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All Journal Indonesian Journal of Urology Medica Hospitalia Diponegoro International Medical Journal (DIMJ)
Nanda Daniswara, Nanda
Department of Urology, Faculty of Medicine/Padjajaran University, Hasan Sadikin General Hospital, Bandung.
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INITIAL EXPERIENCE OF LAPAROSCOPIC PARTIAL NEPHRECTOMY IN HASAN SADIKIN GENERAL HOSPITAL BANDUNG Daniswara, Nanda; Pramod, Sawkar Vijay; Sibarani, Jupiter; Safriadi, Ferry
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.v23i1.204

Abstract

Objective: To describe our experience about laparoscopic partial nephrectomy to treat localized renal tumour patients in Urology Department Hasan Sadikin General Hospital Bandung. Material & method: In 2014, there were 6 female patients that underwent laparoscopic partial nephrectomy in Hasan Sadikin General Hospital Bandung. In one case, there were tumours on both kidneys. Five patients were underwent transperitoneal approach and 1 patient were undergo retroperitoneal approach. All patients were examined with ultrasonography and Abdominal CT scan with contrast. We also calculate RENAL nephrometry score. Results: There were 6 female patients with left flank pain that undergo laparoscopic partial nephrectomy. In one case, there are tumours on both kidneys. In RENAL nephrometry score calculation, there were 3 patients with 10x score, 1 patient with 11x score, 1 patient with 7x score, and 1 patient with 6p score. From all of them, 4 patients were successfully performed laparoscopic partial nephrectomy, 1 patients was undergo laparoscopic nephrectomyand 1 patient is converted to open partial nephrectomy. Five patients were undergo transperitoneal approach and 1 patient was undergo retroperitoneal approach. Surgery ranged from 180-240 minutes. Intra operative bleeding was ranged from 50-200 cc. Tramadol intravenous was used for post operative pain control. With VAS score in first post operative day was 6, and 2 at the time of discharge. Hospitalized time was ranged from 4-6 days. Conclusion: Laparoscopic partial nephrectomy is an alternative treatment that safe for localized renal tumour. This procedure is depend on the technique and approach from each Urologist. Our limitations are we didn’t have laparoscopic ultrasonography and the tumour close to pelvocalyces system.
RETROPERITONEAL LAPAROSCOPIC DISMEMBERED PYELOPLASTY FOR URETEROPELVIC JUNCTION OBSTRUCTION (UPJO) Daniswara, Nanda; Sibarani, Jupiter
Indonesian Journal of Urology Vol 24 No 1 (2017)
Publisher : Indonesian Urological Association

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.32421/juri.v24i1.321

Abstract

Objective: To share our experience of retroperitoneal laparoscopic dismembered pyeloplasty as the treatment of Ureteropelvic Junction Obstruction (UPJO) in Department of Urology, Hasan Sadikin Hospital Bandung. Material & Methods: Boy 8 years old came for a chance to relieve mass at both flank region especially at left flank region. From the ultrasonography there were bilateral hydronephrosis. We decided to urethrocystoscopy, bilateral ureteral catether insertion, bilateral retrograd pyelography guided with c-arm and left retroperitoneal laparoscopic dismembered pyeloplasty. Results: Operative time was 240 minutes and blood loss was about 200cc. Double J Stent was used for ureteral stenting. Parenteral ketorolac was given as needed to control the pain. The Visual Analogue Scale (VAS) post operative day 1 until 4 were6, 4,, 2, 2 respectively. Urethral catheter was removed at post operative day 2 and drain was removed at post operative day 3. Operating wound was good. Patient was hospitalization until post operative day 4. Left nephrostomy was removed at postoperative day 7 after there was no leakage, confirmed with left antegrad pyelography. From post operative ultrasonography we found that hydronephrosis at left kidney became almost normal. Conclusion: In our opinion that the retroperitoneal laparoscopic dismembered pyeloplasty is an alternative treatment for UPJO. This procedure depends on experience and pristine surgical tehnique from the surgeon
MALE URETHRAL STRICTURE CHARACTERISTIC IN DR KARIADI GENERAL HOSPITAL SEMARANG: A DESCRIPTIVE STUDY Parulian Pasaribu, Erwin; Daniswara, Nanda; Santosa, Ardy; Agung Nugroho, Eriawan; Soedarso, M. Adi; Rais Adin, Sofyan
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.v28i2.690

