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INDONESIA
Indonesian Journal of Urology
Published by Universitas Airlangga
ISSN : 0853442X     EISSN : 23551402     DOI : 10.32421
Core Subject : Health,
Health Professions Medicine & Pharmacology Public Health
The aim of Indonesian Journal of Urology is to encompass the whole spectrum of urology. The journal publishes papers on a wide range of urological issues such as oncology, functional urology, reconstructive urology, laparoscopy, robotic surgery, endourology, female urology, andrology, pediatric urology, and sexual medicine. We welcome authors for original article (research), review article, interesting case reports, special article, clinical practices, and medical illustrations that focus on the clinical area of urology.
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Articles 13 Documents
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Search results for , issue "Vol 22 No 1 (2015)" : 13 Documents clear
Laparoscopic transperitoneal approach for vesicovaginal repair : The first experience in Hasan Sadikin Hospital Santoso, Jumadi; Pramod, Sawkar Vijay
Indonesian Journal of Urology Vol 22 No 1 (2015)
Publisher : Indonesian Urological Association

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.32421/juri.v22i1.82

Abstract

Introduction : Obstetric fistula is a severe and debilitating condition occurring throughout the developing world. Although there are no accurate data on the incidence and prevalence of the condition, the majority of vesicovaginal fistulas develop after gynaecologic surgery, with transperitoneal hysterectomy accounting for 90% of cases. Several techniques are available for repairing the fistulas. Transperitoneal  approaches give good results even for difficult posterior located fistulas, but are associated with increased morbidity compared with the transvaginal approach. We performed a laparoscopic repair and omentum interposition. Objective : To report our first experience in transperitoneal laparoscopic repair of vesicovaginal fistula in Hasan Sadikin Hospital. Patient and Method : A 31-year-old female presented with vesicovaginal fistula after sectio caersaeran. After a failed trial of conservative treatment with catheter drainage, a transperitoneal laparoscopic repair was performed. Cystoscopy was performed initially to confirm the fistula location and for bilateral ureteric catheterization. A 4-port technique was performed with the patient in the position with her legs in lithotomy position. Without opening the bladder, the fistula tract was excised with separation of the bladder from the anterior vagina wall. Both the bladder and vagina walls were then closed separately using intracorporeal suturing with an interpositional omentum. Result : Total operative time was 270 min. Normal diet was resumed on day 1, drain was removed on  post operatif day 1 and patient was discharged on the second day  with an indwelling catheter. Good cosmetic result on wound operation  and no leakage under cystogram after 2 weeks. The catheter was removed after 2 weeks. Conclusion : Laparoscopic transperitoneal repair of vesicovaginal fistula  with omentum inteposition  is feasible in  Hasan Sadikin Hospital with good outcomes, short hospital days,  and good cosmetics result. Keywords : Fistula vesico vaginal, laparoscopic.    
Prognosis of obstructive nephropathy patients after percutaneous nephrostomy Sukmagara, Jefri; Danarto, H R
Indonesian Journal of Urology Vol 22 No 1 (2015)
Publisher : Indonesian Urological Association

