wahjoe djatisoesanto
Department Of Urology, Faculty Of Medicine, Universitas Airlangga, Dr Soetomo Hospital, Surabaya, Indonesia

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AGE-RELATED CHANGES IN RENAL RESISTIVE INDEX AFTER ESWL Hermawan, Anton; Alif, Sabilal; djatisoesanto, wahjoe; Wulanhandarini, Tri; Budiono, Budiono
Indonesian Journal of Urology Vol 21 No 1 (2014)
Publisher : Indonesian Urological Association

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.32421/juri.v21i1.7

Abstract

Objective: To determine relation between age and resistive index (RI) changes occurring after extracorporeal shock wave lithotripsy (ESWL). Material & Method: We performed a prospective study in Soetomo Hospital Surabaya. Using duplex ultrasonography, RI was determined in 20 patients with calyceal kidney calculi and pelvic kidney calculi. RI of the interlobar renal arteries were measured in the region near the calculi (distance, less than 2 cm), one hour before ESWL and RI was measured again at 1 hour, 3 days and 7 days after ESWL. Changes in RI values and relation with age (≤ 60 years old and > 60 years old) were evaluated. Results: The renal RI increased significantly 1 hour and 3 days after ESWL, but returned to before ESWL values 7 days after ESWL in the both groups. Although there was positive correlation between age and RI before ESWL, but there was no correlation between age and RI changes after ESWL. Conclusion: Renal RI is higher with age > 60 years, after ESWL renal RI showed transient increase which returned to baseline after 7 days.Key words: Color Doppler Ultrasonography, extracorporeal shock wave lithotripsy, renal resistive index, calyceal kidney calculi, pelvic kidney calculi.
PROFILE OF BLADDER TRANSITIONAL CELL CANCER IN SOETOMO HOSPITAL SURABAYA Abdih, M. Asro; Djatisoesanto, Wahjoe; Hardjowijoto, Sunaryo
Indonesian Journal of Urology Vol 21 No 2 (2014)
Publisher : Indonesian Urological Association

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.32421/juri.v21i2.31

Abstract

Objectives: To describe the characteristic of bladder transitional cell cancer (TCC). Material & methods: We reviewed the medical records of patients with bladder TCC admitted in Soetomo General Hospital Surabaya, from January 2008 until December 2012. The data regarding demographic characteristics, clinical presentation and staging, grading and staging based on pathological examinations results, and the management of the cancer.Results: The 126 cases, consisted of 102 men (81%) and 24 women (19%) with its ratio was 4.2 : 1. All male patients were heavy cigarette smokers. Mean age was 57.8 years, peak incidence was50-59 years. Hematuria was the mostfrequent clinical presentation (112 patients, 88.9%), urinary retention and other complaints (12 patients, 9.5%), and chronic dysuria (2 patients, 1.6%). Clinical staging was T1 as NMIBC in 7 patients (5.7%). MIBC consisted of T2 in 37 patients (30.3%), T3 in 35 patients (28.7%), T4 in 43 patients (35.2%). The pathological grading as an high-grade were 74 patients (64.3%). All patients had underwent TURBT for diagnosis and staging, followed by definitive treatment. It consisted of TURBT and chemotherapy bladder instillation in 7 patients (5.6%), radical cystectomy in 13 patients (10.3%), EBRT in 5 patients (4%), MVAC chemotherapy in 24 patients (19%), EBRT and chemotherapy with MVAC in 3 patients (2.4%). There were 74 patients (58.7%) underwent TURBT alone.Conclusion: Bladder TCC was in advanced stage when diagnosed, most of the patients received only TURBT and refused further treatment. Keywords: Bladder transitional cell cancer, characteristics, managements.
CORRELATION BETWEEN PROSTATIC URETHRAL ANGLE WITH CLINICAL PARAMETERS AND BOO IN LUTS ASSOCIATED WITH BPH Santoso, Kristian Yoci Santoso Yoci; Soebadi, Doddy M.; Djatisoesanto, Wahjoe; Budiono, Budiono
Indonesian Journal of Urology Vol 20 No 1 (2013)
Publisher : Indonesian Urological Association