Abstract

Objective: This research was conducted to describe male urethral stricture characteristic in Kariadi General Hospital Semarang. Material & Methods: The data is collected retrospectively from the male urethral stricture patient medical records Kariadi General Hospital Semarang between January 2013 until December 2017. The data is analyzed descriptively to describe the characteristics of male urethral stricture patients, patient age, etiology, site, definitive surgery, and complications. Results: Within the period, 171 patients with male urethral stricture. The mean age was 52.11 years (range 9-86). The causes of stricture were trauma in 145 patients (84.8%), infection in 25 patients (14.6%) and iatrogenic in 1 patients (0.06%). Strictures site were posterior in 146 patients (85.4%) and anterior in 25 patients (14.6%). The definitive surgery for strictures were from DVIU in 132 patients (77.2%) and urethroplasty in 39 patients (22.8%). Complications rate were recurrence of stricture 56 patients (32.74%), bleeding 6 patients (3.05%), extravasation 14 patients (8.18%), erectile dysfunction 4 patients (2.34%). Conclusion: Trauma is the leading cause of urethral stricture in Kariadi General Hospital. The most common definitive therapy for urethral stricture in Kariadi General Hospital was still DVIU, but there has been an increase for urethroplasty and we still get the learning curve for it.
Hubungan antara Total Waktu Iskemik pada Transplan Ginjal dengan Lama Perawatan di Rumah Sakit: A Single Center Report Nugroho, Eriawan Agung; Kamar, Muhamad Azwin; Santosa, Ardy; Daniswara, Nanda; Addin, Sofyan Rais
Medica Hospitalia : Journal of Clinical Medicine Vol. 7 No. 1 (2020): Med Hosp
Publisher : RSUP Dr. Kariadi

Show Abstract | Download Original | Original Source | Check in Google Scholar | Full PDF (279.269 KB) | DOI: 10.36408/mhjcm.v7i1.426

Abstract

Latar Belakang : Transplantasi ginjal diakui sebagai kemajuan utama pengobatan modern yang memberikan kehidupan berkualitas tinggi kepada pasien penyakit ginjal stadium akhir (End Stage Renal Disease). Waktu iskemik dingin /Cold Ischemic Time (CIT) telah ditemukan sebagai faktor risiko independen yang penting untuk delay graft function (DGF) pada transplantasi ginjal. Terdapat informasi terbaru bahwa waktu iskemik hangat /Warm Ischemic Time (WIT) yang lama dapat mengurangi kelangsungan hidup graft dalam donor hidup transplantasi ginjal. Tujuan dari penelitian ini adalah untuk mengevaluasi hubungan total ischemik time selama operasi penerima dengan lama rawat inap. Metode : Penelitian ini merupkaan studi observational-cross sectional. Data didapatkan dari catatan medis pasien yang telah menjalani transplantasi ginjal dari Januari 2014 – Desember 2018 du RS Umum dr. Kariadi semarang. Terdapat 28 pasien, 18 diantaranya adalah laki-laki dan 10 adalah wanita. Data total waktu iskemik dibandingkan dengan lamanya rawat inap. Data dianalisa dengan tes Spearman menggunakan software SPSS versi 23. Hasil : Pada studi ini menunjukkan adanya korelasi yang signifikan antara total waktu iskemik dengan lama perawatan di rumah sakit (p<0.001). Akan tetapi, umur donor tidak mempengaruhi total waktu iskemik (p=0.673), tidak signifikan (signifikan jika p<0.005). Simpulan : Adanya hubungan yang signifikan antara total waktu iskemik dengan lama perawatan rumah sakit. Namun, tidak ditemukannya hubungan yang signifikan pada usia donor dan total waktu iskemik. Kata kunci: total waktu iskemik, lama perawatan, transplantasi ginjal Background: Kidney transplantation is recognized as an advanced modern therapeutic modality, providing a better life for patients with end stage renal failure globally. Cold Ischemic Time (CIT) has been found as an important independent risk factor for delay graft function (DGF) in kidney transplantation. DGF also associated with patient’s survival post-operatively. Recent studies suggested that prolonged Warm Ischemic Time (WIT) may decrease graft’s survival in living kidney transplantation donor. This study aimed to evaluate the total ischemic time during recipient surgery and accessed its contribution for hospitalization time in kidney transplantation patients. Methods: This is a descriptive retrospective study. This study was started in 2014 until December 2018, including data from patients’ medical record whom underwent kidney transplantation in Kariadi General Hospital Semarang. Data was collected from 28 patients, including 18 male patients and 10 female patients. The author found a significant correlation between patient’s age and total ischemic time. Total ischemic time also compared with hospitalization time. Data was processed using Spearman test in SPSS software. Results: Based on Spearman test, Total ischemic time was significantly correlated with hospitalization time (p < 0.001). However, donor’s age did not affect prolonged total ischemic time with p = 0.673, which is not significant (significant if p value < 0.05). Conclusion: Total ischemic time has a significant correlation with hospitalization time. In contrary, no significant correlation between donor’s age and prolonged total ischemic time. Key Words: Total ischemic time, hospitalization time, kidney transplantation
A Malignant Melanoma of the Penile : A Very Rare Case Report and Literature Review Wijaya, Yanuar Hendra; Daniswara, Nanda; Santosa, Ardy; Soedarso, Mohamad Adi; Nugroho, Eriawan Agung; Addin, Sofyan Rais
Medica Hospitalia : Journal of Clinical Medicine Vol. 8 No. 1 (2021): Med Hosp
Publisher : RSUP Dr. Kariadi