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.32421/juri.v22i1.88

Abstract

Background: Percutaneous nephrostomy is a life-saving procedure for the treatment of obstructive uropathy associated with septicaemia and uraemia. It is regarded as a temporary interventional procedure before definitive treatment. Several factors can affect recovery of renal function after nephrostomy, such as patient age, duration of obstruction, function of the contralateral kidney, pyelolymphatic backflow and compliance of the ureter and renal pelvis.Objective: To determine factors that can predict the decrease in creatinine levels after percutaneous nephrostomy (< 2mg/dl).Methods: This is a retrospective analysis descriptive study. All patients previously performed nephrostomy at Sardjito General Hospital Yogyakarta, from January 2009 to December 2012 were identified. The data were analyzed to evaluate the relationship between reduction of serum creatinine level and following variables including: etiology, nephrostomy (unilateral or bilateral), symptom duration (≤14 days or >14 days), comorbid disease (hypertension, diabetes melitus, heart disease) and degree of hydronephrosis (mild, moderate and severe). The data were analyzed with Chi-Square test and multiple logistic regression to obtain predictive factor and predictive scoring equation to measure the possibility of recoverability of renal function after nephrostomy.Results: We analyzed 117 patients that previously treated by percutaneous nephrostomy. It showed the relationship between reduction of serum creatinine level and the following variables:  nephrostomy (unilateral or bilateral) (p=0,000), symptom duration (p=0,000), hypertension (p=0,004) and degree of hydronephrosis (p=0,000). Whereas etiology of urinary obstruction and other comorbid diseases showed no relationship. Predictive equation result: P= 1/(1+ey), where y= -0,271 + 1,636 (degree of hydronephrosis) + ((-2,216) unilateral or bilateral nephrostomy) + 1,694 (symptom duration) + ((-0,862) hypertension), with sensitivity 74,3% and specificity 70,7% in predicting renal function recoverability.Conclusions: Bilateral or unilateral nephrostomy, symptom duration, hypertension and degree of hydronephrosis are factors affecting the decrease in serum creatinine level. They role as independent predictor to predict recoverability of renal function can be considered. Key words: obstructive uropathy, percutaneous nephrostomy, multiple logistic regression.
Laparoscopic Live Donor Nephrectomy: Comparison of Left-sided and Right-sided Approach in Our First 50 Cases Marcelino, Albertus; Mochtar, Chaidir Arif; Wahyudi, Irfan; Baskoro, Bagus; Rodjani, Arry; Rasyid, Nur
Indonesian Journal of Urology Vol 22 No 1 (2015)
Publisher : Indonesian Urological Association

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.32421/juri.v22i1.89

Abstract

Objectives: To compare the operative results and outcomes between right and left laparoscopic live donor nephrectomy (LLDN). Methods: We retrospectively analyzed the first 50 consecutive LLDN in Indonesia performed between November 2011 and February 2013. Of these patients, 6 underwent right LLDNs and 44 left LLDNs. All patients underwent LLDNs in Cipto Mangunkusumo Hospital. All LLDNs were done by the same surgical teams. Intraoperative, post-operative donor and recipient data results were compared.Results: There were no significant differences of intraoperative, post-operative and recipient data results in both groups.  The first warm ischemic time (mean±SD, 6min 55sec±145sec vs 7min 37sec±177 sec, p>0.05), the second warm ischemic time (41min 35sec ± 7min 45sec vs 48min 36sec ± 8min 41sec, p>0.05), and the operative time (4hour 41min ± 31min vs 4hour 32min ± 49 min, p>0.05) showed similar results in the right and left LLDN, respectively. Active mobilization on 72-hour post-operation was found in 83,3% in the right LLDN compared to 95,5% (p>0.05). There were no delayed graft function and post-operative hemodialysis within one week in the recipients of right LLDN group. Conclusion: Right LLDN has equal operative results and outcomes compared to left LLDN. Right-sided LLDN may be a judicious approach for donors with unfavorable characteristics of the left kidney.
Early detection of Prostate Cancer with Prostate Specific Antigen > 4 ng/ml : A Multivariate Logistic Regression Yuri, Prahara; Rochadi, Sungsang
Indonesian Journal of Urology Vol 22 No 1 (2015)
Publisher : Indonesian Urological Association

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.32421/juri.v22i1.90

Abstract

Background:Early detection of prostate cancer is a possible means of decreasing the mortality and increasing the quality of life. Objective :To determine whether the prostate specific antigen (PSA), abnormal DRE, family history, age, and prostate volume could increase the specificity and sensitivity of screening for prostate cancer. Methods :We included 92 patients with PSA > 4 ng/ml between January and December 2011 in Sardjito Hospital. Patients received prostate biopsy due to having abnormal serum prostate specific antigen (PSA) level. The relationship between the possibility of prostate cancer and the following variables were evaluated including: age; PSA level, prostate volume, DRE finding and family history. By using chi-square analysis, multiple logistic regression and receiver operating characteristic (ROC) curve were drawn based on the predictive scoring equation to predict the possibility of prostate cancer. All analyses were performed with SPSS, version 18.0. Results:We analyzed 92 patients with PSA > 4 ng/ml. It showed the relationship between the possibility of prostate cancer and the following variables, including : age (p < 0.001), PSA level (p < 0,001), DRE finding (p < 0.001) family history (p < 0,001) except prostate volume (p = 0.398). Using a predictive equation, P = 1/(1-e-X), where X= -3,821 +1.846 (if DRE positive) + 2,488 ( if family history positive ) + 1.718 ( when PSA > 10 ) + 1.414 ( when age > 68), followed by receiver-operating characteristic curve analysis, it showed the sensitivity 90,4% and specificity 85 % in predicting the possibility of prostate cancer. Conclusion:  Age,  DRE  finding,  PSA  and  family  history  are  factors  associated prostate cancer. They can be used as independent predictor to predict prostate cancer. Key words: Logistic regression, early detection,prostate cancer
EFFICACY OF INTRAVESICAL INSTILLATION OF NETILMICIN ON MANAGING UTI Praba, Barry Arief; Utomo, Trisula
Indonesian Journal of Urology Vol 22 No 1 (2015)
Publisher : Indonesian Urological Association