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.32421/juri.v20i1.43

Abstract

Objective: We investigated the correlation of the PUA on clinical parameters and bladder outlet obstruction (BOO) in men with lower urinary tract symptoms (LUTS) suggestive of benign prostatic hyperplasia (BPH). Material & Method: This study was performed between January to April 2011. A cross sectional analysis of 24 men with LUTS associated BPH aged > 50 years was performed. Patients underwent evaluation including International Prostatic Symptom Score (IPSS), transrectal ultrasonography, uroflowmetry, and pressure-flow study. Statistical analysis was performed to evaluate correlation of the PUA on clinical parameters and bladder outlet obstruction (BOO). Results: A total of 24 patients, aged 51 to 78 years were enrolled in this study. The mean value of total IPSS, prostate volume, PUA, and Qmax was 22 (range 7-35), 34,4 cm3 (range 21–70 cm3), 37,3° (range 25°–55°), and 10,5 mL/s (range 4,2–17,9 mL/s), respectively. Pearson’s correlation analysis showed that PUA was not significantly correlated with IPSS (p = 0,117), Qmax (p = 0,434), total prostate volume (p = 0,213). Patients with increased PUA (PUA > 35°) had higher incidence and degree of BOO (p < 0,05). Conclusion: PUA may be one method to assess the presence of BOO in men with LUTS associated BPH. Our investigation suggest that PUA may help in the treatment of individuals by better predicting their likely classification from a pressure-flow study.Keywords: Prostatic urethral angle, benign prostatic hyperplasia, lower urinary tract symptoms, bladder outlet obstruction.
DIFFERENCE IN SERUM PSA LEVEL AND IIEF-5 BEFORE AND AFTER TURP IN BPH PATIENTS WITHOUT URINARY RETENTION Hasibuan, Zulfian; Wirjopranoto, Soetojo; Djatisoesanto, Wahjoe; Pujiraharjo, Widodo J
Indonesian Journal of Urology Vol 19 No 1 (2012)
Publisher : Indonesian Urological Association

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.32421/juri.v19i1.54

Abstract

Objective: Determine change in serum prostate-specific antigen (PSA) and International Index of Erectile Function (IIEF-5) following transurethral resection of the prostate (TURP). Material & Method: Eighteen men with age range of 50 – 69 years, were divided in two groups, group I 50-59 years (mean 56,5) and group II 60-69 years (mean 67,2). Both groups underwent measurement of serum PSA and IIEF-5 pre-operative, and repeated at 30, 60, and 90 days after TURP. Results: Level of serum PSA after TURP is decreased in most patients after 30, 60, and 90 days (72%, 72% and 78%). Mean value of PSA pre-operatively is 5,3 ± 3,3 ng/ml. After TURP, serum PSA level was 3,5 ± 3,0 ng/ml (30 days); 2,9 ± 2,9 ng/ml (60 days) and 1,8 ± 1,3ng/ml (90 days). Pre-operative PSA level was significantly decreased in Group I during the 60 and 90 days post TURP, while in Group II pre-operative PSA level was significantly decreased only in 90 days of observation. Overall there is no significant difference in PSA levels in both groups (p > 0,05). The decrease of PSA per gram resected in 30, 60, and 90 days were 0,10 ng/ml; 0,16 ng/ml and 0,24 ng/ml consecutively. There is no change in normal IIEF-5 score. Decrease of the IIEF-5 score in group I was measured at 30 days, but the score increased after 60 and 90 days. Meanwhile Group II showed decrease of IIEF-5 score. Pre-operative IIEF-5 score compared to the 30 days post TURP was significantly different but not significantly different compared with to score at 60 and 90 days. In Group I IIEF-5 score was significantly higher compared to Group II (p < 0,05). Prostatitis was found in 8 patients, but there is no difference in serum PSA level decrease between patients with or without prostatitis. Conclusion: There was significant decrease in serum PSA after TURP in BPH patients with LUTS at every measurement at 30, 60, and 90 days. PSA level after TURP depends on various factors, including pre-operative PSA, pre-operative prostate volume and prostate volume resected. Incidence of erectile dysfunction post TURP was low. Keywords: Prostate-specific antigen, benign prostatic hyperplasia, transurethral resection of the prostate, erectile dysfunction.
THE DIFFERENCE OF PAIN PERCEPTION BETWEEN KETOPROFEN SUPPOSITORY AND 1% PERIPROSTATIC LIDOCAINE INJECTION Azis, Abdul; Djatisoesanto, Wahjoe; Soebadi, Doddy M.; Hakim, Lukman; Budiono, Budiono
Indonesian Journal of Urology Vol 19 No 2 (2012)
Publisher : Indonesian Urological Association

