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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

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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.

Comparison Between Gemcitabine-Cisplatin Chemotherapy Outcome and Body Mass Index in Muscle Invasive Bladder Cancer Patients At Dr. Saiful Anwar General Hospital Malang, Indonesia Kurnia Penta Seputra; Besut Daryanto; Astarin Ardiani
Brawijaya Journal of Urology Vol. 1 No. 01 (2020): Brawijaya Journal of Urology
Publisher : Department of Urology, Faculty of Medicine, Universitas Brawijaya

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Introduction: Malignancy remain a worldwide challenge to overcome, one of the most common malignancy in men is bladder cancer, it represent the seventh most common cause of cancer in men worldwide. Over the past decade 6978 Indonesian were diagnosed with bladder cancer. In Dr. Saiful Anwar Hospital itself, 287 inpatient were hospitalized due to bladder cancer over the past 5 years. Bladder cancer therapy including, radical cystectomy, radiotherapy and chemotherapy depending on the tumor’s stage. Patients requiring chemotherapy, are given six course of Gemcitabine-Cisplatin regiment. Body Mass Index (BMI) acclaimed to take part in cancer treatment outcome, therefore this study aimed to compared body mass index with bladder tumor outcome in bladder cancer patients receiving six course of Gemcitabine-Cisplatin chemotherapy. Method: Fifteen bladder cancer patients with different BMI underwent (transurethral resection of bladder tumor) TURBT staging and received six course of Gemcitabine-Cisplatin Chemotherapy from 2016 to 2018 at Dr. Saiful Anwar General Hospital were recorded, we followed the patients during the six course of chemotherapy and evaluation were carried out using cystoscopy and bladder biopsy. The data then analysed using chi square and t-test to compared. Result: Fifteen patients were eligible for this study, 10 were men and 5 were women. Mean age is 66.6 years old, body mass index (BMI) include normal weight (73.3%), underweight (6.67%), overweight(13.3%) and obese (6.67%). Pathology finding including Transitional Cell Carcinoma of high grade (46,7%) and low grade (53.3%). Tumor staging start from T2 (26.67%), T3 (6.67%) and T4 (66.66%). Three patients had metastatic tumor to the liver, liver and lung and rectum respectively. Lymph node involvement were N0 40%(6),N1 33.3% (5) N2 20%(3) and N3 6.7% (1) continuously. Out of fifteen patients who underwent Gemcitabine-Cisplatin chemotherapy for six series, tumor outcome after therapy was compared with the BMI. Tumor still remain in 11 patient (73.3%), while 4 (26.7%) patients were found to be tumor free after six course of Gemcitabine-Cisplatin chemotherapy. There is no statistically significant between body mass index and chemotherapy success rate (p= 0.159) in this study. Although. there were statistically significant found in the presence of tumor before and after Gemcitabine-Cisplatin chemotherapy (p= 0.041). There are no statistically significant between sex and age when compared to chemotherapy outcome with (p=0.446) and (p=0.469) respectively. Conclusion: Body Mass Index has no relation in determining success rate of bladder cancer chemotherapy using Gemcitabine-Cisplatin.

Urine Metabolite Risk Factors of DJ Stent’s Biofilm Formation in Patients with Urinary Tract Stones Besut Daryanto; Muhammad Miftahul Firdaus
Brawijaya Journal of Urology Vol. 1 No. 01 (2020): Brawijaya Journal of Urology
Publisher : Department of Urology, Faculty of Medicine, Universitas Brawijaya

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Introduction: Since first introduced by Finney and Hepperlen in 1978, the Double-J "DJ" Stent has become a routine armament that every Urologist uses everyday. Over time, there have been developments and improvements in both designs and materials, in order to improve the efficacy of the stents themselves. The use of the DJ Stent can not be separated from the morbidity or complications that might occur, including discomfort arising from the insertion of stents, forgotten to remove, urinary tract infections, biofilm formation, even encrustation of the stent. This research aims to know the correlation between the urine metabolites condition and urinary tract infection in the formation of biofilm and encrustation in patients with urinary tract stones at Saiful Anwar General Hospital, Malang. Method: This is a cohort study using chi-square analysis and relative risk calculation. The datas were obtained from patients at Saiful Anwar General Hospital from March 2016 until December 2017. The examination includes urine metabolites, urinalysis, and urine culture prior to the insertion of DJ Stent, at polyclinic, and before the removal of DJ Stent. After the DJ Stent was removed, we evaluate if there was an encrustation on the DJ Stent or not and biofilm using congo agar plate. The subjects in this research was patient with urinary tract stone and patient without urinary tract stone as control group. Result: There were 60 patients with urinary track stones, as well as 60 patients without a urinary track stone as a control. We found that high level of uric acid prior to removal of DJ Stent and during polyclinic control, and also high level of magnesium urine before DJ Stent removal were five times higher to form biofilm in patients with urinary tract stones. The presence of urinary tract infections when the subject control at polyclinic and before DJ Stent removal, and the presence of bacteria in urine before the insertion of DJ Stent in patients with urinary tract stones is significantly have five times higher risk to form encrustation on the DJ stent. Patients without urinary tract stone have four times higher risk in the formation of encrustation with abnormal level of magnesium that found before the removal of DJ Stent. Delayed in DJ Stent removal in patients without urinary track stone were significantly have ten times higher risk in biofilm formation and six times higher risk in the formation of encrustation in patients with urinary tract stones. Conclusions: There is a relationship between the condition of urine metabolites and urinary tract infections with biofilm formation and DJ Stent's encrustation in patients with urinary tract stones.

