertility and inappropriate physical changes. The management of virilization in CAH with genital ambiguity should be seen from psychological and surgical perspectives. Understanding the disease, the goals of surgery, long-term treatment, and social adaptation help improve quality of life and reduce negative stigma.
Hemodynamic Instability and Severity Grade of Kidney Trauma as The Predictor Factors for Nephrectomy Besut Daryanto; I Gusti Lanang Andi Suharibawa; Kurnia Penta Seputra; Paksi Satyagraha; Pradana Nurhadi
Brawijaya Journal of Urology Vol. 1 No. 01 (2020): Brawijaya Journal of Urology
Publisher : Department of Urology, Faculty of Medicine, Universitas Brawijaya

Show Abstract | Download Original | Original Source | Check in Google Scholar

Abstract

Introduction: Kidney trauma occurs in presumably 1-5% of all trauma cases. Delayed surgery increases the likelihood of persistent urinary extravasation and secondary hemorrhage, whereas immediate surgery results in a high renal loss. Hence, the aims sought to evaluate whether hemodynamic instability, urea and creatinine level, anemia and severity grading of kidney trauma can be the predictor factors of nephrectomy. Materials and Methods: Retrospectively study from January 2005 to December 2016, the authors collected the data of 63 kidney trauma patients. We analyzed the hemodynamic condition, hemoglobin level, and grade of kidney injury. The association of hemodynamic instability, urea and creatinine level, anemia, grade of kidney injury to the decision of nephrectomy were analyzed using statistical software (SPSS). Results: Kidney trauma occurred mostly in first grade (40/63.5%). Only 4 (5.4%) came in high grade of renal trauma (Grade III and IV). Patients who came to the emergency department mostly in stable hemodynamic (52/82.5%). Most of them were subsequently treated uneventfully with non-operative management (60/95.2%). There was a significant association between hemodynamic instability and treatment options that unstable hemodynamic significantly increase nephrectomy rate (p=0.047). The data analysis results associated severe grade of trauma with an increase nephrectomy rate (RR: 174, 95% CI:8.62 – 315.174, p<0.01). Further, there were no significant association between anemia, urea and creatinine levels to nephrectomy rate (p>0.05). Conclusion: Severity grade of kidney trauma and hemodynamic instability increased the risk of nephrectomy. Other factors such as anemia, urea and creatinine levels do not have a significant association with the risk of nephrectomy.
Notice of Retraction: Bilateral synchronous percutaneous nephrolithotomy Paksi Satyagraha; Besut Daryanto; Prasetyo Nugroho
Brawijaya Journal of Urology Vol. 3 No. 01 (2022): Brawijaya Journal of Urology
Publisher : Department of Urology, Faculty of Medicine, Universitas Brawijaya

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.11594/bjurology.2022.003.01.1

Abstract

This article has been retracted by the publisher. ----------------------------------------------------------------------- This article has been retracted at the request of the Authors. The editors and authors have jointly made the decision to retract the paper. Reasonable effort should be made to remove references to this paper. ----------------------------------------------------------------------- Introduction. Bilateral synchronous Percutaneous Nephrolithotomy (PCNL) begins to be considered as an effective therapy as the staged PCNL for bilateral kidney stone treatment, but it remains to be an challenging procedure. Especially on bilateral obstruction patients that already developed severe hydronephrosis.Case. We present a case of a 49 years old male with flank pain on both sides continuously. From non- contrast abdominalCT-scan showed bilateral pyelum stone and bilateral severe hydronephrosis. From laboratory findings, the creatinine serum was 1,5 mg/dL and ureum serum was level 69,8 mg/dL. We performed bilateral synchronous PCNL in a prone position, and stone fragmentation with a pneumatic lithotripter. The operation lasted for about 2 hours with minimal amount of bleeding. After 5 months of follow-up, he already has no stone with normal ureum-creatinine level (0,77mg/dL; 43,7 mg/dL) and did not have any complaint.Conclusion. Bilateral synchronous PCNL is a safe choice to be done in order to treat bilateral pyelum stone, it can decrease length of stay, total cost therapy, and morbidity of the patient.
Clinical Risk Factors of Post Operative Complications in Hypospadias Repair Akmal Fawzi; Paksi Satyagraha; Besut Daryanto
Brawijaya Journal of Urology Vol. 3 No. 01 (2022): Brawijaya Journal of Urology
Publisher : Department of Urology, Faculty of Medicine, Universitas Brawijaya