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.32421/juri.v19i2.63

Abstract

Objective: To compare the pain control results of ketoprofen suppository and periprostatic injection of lidocaine 1% for prostate biopsy. Material & Method: A total of 30 patients who underwent transrectal ultrasound guided prostate biopsy were randomized into 2 groups. Group 1 consisted of 15 patients received 200 mg of ketoprofen suppository. Group 2 received 1% periprostatic lidocaine injection. A visual analog scale was used to assess the pain score during prostate biopsy. Statistical analysis of pain scores was performed using independent t-test and Pearson correlation test. Results: The 2 groups were homogenous in age and prostate volume. There was significant difference in pain score among groups 1 and 2 during prostate biopsy (mean VAS ± SD 0,8 ± 0,8 and 4,5 ± 1,6 respectively, p < 0,0001). There was no significant correlation between pain perception with age (p = 0,779), or prostate volume (p = 0,389) in both groups. Conclusion: Periprostatic lidocaine injection is more effective for decreasing the pain for prostate biopsy compared to ketoprofen suppository. Keywords: Prostate biopsy, pain, transrectal ultrasonography, periprostatic nerve block, visual analog scale.
STONE-FREE RATE DIFFERENCES IN KIDNEY STONES PATIENTS WITH AND WITHOUT TAMSULOSIN AFTER ESWL Prasadja, Nindra; Soebadi, Doddy M; Djatisoesanto, Wahjoe; Pudjirahardjo, Widodo J
Indonesian Journal of Urology Vol 18 No 2 (2011)
Publisher : Indonesian Urological Association

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.32421/juri.v18i2.71

Abstract

Objective: To determine whether the administration of tamsulosin, as adjunctive medical therapy, increases the efficacy of one session of extracorporeal shock wave lithotripsy (ESWL) to treat renal stones. Material & Method: A prospective randomized placebo controlled study enrolled 21 patients. They underwent a single ESWL session to treat solitary radiopaque renal stones 4 to 20 mm in diameter. After ESWL, the study group (11) received 0,4 mg tamsulosin daily and the control group (10) received placebo until stone clearance or a maximum period of 8 weeks. The primary endpoint was stone-free rate and parameters were stone size and clearance time. Results: The overall stone-free rate was better in the study group than in the control group (90,9% vs. 60,0%). The clearance time after 2, 4, 6 and 8 weeks was greater in the study group than in the control group (36,4%; 63,6%; 72,7% and 90,9% vs 30,0%; 50,0%; and 60,0% respectively) but statistically insignificant. Conclusion: Clinically, the results of our study have demonstrated that tamsulosin therapy, as an adjunctive medical therapy after ESWL, is more effective than lithotripsy alone for the treatment of patients with renal stones. Keywords: ESWL, tamsulosin, medical expulsive therapy, renal stones.
URINARY RETENTION EFFECT IN THE INCREASED OF PSA EXPRESSION WITHIN PROSTATIC TISSUE Djatisoesanto, Wahjoe; Soebadi, Doddy M; Sudiana, I Ketut
Indonesian Journal of Urology Vol 22 No 2 (2015)
Publisher : Indonesian Urological Association

