Indonesian Journal of Urology
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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<![CDATA[NORMATIVE DATA OF PENILE LENGTH ON CHILDREN AGE GROUPS WITH TANNER CLASSIFICATION IN HASAN SADIKIN HOSPITAL ]]>
<![CDATA[Wallad, Caesar Khairul]]>;
<![CDATA[Sibarani, Jupiter]]>;
<![CDATA[Tjahjodjati, Tjahjodjati]]>
<![CDATA[ Indonesian Journal of Urology Vol 24 No 2 (2017) ]]>
Publisher : <![CDATA[Indonesian Urological Association ]]>
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DOI: 10.32421/juri.v24i2.226
<![CDATA[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.]]>
<![CDATA[A 87 YEARS OLD MALE WITH GIANT PROSTATIC HYPERPLASIA AND BLADDER STONES, THE LARGEST PROSTATE REPORTED IN INDONESIA ]]>
<![CDATA[Vera, Vera]]>;
<![CDATA[Pramod, Sawkar Vijay]]>
<![CDATA[ Indonesian Journal of Urology Vol 24 No 2 (2017) ]]>
Publisher : <![CDATA[Indonesian Urological Association ]]>
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DOI: 10.32421/juri.v24i2.277
<![CDATA[Objective: The aim of this article is to report a case of Giant Prostatic Hyperplasia and see the correlation between volume of prostate and benign prostate hyperplasia (BPH) symptoms. Giant BPH is defined as a prostate weight over 200 g or 500 g; the lower threshold was suggested by Japanese authors. It’s extremely rare, with only 16 cases exceeding 500 g till 2013. Case presentation: Patient was an 87-year-old male with chief complaint of haematuria. We performed Transabdominal Ultra Sonography (USG) on the patient. Discussion: Transabdominal USG showed enlarged prostate with median lobe protruding into the bladder measuring 86 x 102 x 76 mm and 348 cc in volume. We performed transvesical prostatectomy. The large prostate was enucleated completely in one piece with 23 stones measuring about 1 cm in size. Grossly, the mass measured 12 x 8 cm and weighed 300 g. Histopathology evaluation revealed BPH. Conclusion: To our knowledge, this is the first giant BPH case being reported in Indonesia. We would like to emphasize that severity of BPH symptoms does not correlate with volume of the prostate. Unfortunately, we can not conclude that there were correlation between body mass index (BMI) and volume due to lack of BMI data from the literature.]]>
<![CDATA[COMPARATION OF DIAGNOSTIC VALUE B-MODE ULTRASOUND WITH COLOR DOPPLER TWINKLING ARTIFACT FOR DETECTING RESIDUAL STONE AFTER PCNL ]]>
<![CDATA[Wardhana, Sonny Andikha]]>;
<![CDATA[Rizaldi, Fikri]]>;
<![CDATA[Djojodimedjo, Tarmono]]>;
<![CDATA[Hardjowijoto, Sunaryo]]>
<![CDATA[ Indonesian Journal of Urology Vol 24 No 2 (2017) ]]>
Publisher : <![CDATA[Indonesian Urological Association ]]>
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DOI: 10.32421/juri.v24i2.303
<![CDATA[Objective: To compare the accuracy of B-Mode US and color Doppler twinkling artifact for detecting residual stone after Percutaneous Nephrolithotomy (PCNL) with Non-contrast CT (NCCT) as the standard diagnostic. Material & methods: In this prospective study, 30 patients who underwent Percutaneous Nephrolithotomy (PCNL) were examined with US and NCCT. In US, echogenicity and posterior-shadow (PS) parameters were evaluated and compared with color-Doppler ultrasonography (CDUS) twinkling artifact and NCCT signs. The results then analyzed statistically with Kappa and McNemar tests. Results: More positive residual stone results with color Doppler twinkling artifact in 14 patients than B-Mode US in 11. NCCT detected 17 residual stone with the most location in inferior calyx. (n=10, 58.8%). The sensitivity, specificity and difference positive-negative likehood ratio of B-Mode US were 64.7%, 92.3% and 8.02, both Kappa test was significant (p=0.125) and McNemar tests was significant (p=0.002). The color Doppler twinkling artifact has 82.3%, 92.3%, and 10.5 for sensitivity, specificity and difference positive-negative likehood ratio, the Kappa test was significant (p=0.00), McNemar test was not significant (p=1.00). Conclusion: Color Doppler twinkling artifact was valid, highly sensitive and accuracy better than B-mode US in detecting residual stone after PCNL procedure.]]>
<![CDATA[THE EFFECT OF ANDROGEN DEPRIVATION THERAPY ON THE LIPID PROFILE AND BLOOD GLUCOSE LEVEL IN PROSTATE CANCER PATIENTS IN ADAM MALIK GENERAL HOSPITAL MEDAN ]]>
<![CDATA[Irawan, Willi]]>;
<![CDATA[Warli, Syah Mirsya]]>
<![CDATA[ Indonesian Journal of Urology Vol 24 No 2 (2017) ]]>