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

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

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

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.

Notice of Retraction: The Effectiveness of the webinar in providing non-traumatic urology emergencies education to medical personnel during COVID-19 pandemic Kurnia Penta Seputra; Medianto Medianto; Hamdan Yuwafi Naim; Muhammad Adi S.L.; 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.2022.003.01.4

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. ----------------------------------------------------------------------- Objectives. Basic emergency knowledge is a very important skill for medical personnel. Providing medical information and education is the new challenge in the COVID-19 pandemic situation. Webinar should be considered as one of alternatives to provide and share the knowledge. This study assessed the effectiveness of webinar as a medium to provide information and education in the field of non-traumatic urology emergencies.Methods. A descriptive analytic research design with cross sectional approach was conducted for all participants. The learning outcomes were assessed by comparing the pretest and the post test.Results. A total of 775 participants were included in this study. It showed a significant improvement in average score from pre-test to post-test (p<0.000). It also showed a similar result in almost all of the topics with p<0.005, except for the topic of treatment of urinary retention with p=0.434.Conclusions. The webinar should be considered as one of the effective educational media to provide information and education on non-traumatic urology emergencies for medical personnel during COVID-19 pandemic.

Notice of Retraction: The Characteristic of toddler’s reproductive health in Posyandu Matahari, Blimbing, Malang Kurnia Penta Seputra; Besut Daryanto; Zen Ary Prasetyo; Johannes Dwi Meiyanto
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.2022.003.01.5

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. ----------------------------------------------------------------------- Objectives. The screening of reproductive health plays an essential role in early detection of reproductive health disorder. There was a study which suggested that there was at least one congenital disorder every 100 live births. Congenital reproductive disorders are mostly found in type of hypospadias, enlarged clitoris, micropenis, fusion of labia majora, and genital ambiguity. Data collected in Saiful Anwar General Hospital revealed that during the period of 2012-2017 there were 109 hypospadias cases, 64 undescended testicle cases, and 80 cases of testicular torsion. However, for the Disorders of Sex Development cases, there were 12 cases from the period of 2015-2017, with the mean age was school age (8-14 years old). Unfortunately, there was no data of congenital reproductive disorder in toddlers, thus we conducted screening of toddlers reproductive health in Posyandu Matahari which located in Gedung Serbaguna Rw. 14, Kelurahan Bunulrejo, Kelurahan Jodipan, Kecamatan Blimbing, Malang in order to find out the number of incidence of toddlers congenital reproductive disorder and held the early detection.Methods. This is observational descriptive study. Screening was held in Posyandu Matahari which is located in Gedung Serbaguna Rw. 14, Kelurahan Bunulrejo, Kelurahan Jodipan, Kecamatan Blimbing, Malang, on October 27, 2018. It used a method of physical examination (age, weight, height, external genital examination), and if it was found suspicious of disease or disorder of toddler congenital reproductive health, thus it would be given referral to appropriate health care.Results. This screening event involved 46 toddlers (1-5 years old). From 46 toddlers, there were 14 toddlers (30.43%), 10 toddlers suffered from Phimosis (21.74%), 1 toddler with Hydrocele (2.17%), dan 3 toddlers suffered from Undescended Testis (UDT) (6.52), who were referred to urology clinic in Saiful Anwar General Hospital to undergo further examination and treatment.Conclusions. The incidence of toddlers reproductive disorder of this event was 30,43%, showing that this age group (1-5 years old) had a significant amount of congenital reproductive disorder and screening played an important role for early detection and improving parental knowledge to prevent the delay of treatment for reproductive disorder.

Probability of Cardiovascular Death in Patients with Prostate Cancer Receiving Androgen Deprivation Therapy (ADT): A Comprehensive Analysis Amira Fithri Rofifa; Adhananta Zhafran Prawira; Muhammad Zulfan Rifqiawan; Dinda Eka Permatasari; Besut Daryanto; Kurnia Penta Seputra
Brawijaya Journal of Urology Vol. 4 No. 02 (2024): 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.2024.004.02.4

Background. ADT, or androgen deprivation therapy, is one of the most effective treatments for prostate cancer. It works by reducing testosterone levels to levels that would cause castration either medication or surgery. ADT has been associated with a significant improvement in cancer-related survival; however, reports of cardiovascular (CV) problems connected to ADT treatment are on the rise.Objectives. To demonstrate the risk of cardiovascular death in patients with prostate cancer treated with ADT.Methods. This study demonstrated compliance with the parameters set forth by the Preferred Reporting Items for Systematic Review and Meta-Analysis (PRISMA) 2020. With this search strategy, articles published between 2014 and 2024 were taken into consideration. This was accomplished by utilizing a number of distinct online reference sites, including Pubmed, SagePub, and Google Scholar. Review articles, previously published works, and partially completed works were all selected not to be considered.Results. We found 221 papers in the PubMed database, 47 articles on SagePub, and 9050 items on Google Scholar as a result of our search. 7287 records were removed before screening, hence 2030 articles were received for review. Following a record-exclusion screening, we assembled ten publications in total. Five studies that fulfilled the requirements were included.Conclusion. ADT is frequently a crucial component of the treatment of prostate cancer; patients should also receive counselling regarding their elevated risk of cardiovascular events and should think about taking preventative measures to lower that risk.

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