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.11594/bjurology.2022.003.01.2

Abstract

Objectives. Failed hypospadias refers to any hypospadias repair that leads to complications or causes patient dissatisfaction. Many factors influence the occurrence of complications, therefore this study aims to determine what risk factors can cause complications after hypospadias surgery.Methods. The study was conducted retrospectively by collecting 78 data of hypospadias patients who underwent surgery in Saiful Anwar General Hospital medical record from January 2015 until June 2019. age at the time of surgery, location of the external urethral meatus, degree of chordee, previous surgery history, type of urinary diversion, presence of Urinary Tract Infection (UTI), how many stages of surgery were performed, the surgical technique used at each stage and the complication recorded and analyzed.Results. Hypospadias patients who underwent surgery were 78 patients. The mean patient age was 9.96 years SD ± 6.959. Most of the ages were 11-18 years old with 28 patients. The location of the external urethral meatus was mostly found proximal to the penis of 40 patients. 44 patients were accompanied by mild chordee. 10 patients had previously undergone hypospadias surgery. 16 patients suffered from significant urinary tract infections but had no symptoms. 60 patients were inserted urethral catheter placement after hypospadias surgery. The most surgical technique used in stage 1 hypospadias surgery is Tubularized Incised Plate (TIP) Urethroplasty. While the technique used in 2 stage hypospadias surgery was Dorsal onlay preputial graft followed by TIP Urethroplasty. Complications that occurred in 1 stage hypospadias surgery were urethrocutan fistule in 9 patients and chordee in 1 patient. In 2 stage hypospadias surgery 3 patients obtained urethrocutan fistules, 2 patients with scrotal abscess and 1 patient obtained graft shrinkage. Age at surgery, location of Meatus Urethrae Externus (MUE), presence of UTI and also the choice of urinary diversion type correlated with the presence of complications. (P=0,004, P=0,033, P=0,049, P=0,000).Conclusions. Our results suggest that the success of hypospadias surgery is associated with age at surgery, location of MUE, presence of UTI and also the choice of postoperative urinary diversion type.
Characteristic of Urethral Stone Patients in Tertiary Hospital, East Java Akmal Fawzi; Paksi Satyagraha; Besut Daryanto
Brawijaya Journal of Urology Vol. 3 No. 01 (2022): Brawijaya Journal of Urology
Publisher : Department of Urology, Faculty of Medicine, Universitas Brawijaya

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.11594/bjurology.2022.003.01.3

Abstract

Objectives. Urethral stone is uncommon with proportion < 2% of all urinary tract stones. The common symptom is urinary retention. Urethral stone therapy depends on the stone location and size. The aim from this research is to find out characteristic urethral stone patients.Methods. The study was conducted retrospectively by collecting data from Saiful Anwar General Hospital and urology medical records from January 2014-August 2017. There were a total of 59 patients with urethral stones.Results. Fifty nine patients were obtained with mean age 52±13.66 years old. The most common chief complaint is urinary retention in 47 patients (80%) with duration of retention between 1 hour and 3 days. Stone size is 1-2 cm in 36 patients (61%) and the largest stone is 6 cm. Anterior urethral stones were located in naviculare fossa in 24 patients (41%) and treated by dorsal meatotomy and meatoplasty. Posterior urethral stones were in 12 patients (20%) and treated by vesicolithotripsy. Anterior and posterior lubrication procedures have 33% and 60% successful rate. There were 27 patients who underwent vesicolithotripsy for further management. Urethrolitotomy and repair urethra was performed for 6 cm stone size.Conclusions. The most chief complaints are urinary retention in urethral stone patients. Most urethral stones were located in naviculare fossa with dorsal meatotomy and meatoplasty as the leading management of choice.
Peranan Ultrasonografi dalam Diagnosis Trauma Testis Rizqi, Putri; Erawati, Dini; Satyagraha, Paksi
Jurnal Klinik dan Riset Kesehatan Vol 1 No 2 (2022): Edisi Februari
Publisher : RSUD Dr. Saiful Anwar Province of East Java