Publisher : <![CDATA[Indonesian Urological Association ]]>
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DOI: 10.32421/juri.v24i2.304
<![CDATA[Objective: The aim of this study is to observe the effect of Androgen Deprivation Therapy (ADT) on patients with advanced stage of prostate cancer on the lipid profile and blood glucose level. Material & Methods: This is a descriptive cross-sectional study and include the prostate cancer patients which were admitted to Urology Policlinic in Haji Adam Malik General Hospital, Medan from June 2014 – June 2015 and also received ADT. Results: From June 2014 – June 2015, a total of 25 prostate cancer patients receiving ADT was included in this study with an average age of 67.08 ± 7.48 years old. The median prostate specific antigen (PSA) level of this group of patients is 19.6 ng/mL and the lowest and highest value of 3.4 and 278 ng/mL respectively. ADT administration is found to cause a significant elevation of 2-hour postprandial blood glucose (121.12 ± 21 mg/mL vs 134.64 ± 33.35 mg/mL, p-value=0.011) and Glycosylated hemoglobin (5 ± 0.5% vs 5.5 ± 0.79%, p-value=0.000) (HbA1c) after 6 months of therapy. Additionally, ADT administration within 3 and 6 months of duration had also significantly increased triglyceride (TG) level when compared to before treatment (104.4 ± 38.67 vs 131.2 ± 32.27 vs 127 ± 33.43 respectively, p-value=0.005). Conclusion: ADT treatment in prostate cancer patients increase triglyceride levels after 3 and 6 months of treatment followed by 2-hour postprandial blood glucose and HbA1C levels after 6 months of the treatment.]]>
<![CDATA[THE EFFICACY OF DUTASTERIDE AND GREEN TEA TOWARDS BLEEDING ON BPH AFTER TURP: STUDY THEIR EFFECT ON HIF-1α EXPRESSION & HEMATOCRIT ]]>
<![CDATA[Irawan, Andry]]>;
<![CDATA[Riwanto, Ignatius]]>;
<![CDATA[Nugroho, Eriawan Agung]]>
<![CDATA[ Indonesian Journal of Urology Vol 24 No 2 (2017) ]]>
Publisher : <![CDATA[Indonesian Urological Association ]]>
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DOI: 10.32421/juri.v24i2.306
<![CDATA[Objective: This study proves differentiation of the combination of dutasteride and green tea, dutasteride, green tea, and placebo alone and their association with differences in hematocrit levels and the expression of hypoxia induced factor-1 alpha (HIF-1α) in patients with Benign Prostate Hyperplasia (BPH) were performed Trans urethral resection of the prostate (TURP) surgery. Material & method: Experimental study with the draft "randomized control trial". Comparing angiogenesis changes between groups of BPH patients who underwent TURP surgery to assess the expression of HIF-1α and Δ Ht (Hematocrit) after administration of dutasteride, green tea with combination of dutasteride and green tea for 14 days. Results: The combination of dutasteride and green tea was not significant in reducing the expression of HIF-1α. Mean P1 group (59.32 ± 14.69); P2 group (59.11 ± 20.73); P3 group (64.21 ± 14.95); K group (58.16 ± 16.00). Kruskal test results obtained p=0.491 walis which means the difference percentage of HIF-1α among the 4 groups was not significant. The mean Δ Ht P1 group (0.61 ± 0.204); P2 group (0.54 ± 0.250); P3 group (0.41 ± 0.275); group K (0.41 ± 0.275). In statistical test with Mann Whitney test comparing the percentage reduction obtained Ht levels dutasteride group against group of green tea obtained p=0.213 means that there is no significant difference. Where a significant difference to the other groups. Conclusion: The combination of dutasteride and green tea for 14 days before TURP surgery does not reduce the expression of HIF-1α in BPH patients who underwent TURP surgery. Δ Ht significant decline in the combination group compared with other groups and might be influenced by several factors during TURP surgery.]]>
<![CDATA[EXTRAPERITONEAL LAPAROSCOPIC RADICAL PROSTATECTOMY: INITIAL EXPERIENCE AND LEARNING CURVE OF A VERY LOW VOLUME CENTER ]]>
<![CDATA[Yunir, Peri Eriad]]>;
<![CDATA[Hamid, Agus Rizal AH]]>;
<![CDATA[Umbas, Rainy]]>;
<![CDATA[Mochtar, Chaidir Arif]]>
<![CDATA[ Indonesian Journal of Urology Vol 24 No 2 (2017) ]]>
Publisher : <![CDATA[Indonesian Urological Association ]]>
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DOI: 10.32421/juri.v24i2.319