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.32421/juri.v22i2.189

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Objective: To determine whether the increased of PSA expression within prostatic tissue and subsequent systemic blood circulation in acute urinary retention cases of nonmalignant origin were caused by acute inflammation on the prostatic gland. Following this inflammation, PSA willincrease, producing byacinar epitelial cells in the gland and continue to capillary vessels before entering the blood circulation. Material & method: Thirty male Rattus Norvegicus were randomly allocated into 3 groups. A control group underwent urethral manipulation, treatment-1 group and -2 group underwent proximal urethral ligation. Prostatectomy was performed after 24 hours in the control and treatment-1 group. Ligation was removed after 24 hours in treatment-2 group, and prostatectomy performed after 4x24 hours. Each prostate specimen was examined for PSA expression by immunohistochemistry methods in the prostatic gland. Statistical analysis of study data was analyzed by descriptive statistics and performed ANOVA with level of significance α = 0.01.Results: Study results showed an increase PSA expression significantly after urinary retention and returned to normal values four days later after relief of retention.Conclusion: Urinary retention caused acute inflammation on the prostatic gland and increased PSA expression within prostatic tissue. Entry of PSA into stroma and subsequent systemic blood circulation occur through significant increase in PSA production by acinar epithelial cells.
TESTICULAR CANCER IN SOETOMO HOSPITAL SURABAYA: RETROSPECTIVE STUDY Mukti, Ade Indra; Hakim, Lukman; Djatisoesanto, Wahjoe; Hardjowijoto, Sunaryo
Indonesian Journal of Urology Vol 25 No 1 (2018)
Publisher : Indonesian Urological Association

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.32421/juri.v25i1.386

Abstract

Objective: The aim of this study was to determine the characteristics of the testicular cancer that were managed in Soetomo Hospital. Materials & Methods: This was a retrospective descriptive study. We reviewed the medical records of patient with testicular tumor admitted in Soetomo Teaching Hospital Surabaya, from January 2008 until December 2013. The data regarding demographic characteristics, clinical presentation, grading and staging based on pathological examination result, and the management of the cancer. Data was presented in tabular and narrative in order to know the number and percentage of testicular cancer in Surabaya. Results: There were 46 patients with testicular cancer with mean age of 27.1 ± 7.9 years. Peak incidence was 15–35 years old (54%). Testicular mass was the most frequent clinical presentation in 42 patients (91%), abdominal mass and other complaints in 4 patients (9%). Most of the patients live outside Surabaya in 34 patients (72%). Location of the tumor was more frequently in scrotum, which occured in 42 patients (91%). A total of 4 patients (9%) were found to have a history of UDT. Based on the TNM staging, patients with stage pT3 were as many as 20 patients (43%), pT4 11 patients (24%), pT2 7 patients (15%) and pT1 4 patients (9%). In regional lymph nodes staging (N) N3 were as many as 26 patients (57%), N0 9 patients (20%), N2 5 patients (11%) and N1 2 patients (4%). Metastase staging (M) M0 was found in 27 patients (58%) and M1 tumor was found 42%. The major pathological finding was seminoma in 37 patients (80%), Yolk sac tumor in 4 patients (9%), Embryonal Ca in 1 patient (2%), Teratoma in 1 patient (2%) and mixed germ cell tumor in 3 patients (7%). The most widely theraphy was underwent orchidectomy followed by PEB chemotheraphy in 29 patients (64%), 3 patients (6%) underwent EBRT and PEB chemotheraphy, 5 patients (11%) underwent PEB chemotheraphy, There were 9 patients (19%) underwent orchidectomy alone. Group of seminoma tumor show normal limit of tumor marker α-FP and β-HCG and increased in non seminoma. Conclusion: Testicular cancer mostly appears in younger males. Most of testicular cancer was seminoma, diagnosed in advanced stage with metastase 42% of the patient. Most of the patients received orchidectomy followed by PEB chemotheraphy.
THE ROLE OF VITAMIN E (α-TOCOPHEROL) ON TESTOSTERONE LEVEL IN SPRAGUE DAWLEY RATS FOLLOWING CISPLATIN TREATMENT Rezia, Dian Kartika; Hakim, Lukman; Djatisoesanto, Wahjoe
Indonesian Journal of Urology Vol 26 No 1 (2019)
Publisher : Indonesian Urological Association