Show Abstract | Download Original | Original Source | Check in Google Scholar | Full PDF (858.04 KB) | DOI: 10.11594/jk-risk.01.2.7

Abstract

External genitalia trauma is more common in men than women, especially in the age range of 15 & 40 years. This is due to the anatomical differences and the increase in the frequency of traffic accidents. The number of external genitalia trauma ranged from 33–66% of all urological cases. External genitalia trauma is most often caused by blunt trauma, one of which is testicular rupture. Testicular rupture refers to a tear in the tunica albuginea resulting in extrusion of testicular contents. Determining the appropriate examination procedure requires adequate physical examination and information about the mechanism of trauma to allow a good prognosis. Scrotal ultrasound (SUS) is the first choice of modality in the case of testicular injury with sensitivity in detecting testicular rupture up to 100%. In addition, the SUS examination procedure can be carried out immediately, non-radiatively, and non-invasively. The main ultrasound findings for testicular rupture include testicular heterogeneity, contour abnormalities, and a tear in the tunica albuginea. These findings can be used to determine the degree of testicular injury according to the AAST (American Association for the Surgery of Trauma), which can then be used to determine the definitive treatment management. We present a case of a 19-year-old male patient complaining of pain on his left testicle since 16 hours before hospital admission after a traffic accident. Physical examination revealed a scrotal hematoma, and nausea and vomiting were found. Ultrasound examination indicated extensive tearing of the left testicular structure according to AAST grade IV with complex hydrocele.
CONSERVATIVE MANAGEMENT PELVIC FRACTURE URETHRAL INJURY (PFUI) IN A GIRL: A CASE REPORT Sulistyanti, Rachma Fitri; Satyagraha, Paksi; Nurhadi, Pradana; Daryanto, Besut
Indonesian Journal of Urology Vol 30 No 3 (2023)
Publisher : Indonesian Urological Association

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.32421/juri.v30i3.905

Abstract

ABSTRACT Objective: This case report aims to describe a different approach of PFUI by conservative management that resulted in good outcome. Case(s) Presentation: A 7-year-old girl patient was brought to the emergency department after falling from public transportation diagnosed with suspicious urethral rupture, perineal rupture grade III, vertical-shear type pelvic-ring injury, laceration wound on the right lower leg, abrasion on the medial side left lower leg and urinary retention. The patient underwent percutaneous cystostomy, pelvic bandage, a perineal debridement and repair, a cystography, percutaneous vesicolithotripsy, cystostomy and synechiae incision. One year after the first admission it was planned for urethroplasty due to completely obliterated from antegrade and retrograde panendoscopy. Discussion: 8 months later urethroplasty was aborted because of an open bladder neck, a fistula at the anterior connected to the distal of the bladder neck with size of 3 mm. The patient was performed a silicon cystostomy catheter insertion for 6 weeks. At the time of evaluation, the fistula was closed, it was proven by Qmax uroflowmetry was 18ml/s with average flow: 9.8 ml/s, voiding volume: 90ml, flow time: 9s, voiding time: 9s, hesistance:1.5, and PVR:5.35 cc. Conclusion: In this case, it showed that conservative management could improve PFUI with satisfactory result, proved by good result of uroflowmetry. However, periodic evaluations must be carried out to follow the progress of the disease and the possibility of future complications including sexual function. Keywords: PFUI, girl, urethral rupture
Co-Authors A.A. Ketut Agung Cahyawan W Akmal Fawzi Basuki B. Purnomo Besut Daryanto Dhani, Fauzan Kurniawan Dicky Faizal Irnandi Erawati, Dini Gede Wirya Diptanala Putra Duarsa Gede Wirya Kusuma Duarsa Hanggara, Dian Sukma I Gusti Lanang Andi Suharibawa Ida Bagus Putra Pramana Kurnia Penta Seputra Kurnia Penta Seputra Kustono, Andri Muhammad Ilham Negara, Edvin Prawira Nikmatus Sholihah Nurhadi, Pradana Pradana Nurhadi Pradana Nurhadi Prasetyo Nugroho Purnomo, Athaya Febriantyo Rabbani, Ahmad Zahid Rahmat Husein Rizqi, Putri Soetojo Soetojo Sulistyanti, Rachma Fitri Tarmono Djojodimedjo Taufiq Nur Budaya