Show Abstract | Download Original | Original Source | Check in Google Scholar | Full PDF (365.521 KB) | DOI: 10.36408/mhjcm.v8i1.576

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Background: Malignant melanoma of the penis is very rare, accounting for approximately 1.4% of all primary penile carcinomas. With a small prevalence of penile melanoma, there is lack of data about quality of the therapy. The primary treatment of melanoma of the penile is surgical, although there is a lack of consensus regarding the extent of treatment that is indicated. Case Report: A 60-year-old Caucasian man came to Division of Urology, Department of Surgery, Dr. Kariadi General Hospital Semarang with chief complaint painless and fast growing lesions on his penile. His general condition was fine, and has a normal vital signs. On the physical examination of penile region, there were found lesions on the ventral of the glans and penile foreskin and covered with blood and pus, with bilateral inguinal lymph nodes and lung metastasis from Multi Slice Computed Tomography. We already performed partial penectomy and bilateral inguinal lymph nodes dissection with histopathological results a malignant melanoma Clark IV. The final stage of penile melanoma was pT2N1M1. We follow-up the patient until 1 year after procedure, and there wasn’t any recurrence. Conclusion: Malignant melanoma of the penis is rare. Penile melanoma is highly treatable with surgical excision in its early stages because of resistant to both chemotherapy and radiotherapy. Delay in diagnosed and surgical treatment can lead to an adverse prognosis. The anamnesis, physical examination, and imaging studies must be done appropriately to improve the survival.
Seorang Pasien dengan Batu Staghorn Bilateral dan Spondilitis Ankilosis : Laporan Kasus Langka Chandra, Sibin; Addin, Sofyan Rais; Santosa, Ardy; Nugroho, Eriawan Agung; Soedarso, Mohamad Adi; Wibisono, Dimas Sindhu; Daniswara, Nanda
Medica Hospitalia : Journal of Clinical Medicine Vol. 8 No. 2 (2021): Med Hosp
Publisher : RSUP Dr. Kariadi

Show Abstract | Download Original | Original Source | Check in Google Scholar | Full PDF (401.198 KB) | DOI: 10.36408/mhjcm.v8i2.607

Abstract

Latar Belakang : Spondilitis ankilosis merupakan penyakit peradangan sendi yang bisa mempengaruhi tulang-tulang axial yang dapat menyebabkan nyeri sendi, dan dapat berlanjut kepada penyatuan dari tulang belakang1. Prevalensi penyakit ini diperkirakan mencapai 16,7 dari 10.000 orang di daerah Asia.2 Meskipun penyakit ini utamanya menyerang sendi, tetapi dilaporkan pula bahwa terdapat kasus manifestasi ekstraartikuler seperti halnya nefrolitiasis. Nefrolitiasis menyumbang sekitar 13,6% dari penderita spondilitis ankylosis.3 Kasus Nefrolithiasis Staghorn sinistra dengan spondilitis ankilosis pernah dilaporkan, tetapi belum pernah dengan kasus nefrolithiasis staghorn bilateral4 Tujuan studi kasus ini adalah untuk mengetahui diagnosis dan tatalaksana spondilitis ankilosis dan nefrolitiasis staghorn bilateral. Presentasi Kasus : Seorang pria berumur 38 tahun datang dengan keluhan nyeri hilang timbul pada pinggang sebelah kiri. Pasien sebelumnya telah didiagnosis dengan spondilitis ankilosis dan nefrolitiasis bilateral dekstra dan sinistra serta telah menjalani operasi Percutaneous Nephrolithotomy dekstra pada bulan Juni 2018. Pada pemeriksaan didapatkan keterbatasan gerak sendi tulang belakang dan nyeri ketok kostovertebra di sebelah kanan dan kiri. Dari pemeriksaan foto polos didapatkan gambaran batu staghorn bilateral Kesimpulan : Pasien didiagnosis dengan spondilitis ankilosis dan nefrolitiasis staghorn bilateral. Prosedur penegakan diagnosis melalui anamnesis, pemeriksaan fisik dan pemeriksaan penunjang perlu dilakukan dengan tepat untuk menghindarai kesalahan diagnosa. Penatalaksanaan nefrolitiasis perlu memperhatikan banyak aspek seperti ukuran batu, ketersediaan sarana dan prasarana, serta mobilitas pasien, supaya dicapai tingkat kesembuhan yang tinggi.
Polip Fibroepithelial di Leher Kandung Kemih Pada Anak : Laporan kasus Addin, Sofyan Rais; Nugroho, Eriawan Agung; Sudarso, M. Adi; Santosa, Ardy; Daniswara, Nanda; Muhammad, Krisna; Sugiharto, Jonathan
Medica Hospitalia : Journal of Clinical Medicine Vol. 8 No. 3 (2021): Med Hosp
Publisher : RSUP Dr. Kariadi