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.32421/juri.v22i1.92

Abstract

INTRODUCTION Urinary tract infections (UTIs) are common, affect men and women of all ages, and vary dramatically in their presentation and sequelae. They are a common cause of morbidity and can lead to significant mortality. New antimicrobial agents that achieve high urinary and tissue levels, that can be administered orally, and that are not nephrotoxic have significantly reduced the need for hospitalization for severe infection. Shorter-course therapy and prophylactic antimicrobial agents have reduced the morbidity and cost associated with recurrent cystitis in women. Intravesical instillation of aminoglycoside has been used empirically as prophylaxis and to treat bacilluria in spinal-cord-injured patients undergoing clean intermittent catheterization.METHODS In a prospective clinical trial performed in the urologic ward of Dr. Sardjito Hospital, yogyakarta, Indonesia, we studied 56 patients who has indwelling urethral catheter more than 4 days. Patients were divided into two groups. In group 1 (28 patients) one-time intravesical instillation of Netilmicin 25 mg was administred, and in group 2 (28 patients) none were given any treatment. Urinalysis was evaluated before and after instillation of Netilmicin. Statistical data and results were studied using descriptive statistics as median (minimum and maximum). To compare the response to treatment, Chi-Square test was used in two groups. Consequently, the data were analyzed using the SPSS 17 software.RESULTS Urinalysis were evaluated in two groups 4 days after intravesical instillation of 50 mg netilmicin. The patients we studied, the median age 59 years old (min. 29; max. 81). In the first group we found 22 (78,5 %) patients still without UTI, 6 (21,5 %) patients with UTI, in the second group we found 4 (14,3 %) still without UTI, 24 (85,7 %) patients with UTI. The difference was statistically significant (p=0.0001)CONCLUSIONS Intravesical instillation of netilmicin on patients with indwelliing urethral catheter were effective on preventing catheter-related UTI.Keywords : UTI, indwelling catheter, netilmicin, intravesical antibiotic instillation.
Diagnostic Value of Ureteric Jet Frequency Examination using Color Doppler Ultrasonography to Predict Success of Retrograde DJ Stent Insertion in Uterine Cervicis Carcinoma patients with Hydronephrosis sriyono, sriyono; Santoso, Adi; Djojodimedjo, Tarmono; Soebadi, Moh Ayodhia; Pudjirahardjo, Widodo J
Indonesian Journal of Urology Vol 22 No 1 (2015)
Publisher : Indonesian Urological Association

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.32421/juri.v22i1.95

Abstract

AbstractObjective:  To prove that ureteric jet examination using Color Doppler Ultrasonography (CDU) can be used as a diagnostic tool to predict success of retrograde Double J Stent insertion in uterine cervicis carcinoma patients with hydronephrosis.Materials and Methods: This observational analytic study took 32 samples since May until October 2013. Before, the ureteric jet were counted for 5 minutes using CDU, then continued on the same day with cystoscopy and retrograde DJ Stent insertion. The analysis was using Chi-Square and also Coefficient Contingency test.Results: In both Chi-Square and Coefficient Contingency test, it is proven a significant correlation between success of retrograde DJ Stent insertion and Blood Urea Nitrogen (BUN), creatinine value, grade of hydronephrosis and also ureteric jet examination using CDU, with probability value (p < 0,005). The normal of BUN, creatinine level and the lower grading of hydronephrosis, the more likely successful DJ Stent insertion. Successfulness of DJ Stent insertion is also greater in a positive ureteric jet samples on examination using CDU, with sensitivity value 90,9% and specificity 89,5%, positive predictor value 83,3%, negative predictor value 95% and accuracy value 0,9.Conclusion: Ureteric jet frequency examination using CDU can be used as a success predictor of retrograde DJ Stent insertion in hydronephrosis uterine cervicis carcinoma patients with sensitivity value 90,9% and specificity 89,5%.Keywords: Ureteric jet, Color Doppler Ultrasonography, Double J Stent, Uterine Cervicis Carcinoma
COMPARISON OF FOSFOMYCIN TROMETAMOL WITH CIPROFLOXACIN FOR UNCOMPLICATED UTI DUE TO E.COLI IN WOMEN budiono, heri; Hardjowijoto, Sunaryo; Djojodimedjo, Tarmono; Soebadi, Doddy M; Widodo, Agung Dwi Wahyu; Budiono, Budiono
Indonesian Journal of Urology Vol 22 No 1 (2015)
Publisher : Indonesian Urological Association