<![CDATA[Objective: This study is aimed to report and evaluate the experience and learning curve of extraperitoneal Laparoscopic Radical Prostatectomy (LRP) performed in Cipto Mangunkusumo General Hospital Jakarta. Material & method: We collected all data of patients that had been performed extraperitoneal LRP from June 2013 until February 2016, retrospectively. We divided those data into 3 groups with equal number in each group. We compared the preoperative (age, prostate volume, PSA level and prostate cancer staging), intraoperative (surgery time, total blood loss, conversion to open surgery and other organ injury), and postoperative (postoperative length of stay) variables between those 3 groups using ANOVA and Kruskal-Wallis test. Results: We performed 15 extraperitoneal LRP from June 2013 until February 2016 with patient’s mean age was 64.40 (SD ± 5.30) years old and mean prostate volume was 42.39 (SD ± 29.21). In this study, we found significant differences in surgery time, total blood loss, and postoperative length of stay (LOS) in all group with decrease on each intraoperative and postoperative variables. We also found no conversion to open surgery or other organ injury in all patients. Conclusion: The increase of surgeon’s experience and the number of surgery, and the consistency undergo the procedure of LRP demonstrate a decrease in surgery time, intraoperative blood loss and LOS in LRP patients.]]>
<![CDATA[PROGNOSTIC FACTORS OF RENAL CANCER ]]>
<![CDATA[Kurnia, Riyan Adi]]>;
<![CDATA[Warli, Syah Mirsya]]>;
<![CDATA[Siregar, Ginanda Putra]]>
<![CDATA[ Indonesian Journal of Urology Vol 24 No 2 (2017) ]]>
Publisher : <![CDATA[Indonesian Urological Association ]]>
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DOI: 10.32421/juri.v24i2.326
<![CDATA[Objective: Course of the disease of kidney cancer may be unpredictable. For example, between 4.2–7.1% of patients with tumours ≤4 cm that are usually slow-growing may have metastases at diagnostic and are at an elevated risk of disease-specific mortality. Conversely, as many as 40% of patients with lymph node metastases were diagnosed at nephrectomy are alive 5 year after surgery. Several approaches have been proposed to help predict the course of disease of kidney cancer and to distinguish between poor and favourable risk patients. In this study, we review the existing prognostic factors and compared with established prognostic models. Material & methods: This is an analytic descriptive study of all kidney cancer patients treated at Haji Adam Malik Hospital between 2011 and 2015. Individual patient data was collected from medical record and compiled. Results: The number of samples analyzed in this study were 38 patients. We found seven patients remain alive of the entire sample. From the results of the univariate test, the factors that have a significant relationship with the mortality rate were low KPS (<80), weight loss, and nephrectomy. From the results of multivariate analysis, nephrectomy is the only prognostic factor in patients with kidney cancer. Mortality rate was 0.056x lower in patients who underwent nephrectomy compared with patients who did not underwent nephrectomy. Conclusion: Despite the high mortality rate that is found in this study, nephrectomy still has a place in kidney cancer management, even in patients with advanced stage.]]>
<![CDATA[TUBULARIZED INCISED PLATE URETHROPLASTY FOR ONE-STAGE HYPOSPADIA REPAIR IN CHILDREN AT HASAN SADIKIN HOSPITAL BANDUNG ]]>
<![CDATA[Oetama, Harris]]>;
<![CDATA[Siregar, Safendra]]>
<![CDATA[ Indonesian Journal of Urology Vol 24 No 2 (2017) ]]>
Publisher : <![CDATA[Indonesian Urological Association ]]>
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DOI: 10.32421/juri.v24i2.330
<![CDATA[Objective: To determine the outcome of tubularized incised-plate (TIP) urethroplasty for one stage hypospadia repair in children. Material & methods: A 7-year retrospective experience at Hasan General Sadikin Hospital Bandung on the outcome of tubularized incised plate for one-stage hypospadias repair in children during 2009-2015. Results: A total of 102 children was undergone one stage hypospadias repair with TIP urethroplasty. The mean age was 6.97 years old. As much as 65 (63.72%) children had distal, and 37 (36.28%) children had proximal hypospadia. The mean length of surgery was 112.56 minutes. Post operative complications was rarely found, consisting of 5 (6.32%) children had urethrocutaneus fistula formation and 11 (13.9%) children had haematoma. 4 (10.81%) children with proximal hypospdia and 1 (1.53%) children with distal hypospadia had urethrocutaneus fistula formation. 4 (6.15%) children with distal hypospadia and 7 (18.91%) children with proximal hypospadia had haematoma. Conclusion: Tubularized incised-plate (TIP) urethroplasty for one stage hypospadia repair in children was highly effective with rare complications comparable with recently published study.]]>