Show Abstract | Download Original | Original Source | Check in Google Scholar | Full PDF (312.938 KB) | DOI: 10.36408/mhjcm.v8i3.675

Abstract

Latar Belakang : Fibroepithelial polyps (FEP) adalah tumor jinak non-epitel yang sangat jarang yang berasal dari mesodermal di sistem perkemihan. Insidensi FEP tersering pada Dewasa muda (40%). Sebagian besar FEP ditemui di ureter distal, 15% terletak di pelvis renalis; FEP lebih jarang ditemukan di uretra, kandung kemih, dan ureter proksimal. Polip dengan fitur ini jarang ditemukan pada anak-anak. Kasus ini diharapkan dapat menjadi gambaran untuk menangani kasus FEP terutama bila predileksi di vesika urinaria. Laporan Kasus : seorang anak umur dua tahun dengan keluhan sulit buang air kecil disertai nyeri. Pasien pernah mengeluh buang air kecil disertai darah. Dilakukan pemeriksaan ultrasonography pada lower abdomen didapatkan massa dan hidronefrosis bilateral. Pasien dilakukan cystoscopy dengan pengambilan sampel biopsi. Hasil patologi anatomi menunjukan gambaran FEP. Diskusi :. Kasus tumor vesica urinaria primer jinak jarang ditemukan dan di antara tumor jinak vesica urinaria, polip fibroepitel dianggap sebagai lesi yang paling umum. Guideline konsensus dalam tatalaksana manajemen optimal tumor FEP masih jarang, saat ini eksisi melalui cystoscopy paling sering digunakan. Modalitas baru dengan menggunakan Laser baik Thalium maupun Holmium. Kesimpulan : FEP merupakan penyakit yang jarang prevalensinya tetapi tetap menjadi diferensial diagnosis pada pasien anak dengan nyeri pinggang dan hematuria.prosedur endoskopik sebagai modalitas penatalaksaan pilihan utama pada pasien FEB.
Efektivitas Diversi Urin pada Pasien Kanker Serviks di Rumah Sakit Tersier Semarang Nugroho, Eriawan Agung; Setyasworo, Singgeh; Simangunsong, Ragam Pesona; Listiyanto, Yandhi Ari; Yudha, Fajar Gemilang Purna; Santosa, Ardy; Soedarso, Moh Adi; Wibisono, Dimas Sindhu; Daniswara, Nanda; Addin, Sofyan Rais
Medica Hospitalia : Journal of Clinical Medicine Vol. 10 No. 1 (2023): Med Hosp
Publisher : RSUP Dr. Kariadi

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.36408/mhjcm.v10i1.847

Abstract

BACKGROUND: Obstructive uropathy and hydronephrosis are common complications of cervical cancer. In order to provide an alternative route due to ureteral obstruction, urinary diversion was performed. Urinary diversion procedures are a therapeutic option for obstructive uropathy but their effectiveness is remain unclear. There is limited data that support urinary diversion as a treatment of ureteral obstruction to improve overall survival and progression-free survival. AIM:  To determine the effectiveness of urinary diversion in the treatment of obstructive uropathy in cervical cancer patients. METHOD: This study is a cross sectional involved cervical cancer patients with symptoms of obstructive uropathy. Data were obtained from medical records and limited to patients admitted from May, 2020 to May, 2021. Primary outcome was urea level, creatinine level, stage of hydronephrosis and overall survival rate of patients. RESULT: A total of 100 patients were included in the study. In both groups, the mean age of study subjects was 52-53 years with stage IIIB being the most widely reported. There was an improvement in post creatinine in the urinary diversion group. There was a significant difference in post creatinine levels between the non-urine diversion and urinary diversion groups (p=0.039).The 12-month survival rate, in the non-urinary diversion group had a value of 86% while the urinary diversion group had a value of 94%. CONCLUSION: This study shows that urinary diversion procedure is effective in increasing the renal function and increasing the 12-month survival of cervical cancer patients with obstructive uropathy.
Incident Rate of Vesicovaginal Fistula at Dr. Kariadi General Hospital Semarang in 2022 Zunaidhi Bahar, Rully; Arya Putra, Aditya; Agung Nugroho, Eriawan; Wiryawan Cahyono, Chemmy; Erwinanto, Erwinanto; Santosa, Ardy; Sindhu Wibisono, Dimas; Daniswara, Nanda; Rais Addin, Sofyan
Diponegoro International Medical Journal Vol 4, No 2 (2023): December 2023
Publisher : Faculty of Medicine, Diponegoro University