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.32421/juri.v22i1.96

Abstract

Objective: To compare clinical therapeutic effects (frequency, dysuria, and pyuria), microbiology, pharmacokinetics index Cmax/MIC Fosfomycin Trometamol 3 gr single dose with Ciprofloxacin 2 x 500 mg/12 hours for 5 days in the treatment of uncomplicated UTI in women due to Escherichia coli (E.Coli). Materials & Methods: Experimental observational design from February until July 2013. Twenty two women with uncomplicated UTI due to E.Coli performed clinical and microbiological examination. Pharmacokinetics index (Cmax/MIC) is looked for. Patients are divided 2 group, Ciprofloxacin 500 mg/12 hours 5 days and Fosfomycin Trometamol single dose. Repeat clinical and microbiological evaluation is performed in 7 days after therapy. Statistic analysis use Chi Square test, Paired T test, and Independent T test. Results: In the treatment of uncomplicated UTI in women, Fosfomycin Trometamol single dose therapy provides clinical cure (dysuria 81.2%, p = 0.338, frequency 90.9%, p = 0.004, pyuria 90.9%, p = 0.009) much better than Ciprofloxacin 500 mg/12 hours 5 days. Fosfomycin Trometamol single dose therapy also provides bacteriological eradication (100%) better than Ciprofloxacin 500 mg/12 hours 5 days (p = 0.035). Fosfomycin Trometamol single dose had a higher pharmacokinetics index (Cmax/MIC) compared to Ciprofloxacin 500 mg/12 hours (p = 0.035). Conclusion: Fosfomycin Trometamol single dose therapy is superior to Ciprofloxacin 500 mg/12 hours 5 days in the treatment of uncomplicated UTI in women. Keywords: Therapeutic effect, fosfomycin trometamol, ciprofloxacin, uncomplicated UTI, Escherichia coli.
URINARY CONTINENCE DIVERSION IN CHILDREN WITH NEUROGENIC BLADDER Satyawan, Yopie T; Rodjani, Arry; Wahyudi, Irfan
Indonesian Journal of Urology Vol 22 No 1 (2015)
Publisher : Indonesian Urological Association

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.32421/juri.v22i1.98

Abstract

Objective: We evaluate the initial experience of the implementation of the urinary diversion procedure in patients with neurogenic bladder continence in children. Material & method: The study was conducted retrospectively by collecting data contained in patient medical records of patients who come for treatment to Cipto Mangunkusumo Hospital Jakarta, from 2003 to 2012, and by interviews with parents of patients over the phone or when the patients control to the clinic. The patient is a child (age 0-18 years), diagnosed with congenital neurogenic bladder, and had urinary diversion continence procedure. Results: There are eight cases with urinary diversion continence undertaken in Cipto Mangunkusumo Hospital and found only 7 cases met the inclusion criteria with more girls than boys. Common etiology was spina bifida (57%). Most of the patients complained of recurrent UTI, and the most techniques used are Mitrofanoff (72%) with complications 33%. Conclusion: Urinary diversion continence procedure that has been done in Urology of Cipto Mangunkusumo Hospital is Mitrofanoff-Monti. Of the total of seven cases performed, the initial evaluation gives good results after urinary diversion continence procedure. Improved quality of life of patients with the achievement continence, overcome recurrent UTI problems and kidney function can be retained. Keywords: Neurogenic bladder, Mitrofanoff techniques, Yang-Monti.
DIAGNOSTIC VALUE OF NON-CONTRAST HELICAL CT-SCAN AND INTRAVENOUS UROGRAPHY IN UROLITHIASIS EVALUATION Hasan, Fadhli; Soebadi, Doddy M; Hardjowijoto, Sunaryo; Soebadi, Mohamad Ayodhia; Pria, Triyono Karmawan Sukmana; Pudjirahardjo, Widodo J
Indonesian Journal of Urology Vol 22 No 1 (2015)
Publisher : Indonesian Urological Association

