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LATERAL PERCUTANEOUS NEPHROLITHOTOMY: A CASE SERIES Wijayanti, Zola; Vijay Pramod, Sawkar
Indonesian Journal of Urology Vol 27 No 2 (2020)
Publisher : Indonesian Urological Association

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.32421/juri.v27i2.580

Objective: To report our experience on lateral PCNL in the management of complex kidney stone in patients with many morbidities. Case(s) Presentation: In our hospital, there were 2 cases of incomplete stone clearance after PCNL which underwent lateral PCNL. The first case was a 47 years old woman who was morbidly obese and some cardiac problems such as coronary artery disease (CAD) and arrhythmia. Her intravenous pyelography shows that she has incomplete double collecting system with kidney stone in her upper moiety. She underwent PCNL in supine position which was halted due to arrhythmia with rest stone on her upper moiety system. The second case was a 57 years old male with multiple right kidney stone with hydronephrosis in his upper calyceal system. He has some comorbidities such as obese and CAD. He had history of open kidney surgery and right PCNL. Due to incomplete stone clearance after first procedure and some morbidities of those patients, we decided to perform PCNL on lateral position of both cases. The surgery went successfully with duration of 100 minutes in average with less than 100cc of blood loss. Both of the patients were discharged on second operation day without any complication. Discussion: Positioning for the patient who undergo PCNL is important. The lateral position of PCNL is useful in morbid obesity and have least effect on cardiac and respiratory function. This technique proved to increase patient comfort and safety. Conclusion: Lateral PCNL is safe and effective procedure to treat kidney stone in patients with history of incomplete stone clearance after supine or prone PCNL. It also can be performed safely in patients with comorbidities.

LATERAL PERCUTANEOUS NEPHROLITHOTOMY: A CASE SERIES Wijayanti, Zola; Vijay Pramod, Sawkar
Indonesian Journal of Urology Vol 27 No 2 (2020)
Publisher : Indonesian Urological Association

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.32421/juri.v27i2.580

Objective: To report our experience on lateral PCNL in the management of complex kidney stone in patients with many morbidities. Case(s) Presentation: In our hospital, there were 2 cases of incomplete stone clearance after PCNL which underwent lateral PCNL. The first case was a 47 years old woman who was morbidly obese and some cardiac problems such as coronary artery disease (CAD) and arrhythmia. Her intravenous pyelography shows that she has incomplete double collecting system with kidney stone in her upper moiety. She underwent PCNL in supine position which was halted due to arrhythmia with rest stone on her upper moiety system. The second case was a 57 years old male with multiple right kidney stone with hydronephrosis in his upper calyceal system. He has some comorbidities such as obese and CAD. He had history of open kidney surgery and right PCNL. Due to incomplete stone clearance after first procedure and some morbidities of those patients, we decided to perform PCNL on lateral position of both cases. The surgery went successfully with duration of 100 minutes in average with less than 100cc of blood loss. Both of the patients were discharged on second operation day without any complication. Discussion: Positioning for the patient who undergo PCNL is important. The lateral position of PCNL is useful in morbid obesity and have least effect on cardiac and respiratory function. This technique proved to increase patient comfort and safety. Conclusion: Lateral PCNL is safe and effective procedure to treat kidney stone in patients with history of incomplete stone clearance after supine or prone PCNL. It also can be performed safely in patients with comorbidities.

TEN YEARS EXPERIENCE IN MANAGEMENT OF BLADDER TRAUMA AT TERTIARY HOSPITAL IN WEST JAVA INDONESIA Indra Firdaus, Gugum; Wijayanti, Zola; Mustafa, Akhmad; Adi, Kuncoro
Indonesian Journal of Urology Vol 31 No 1 (2024)
Publisher : Indonesian Urological Association

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.32421/juri.v31i1.834

Objective: The aim of this study is to provide the characteristics, management, and outcome of bladder trauma at the center of trauma referral hospital in West Java, Indonesia. Material & Methods: This is a retrospective and descriptive study. The data of bladder trauma were collected from the medical records from January 2010 to December 2019. The data were presented using descriptive statistics in frequency and percentage. Results: Over a ten-year period, there were 1,174 cases of urogenital trauma, with 170 cases (14.48%) involving bladder injuries. The majority of the was 21-30 years old and were men (55.88%). The most common cause was blunt abdominal trauma (68.82%), which was caused by traffic accidents (91.45%). With 42.24% pelvic fracture as the most common associated injury. The most common type of bladder injury (45.88%) was bladder contusion. Iatrogenic trauma was the second leading causes (29.42%) with obstetrics and gynecology operations accounted for 84% of iatrogenic bladder trauma cases. The majority of bladder injuries were identified using a computed tomography (CT) scan. In 59.41% of cases, surgical intervention was required. The mortality rate was 2.94% during post-operative treatment due to coexisting or associated multiple injuries. Conclusion: We discovered that bladder trauma most commonly affects males of reproductive age with blunt abdominal trauma as the most common etiology and pelvic fractures as the most common associated injury. Surgical intervention often was required. Keywords: Bladder injury, blunt abdominal trauma, iatrogenic bladder injury.

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

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.

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