<![CDATA[PROSTATE CANCER RISK CALCULATOR COMPARISON: IPCRC vs KPCRC vs PCPT-RC vs ERSPC-RC IN PREDICTING PROSTATE CANCER AT HASAN SADIKIN HOSPITAL ]]>
<![CDATA[Tansol, Christiano]]>;
<![CDATA[Safriadi, Ferry]]>
<![CDATA[ Indonesian Journal of Urology Vol 24 No 2 (2017) ]]>
Publisher : <![CDATA[Indonesian Urological Association ]]>
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DOI: 10.32421/juri.v24i2.368
<![CDATA[Objective: To compare the validated calculators of Indonesian Prostate Cancer Risk Calculator (IPCRC) vs Korean Prostate Cancer Risk Calculator (KPCRC) vs Prostate Cancer Prevention Trial Risk Calculator (PCPT-RC) vs European Randomized Study of Screening for Prostate Cancer Risk Calculator (ERSPC-RC) in predicting prostate cancer in our patients at Hasan Sadikin Hospital Bandung. Material & methods: This study is a prospective study conducted from August 2014 – December 2015 at Urology Clinic at Hasan Sadikin Hospital that included all patients with BPH or suspected PCa who have been undergoing prostate biopsy. Variables such as age, PSA level, prostate volume (transabdominal or transrectal ultrasound) and digital rectal examination (DRE) finding were recorded. Risk calculation was generated using each risk calculator. Data were analyzed using Chi-square analysis, Kolmogorov-Smirnov, and finally receiver operating characterisitic (ROC) curve. All statistical analyses were performed with SPSS version 20. Results: There were 89 BPH and 43 PCa patients between August 2014 – December 2015. The mean age, PSA and prostate volume are 65.78 ± 8.33 years; 121.16 ± 375.76ng/ml; 55.86 ± 31.9ml respectively. Abnormal DRE was found in 27 PCas and 4 BPHs. Receiver operator curve analysis of IPCRC showed AUC 0.861 vs KPCRC (AUC=0.779) vs ERSPC-RC (AUC=0.745) vs PCPT-RC (AUC=0.794) vs PSA (AUC 0.794), sensitivity 81.4% and specificity 71.9% with cut-off point 19.67 for the IPCRC in predicting the prostate cancer in our center. Conclusion: IPCRC is better than KPCRC, PCPT-RC and ERSPC-RC in predicting prostate cancer in our center.]]>
<![CDATA[EFFICACY AND SAFETY OF LUBRICATING JELLY INSTILLATION TO PREVENT RETROPULSION DURING URETEROLITHOTRIPSY FOR URETERAL STONES ]]>
<![CDATA[Yuanda, Rameshdo]]>;
<![CDATA[Soebadi, Doddy M]]>;
<![CDATA[Soetojo, Soetojo]]>;
<![CDATA[Hardjowijoto, Sunaryo]]>
<![CDATA[ Indonesian Journal of Urology Vol 24 No 2 (2017) ]]>
Publisher : <![CDATA[Indonesian Urological Association ]]>
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DOI: 10.32421/juri.v24i2.377
<![CDATA[Objective: We studied the efficacy and safety of lubricating jelly instillation before ureterolithotripsy for prevention of retropulsion and improvement in stone-free rate. Material & methods: We enrolled 22 subjects with ureteral stone in this prospective, randomized, single-blind and controlled clinical trial. Each subject was randomly assigned to the lubricating jelly instillation group (n=11) and control group (n=11). Ureteroscopy and lithotripsy was performed according the standard protocol, using 9.8 F semirigid ureteroscope and pneumatic lithotripter. A 6 F ureteral catheter was advanced beyond the stone, and lubricating jelly was instilled through the catheter lumen. Retropulsion and the presence of residual fragments were evaluated with plain kidneys, ureters and bladder x-ray and ultrasonography, or Non Contrast-enhanced Computed Tomography. Any complication was reported and graded using the Modified Clavien Classification System.Results: The 2 groups had comparable preoperative characteristics. There were no statistically significant difference between the lubricating jelly instillation group and control group regarding the retropulsion rate (54.5% vs 72.7%, ρ=0.375), the stone-free rate (54.5% vs 36.4%, ρ=0.392), and the complication rate (45.5% vs 54.5%, ρ=0.670). Conclusion: Lubricating jelly instillation during ureterolithotripsy has limited value for prevention of retropulsion and improvement in stone-free rate.]]>