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.32421/juri.v22i1.99

Abstract

Objective: To evaluate the diagnostic value of Non Contrast Helical Computed Tomography (NCHCT) scanning as the first choice diagnostic modality for detecting urolithiasis cases in Soetomo General Hospital Surabaya and evaluate the feasibility as alternative to Intravenous Urography (IVU). Material & Methods: Seventeen patients with clinical manifestation of suspected urolithiasis underwent NCHCT and IVU to evaluate suspected urolithiasis. Reformatted three-dimensional CT was performed in all patients. The images were correlated with findings from surgical procedure (ureteroscopy, percutaneous nephrolithotomy, and open surgery). Sensitivity, specificity, positive predictive value, negative predictive value, and diagnostic accuracy were determined for NCHCT and IVU. Results: The diagnosis of urolithiasis was defined as unequivocal evidence of urolithiasis on either NCHCT or IVU. Sixteen of seventeen patients evaluated were diagnosed with urolithiasis. NCHCT established the diagnosis in 16 of 17 patients while IVU was positive in 11 of 17 patients. IVU was negative in 6 of the 17 cases. The sensitivity, specificity and accuracy of NCHCT was 100%, 100%, and 100% respectively (p = 0.05) and the sensitivity, specificity, and accuracy of IVU was 68%, 100% and 70% respectively (p = 0.35). There was no statistically significant difference between IVU and NCHCT using Fisher’s exact test. Conclusions: NCHCT accurately diagnosed urolithiasis in patients with suspected urolithiasis. Considering that NCHCT is more effective and efficient than IVU as diagnostic modality in determining the presence of urolithiasis, it may be considered to replace IVU as the first line diagnostic tool for urolithiasis in Soetomo General Hospital Surabaya. Keywords: Non Contrast Helical CT Scan, Intravenous Urography, Urolithiasis.
ADIPOSE-DERIVED STEM CELL TRANSPLANTATION ON URETHRAL MICROVESSEL AND VOIDING FUNCTION Mahadi, Endi Prilansa; Hardjowijoto, Sunaryo; Alif, Sabilal; Purwati, Purwati; Sandhika, Willy; Budiono, Budiono
Indonesian Journal of Urology Vol 22 No 1 (2015)
Publisher : Indonesian Urological Association

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.32421/juri.v22i1.101

Abstract

Objective: To examine the effects of adipose-derived stem cell (ADSC) transplantation on urethral tissue microvessel and voiding function on artificial stress urinary incontinence (SUI) in rats. Material & methods: 25 of 32 female wistar rats underwent vaginal distension as animal-SUI model. ADSCs were isolated from the peri-ovary fat, examined for stem cell properties, and labeled with PKH-2. Seven rats without vaginal distension and periurethral ADSCs injection as control. Twelve rats received periurethral injection of phosphate buffer saline as plasebo and 13 rats received periurethral injection of ADSCs. 14 and 28 days later, voided volume was meassured with voided stained on paper and microvessel density was meassured with immunohistochemical analysis (factor VIII R-Ag). Results: Voided volume analysis showed that rats in the plasebo group had abnormal voided volume compare to normal rats in day 14 (168.5 ± 119.05l vs 621.21 ± 283.85l; p < 0.05), and insignificant improvement of voided volume compare to normal rats in day 28 (852.09 ± 626.7l vs 868.49 ± 578.0l; p > 0.05). While in the ADSCs group only showed significant improvement of voided volume compare to abnormal rats in days 14 (379.35 ± 191.74l vs 228.18 ± 56.26l; p < 0.05). Immunohistochemical analysis showed that microvessel density higher in the ADSCs group compare to plasebo group in days 28 (12.86 ± 2.5 vs 9.50 ± 1.64; p < 0.05). Conclusion: ADSCs transplantation promotes improvements voided volume and urethral microvessel in the rat-SUI model. Keywords: Adipose-derived stem cell, vaginal distension, voided stained on paper, microvessel density.

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