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.14710/dimj.v4i2.17873

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Background: Vesicovaginal fistula (VVF) is an abnormal connection between the vesicourinaria and the vagina which causes urine to continuously leak through the vagina. The etiology of VVF fistulas has changed from being obstetric to being more hysterectomy related. While management is as early as possible appropriately and prevents further complications that can occur. Aim: Analyzing the comparison of the characteristics of patients with VVF at Dr. Kariadi General Hospital Semarang in 2022.Methods: The study design in this study was a retrospective descriptive observational study. Results: During the period from 3 January to 30 December 2022, 20 patients were found with VVF. Based on the data obtained, the average age of the patients was 39.4 years. Parity in the study subjects consisted of 2 nulliparas (10%), 5 primiparas (25%) and 13 multiparas (65%). Types of fistulas in patients included 14 fistulas after gynecological surgery (70%), 4 fistulas after caesarean section (20%), 1 fistula after radiotherapy (5%) and 1 fistula after trauma (5%). Conclusion: VVF incident in Dr. Kariadi General Hospital Semarang in 2022 were 20 cases with the majority of fistula types after gynecological surgery as many as 14 cases.  
Case Report: Early Recognition and Repair of Distal Iatrogenic Ureteral Injury During Laparoscopic Rectal Surgery Mughni, Abdul; Fuadi, Ahmad Fathi; Daniswara, Nanda
Diponegoro International Medical Journal Vol 2, No 2 (2021): December
Publisher : Faculty of Medicine, Diponegoro University

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.14710/dimj.v2i2.12259

Abstract

Background: Ureteral injury is an uncommon complication of the colorectal procedure. The colorectal procedure is the second most common cause of ureteral injury. The laparoscopic approach for colorectal surgery has contributed to the increase of ureteral injury. Delayed diagnosis of the iatrogenic ureteral injury is associated with higher morbidity. However, the early diagnosis of ureteral injury during the operation is difficult. We presented an early recognition and laparoscopic repair of iatrogenic ureteral injury during laparoscopic rectal cancer surgery cases and the strategy for recognizing and managing that injury for the surgeon.Case Presentation: A Male, 34 years old, had an iatrogenic ureteral injury during laparoscopic low anterior resection for rectal cancer. The left distal ureter was transected by an energy device. The diagnosis of ureteral injury was prompt. The repair of the ureter was done endo-laparoscopically. The patient had an uneventful recovery and was discharged on day 6 after surgery.Conclusion: The iatrogenic ureteral injury, although uncommon, is a serious complication of laparoscopic colorectal surgery. Direct visual identification of the distal ureter is mandatory in every rectal surgery. The iatrogenic ureteral injury is not an indication for open conversion when there is an adequate resource to do the endo-laparoscopic ureteral repair.
Co-Authors Abdul Mughni Addin, Sofyan Rais Agung Nugroho, Eriawan Ardy Santosa Arya Putra, Aditya Chandra, Sibin Dimas Sindhu Wibisono Eriawan Agung Nugroho, Eriawan Agung Erwinanto, Erwinanto Ferry Safriadi Fuadi, Ahmad Fathi Jupiter Sibarani Kamar, Muhamad Azwin Krisna Muhammad, Krisna Listiyanto, Yandhi Ari Parulian Pasaribu, Erwin Rais Addin, Sofyan Rais Adin, Sofyan Sawkar Vijay Pramod Setyasworo, Singgeh Simangunsong, Ragam Pesona Sindhu Wibisono, Dimas Soedarso, M. Adi Soedarso, Moh Adi Soedarso, Mohamad Adi Sudarso, M. Adi Sugiharto, Jonathan Wijaya, Yanuar Hendra Wiryawan Cahyono, Chemmy Yudha, Fajar Gemilang Purna Zunaidhi Bahar, Rully