Caesar Khairul Wallad, Caesar Khairul
Department of Urology, Faculty of Medicine/Padjajaran University, Hasan Sadikin General Hospital, Bandung.

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THE EFFICACY OF NASOGASTRIC TUBE IN A LARGE BLOOD CLOT EVACUATION DURING CYSTOSCOPY Wallad, Caesar Khairul; Santoso, Jumadi; Adi, Kuncoro
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.v23i2.224

Abstract

Objective: In this study we introduce using nasogatric tube as an alternative to procure a safe and efficient way to remove large troublesome blood clots during cystoscopy procedure. Material & methods: We prospectively perform blood clot evacuation using nasogastric tube suction (NGT) on 21 patients in Hasan Sadikin GeneralHospital Bandung,within 6 months period. A 24 fr sheath and 16 fr NGT connected to suction unit with a 300 mmhg negative pressure was set. A repetitive back and forth technique was set in motion during the procedure. Cystoscopy time and NGT suction time was documented. Results: All patients were successfully managed with this method without complication during the procedure. The average time for clot removal was 5 minutes 8 seconds with average cystoscopy time was 20 minutes 12 seconds and average estimated blood clots volume was 483 grams. Conclusion: Evacuation using NGT suction is effective, safe and an efficient way to remove a large bothersome clots.
NORMATIVE DATA OF PENILE LENGTH ON CHILDREN AGE GROUPS WITH TANNER CLASSIFICATION IN HASAN SADIKIN HOSPITAL Wallad, Caesar Khairul; Sibarani, Jupiter; Tjahjodjati, Tjahjodjati
Indonesian Journal of Urology Vol 24 No 2 (2017)
Publisher : Indonesian Urological Association

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.32421/juri.v24i2.226

Abstract

Objective: It has been reported that normal value of penile length were varied among countries. Difference in race, ethnicity, genetics and nutrition plays a factor in penile length. Micropenis is an abnormality in which penile length were considered smaller in comparison of  a ‘normal penile length’. There are published article in Asia and Europe in terms of local penile length figures unfortunately none in West Java. This study was aim to establish local data as a reference in order to define micropenis. Material & method: All subjects in pediatric outpatient clinics were collected with cross sectional method. Exclusion criteria includes: congenital penile disease (hypospadias, burried penis, chordee, fistulas, webbed, etc), history of hormonal therapy, malnourished, and congenital syndromes. Subjects will undergone examination of stretched penile length. Results: A total of 276 children were included in the study with 23 subjects in each Tanner groups. The average penile length in Hasan Sadikin Hospital were inferior in all groups in contrast with the Tanner age groups as cited in table 1. Conclusion: Normative local data of penile length is necessary. Not using the local reference may result in underestimation and overdiagnosis.
SIMULTANEOUS BILATERAL UPPER URINARY TRACT UROTHELIAL CARCINOMA (UTUC) WITH LEFT NEPHROURETERECTOMY AND RIGHT ILEOURETERAL REPLACEMENT: A CASE REPORT OF CURATIVE APPROACH Effendi, Rudini; Hudaya, Syamsu; Wallad, Caesar Khairul
Indonesian Journal of Urology Vol 31 No 3 (2024)
Publisher : Indonesian Urological Association

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.32421/juri.v31i3.867

Abstract

Objective: The report aims to present a rare bilateral UTUC focusing on diagnostic and surgical treatment to improve the survival rate of patients with bilateral UTUC. Case(s) Presentation: We present a case report of a 59-year-old male who came in with gross hematuria accompanied with clots. Laboratory reveals a decreased renal function, while CT shows a bilateral mass in both ureters and left renal pelvis without bladder involvement. The patient then underwent left nephroureterectomy and right ureterectomy. In Intraoperative we preserve the right kidney by evaluating the tumor margin using ultrasound and ureteroscopy and deciding to substitute a full-length ureter with ileum as a precaution for a safety margin. Later on the pathological examination shown high-grade invasive urothelial cell carcinoma on both sides with staging pT2N0M0. Six months after surgery patient is in an excellent condition; weight and karnofsky score improvement. The Baseline Creatinin level was decreased, whereas CT showed no residual tumor in the right urinary tract system. Discussion: This article presents a rare case of bilateral UTUC with staging pT2N0M0 that was successfully treated with multidisciplinary care of radical and reconstructive surgery without chemotherapy. Conclusion: Bilateral UTUC is a scarce case, even among all urologic malignancies. Preserving kidney function in these cases is a priority to reduce further morbidity for the patient. Keywords: Bilateral UTUC, nephroureterectomy, ileoureteral replacement.
ALLIUM STENT IN EXTENSIVE URETERAL STENOSIS: LESSON LEARNED FROM ITS FIRST OFF LABEL USED IN INDONESIA Nainggolan, Ebram; Hudaya, Syamsu; Wallad, Caesar Khairul; Firdianto; Rahman, Fakhri
Indonesian Journal of Urology Vol 31 No 3 (2024)
Publisher : Indonesian Urological Association

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.32421/juri.v31i3.907

Abstract

Objective: This study aims to determine the use of allium stents for ureteral stenosis. Case(s) Presentation: This study reported a case of 50-year-old-male with right ureteral stenosis that underwent allium installation, the first ever used in Indonesia. Discussion: . Long-term ureteral stenting is commonly used when major surgery is not an option for patients. Metallic stents offer an alternative method to address the blockage in a single procedure, without the risk of issues like tissue erosion, infection, or tube encrustation. The design of the Allium stent ensures that the ureter remains open by providing direct support to the walls, resulting in better dilation compared to the double-J stent. In this study, the patient who received an Allium stent could benefit from its use. The stent has shown effectiveness in treating ureteral stenosis, relieving bothersome urinary symptoms, and reducing the need for frequent visits to the operating room for JJ stent replacement. Conclusion: Allium stents improve quality of life in patients with irritative symptoms from JJ stents, reducing Re-operations of JJ insertion, and hospital stay. Keywords: Ureteral stenosis, allium stent, Indonesia.
EVALUATION OF STENOSIS AFTER LAPAROSCOPIC URETEROLITHOTOMY Andrea Putra, Aze; Wallad, Caesar Khairul; Umran, Amrizal; Hudaya, Syamsu; Hutasoit, Yonas Imanuel
Indonesian Journal of Urology Vol 32 No 1 (2025)
Publisher : Indonesian Urological Association

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.32421/juri.v32i1.899

Abstract

Objective: This study aims to evaluate the probability of stenosis that occurs in the ureter due to the use of electrocautery during ureteral incision procedures in Laparoscopic ureterolithotomy (LU). Material & Methods: This study was conducted in Fatmawati Hospital Jakarta, we collected the data retrospectively in 22 patients diagnosed with ureteral stones who underwent LU procedure from 2014 to 2021, are eligible and have completed the follow-up protocol. The patient was evaluated by assessing the condition of the kidney after the procedure using ultrasound and CT scan to evaluate the presence of ureteral stenosis. Result: Ureteral stenosis was found in 6 of 22 patients (27.3%). Median follow-up time was 45 months (3-4 years). All of them were asymptomatic. Conclusion: There is a 27.3% chance patient will develop ureteral stenosis after LU. Though LU is one of the best methods for extracting large ureteral stone, the late complication after LU should be considered. Keywords: Electrocautery, laparoscopy ureterolithotomy, ureteral stenosis.