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.32421/juri.v26i1.545

Abstract

Objective: To observe the difference of testosterone levels in adult male Sprague Dawley rats treated with combination of cisplatin and vitamin E compared to those treated with cisplatin only. Material & Methods: We used 24 adult male Sprague Dawley rats weight 200–300 grams and randomly assigned into 4 groups (n=6). Rats in negative control group (NC) were given intraperitoneal normal saline injection, while the positive control (PC) group were injected with cisplatin 5 mg/kgBW at the end of the 3rd week. Two other groups, P1 and P2, were injected with cisplatin 5 mg/kgBW and given vitamin E orally 50 mg/kgBW and 200 mg/kgBW, respectively. Cardiac blood was aspirated at the end of the 7th week and processed for analysis of testosterone levels. Results: We recorded a significantly lower testosterone levels in rats treated only with cisplatin 5 mg/kgBW (CP) compared to those in CN group (p=0.006), and those receiving combination of cisplatin and vitamin E 50 mg/kgBW (p=0.003) and 200 mg/kgBW (p=0.001). Though not significant, testosterone levels were higher in P2 group than in P1 group (p=0.702). Conclusion: Exposure to cisplatin can lower testosterone levels in white rats, and the administration of vitamin E gives protection against such effect. 
EFFECT OF VITAMIN E (α TOCOPHEROL) ADMINISTRATION ON APOPTOSIS OF GERMINAL CELLS EPITHELIUM TESTIS IN SPRAGUE DAWLEY WHITE STRAIN RATS AFTER EXPOSED BY CISPLATIN Nugroho, Achmad; Djatisoesanto, Wahjoe; Soebadi, Doddy M
Indonesian Journal of Urology Vol 26 No 1 (2019)
Publisher : Indonesian Urological Association

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.32421/juri.v26i1.546

Abstract

Objective: To determine the differences of germinal epithelial testicular cell apoptosis in white Sprague Dawley strain rat that received combination of cisplatin and vitamin E compared to Sprague Dawley strain rat that received cisplatin only. Material & Methods:  Twenty four Sprague Dawley rats were divided into 4 groups randomly. Group 1 Negative Control (NC) was given an injection of 1 cc 0.9% normal saline intraperitoneally as a placebo, group 2 Positive Control (PC) was given 5 mg/kgBW cisplatin intraperitoneally, group 3 (P1) was given cisplatin injection 5 mg/kgBW intraperitoneally + vitamin E (α tocopherol) 50 mg/kgBW by gavage and group 4 (P2) was given cisplatin injection 5 mg/kgBW intraperitoneally + vitamin E (α tocopherol) 200 mg/kgBW by gavage. Vitamin E (α tocopherol) was given 3 weeks before up to 4 weeks after cisplatin injection. Observation of the germinal epithelial cells apoptosis was carried out by calculating germinal epithelial cells apoptosis in the cross-section preparations of the seminiferous tubule which gave a positive reaction to the apoptag staining, using a 400x magnification light microscope. Results: Apoptosis on positive control (PC) group was different significantly compared to the negative control (NC) group (p<0.05). There was a significant difference in the apoptosis of germinal epithelial testicular cells in the cisplatin + vitamin E 50 mg/kgBW compared to the PC group (p<0.05). The cisplatin + vitamin E 200 mg/kgBW group; had a lower number of apoptosis compared to the cisplatin + vitamin E 50 mg/kgBW (p<0.05). Conclusion: Vitamin E provides a protective effect on decreasing the amount of apoptosis due to cisplatin exposure. The protective effect of vitamin E is dose-dependent.