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Tarmono Djojodimedjo
Department Of Urology, Faculty Of Medicine, Universitas Airlangga; Dr. Soetomo General Academic Hospital, Surabaya, Indonesia
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DIURETIC DOPPLER ULTRASOUND FOR EVALUATING OBSTRUCTED AND NON-OBSTRUCTED KIDNEY Fajrial, Ahmad Fajrial; Soebadi, Doddy M; Djojodimedjo, Tarmono; S, Muhammad Yamin; Pudjirahardjo, Widodo
Indonesian Journal of Urology Vol 20 No 2 (2013)
Publisher : Indonesian Urological Association

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.32421/juri.v20i2.11

Abstract

Objective: The objective of this study was to evaluate the implementation of diuretic Doppler Ultrasound (DDU) to differentiate the obstructed and non-obstructed kidney. Material & Method: From 28 patients, we gathered data of 48 kidneys in accordance with the inclusion criteria. We evaluated the Doppler Ultrasound Resistive Index (RI) before and after administration of diuretic, using the renogram as the comparison. The result of renogram was categorized into total obstruction (n = 19), partial obstruction (n = 18), and non-obstructive dilatation (n = 3). The statistical analysis was performed using Anova test followed by Tukey HSD test. We also performed diagnostic test, the total and partial obstruction were categorized within obstructed group (n = 37) whereas normal and non-obstructed dilated kidney categorized as non-obstructed group (n = 11). Results: Average change of RI (ΔRI) was 0,542 ± 0,0457 for total obstruction, 0,0428 ± 0,0439 for partial obstruction, 0,0275 ± 0,0392 for normal kidney, -0,0300 ± 0,0361 for non obstructed dilated kidney. The result of normality and homogeneity test indicated the data were normally distributed. One-way Anova test revealed significant differences of ΔRI between groups. The subsequent Tukey HSD test indicated that there were significant differences in total and partial obstruction groups, compared to non-obstructive dilated kidney group. Based on ΔRI cut-off point (0,035) the diagnostic characteristics were 88,5% sensitivity and 72,3% specificity. Conclusion: RI of Diuretic Doppler Ultrasound is a valuable examination to evaluate obstructed and non-obstructed kidney. The cut-off point of 0,035 indicated probability of obstructive kidney. Keywords: Resistive index, renogram, obstructive kidney, non-obstructive kidney. 
TAMSULOSIN OR SOLIFENACIN IN LUTS PATIENTS DUE TO DJ-STENT INSERTION Subkhan, Subkhan; Djojodimedjo, Tarmono; Hakim, Lukman; Budiono, Budiono
Indonesian Journal of Urology Vol 20 No 2 (2013)
Publisher : Indonesian Urological Association

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.32421/juri.v20i2.13

Abstract

Objective: To evaluate the efficacy of tamsulosin or solifenacin for treatment of Lower Urinary Tract Symptoms (LUTS) due to an indwelling ureteral stent. Material & Method: In this study, we enrolled 24 patients who had polyurethane DJ-stent inserted for urinary stone disease or ureteral stenosis. Patients were divided into 3 equal groups as follows and study medications were started on postoperative day 7. Group I received tamsulosin 0,4 mg once daily, group II received solifenacin 5 mg once daily, and group III only received placebo. LUTS were evaluated using International Prostatic Symptoms Score (IPSS) questionnaire at 7 and 14 days after the procedure and stent insertion. The evaluation of IPSS score included not only total score but also irritative and obstructive subcores. Results: All 24 patients fulfilled the inclusion and exclusion criteria, mean age of tamsulosin group was 54,3 years old, solifenacin group was 45,3 years old and placebo was 46,7 years old. There was significant difference in the total IPSS and irritative subscores between groups who received either tamsulosin or solifenacin (group I and II), whereas the obstructive subscore showed a difference though not statistically significant. Conclusion: Tamsulosin or solifenacin significantly improved irritative symptoms of LUTS in patients with an indwelling ureteral stent.Keywords: Lower urinary tract symptoms, DJ-stent, tamsulosin, solifenacin.
RELATIONSHIP BETWEEN TZI AND TZV WITH IPSS, QMAX, AND BOO Satyagraha, Paksi; Djojodimedjo, Tarmono; Wirjopranoto, Soetojo; Budiono, Budiono
Indonesian Journal of Urology Vol 20 No 2 (2013)
Publisher : Indonesian Urological Association

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.32421/juri.v20i2.15

Abstract

Objective: This study evaluate the relationship between the IPSS score, Qmax,  and degree of bladder outlet obstruction with transitional zone volume (TZV) and transitional zone index (TZI) in clinical BPH patient. Material & Methods: This is an observational cross sectional study which 26 patients included with clinical BPH between September 2011 until January 2012. General information and other variables are recorded (total prostate volume, TZV, TZI, IPSS score, Qmax and degree of bladder outlet obstruction (BOO) according to Schaefer normogram. The data will be descriptive and analytically analyzed. Results: 26 patients with clinical BPH are included in this study, with average age is 64,7 (± 5,98) years. The average volume of the total prostate volume and TZV are 30,35 (± 15,35) gram and 15,31 (± 11,77) gram. Meanwhile the average of TZI is 0,4 (± 0,13). After the normal distribution test was performed, all data is analyzed with Pearson correlation test. A strong correlation was found between IPSS and total prostate volume (r = 0,526, p = 0,006), TZV (r = 0,671, p = 0,000) and TZI (r = 0,812, p = 0,000). A strong correlation is also found between TZI and BOO (r = 0,560, p = 0,003). Meanwhile weak correlation is found between Qmax and total prostate volume (r = -0,105, p = 0,608), TZV (r = -0,103, p = 0,616) and TZI (r = - 0,084, p = 0,734). Another weak correlation is shown between total prostate volume (r = 0,233, p = 0,253) and TZV (r = 0,37, p = 0,062) with degree of BOO according to Schaefer nomogram. Conclusion: TZV has significant correlation with IPSS score, but no significant correlation with Qmax and degree of BOO in patients with clinical BPH. Meanwhile TZI has a significant correlation with IPSS and degree of BOO in patients with clinical BPH. TZI could be performed as a single non invasive procedure to determine BOO in patients with clinical BPH.Keywords: Prostatic hyperplasia, transition zone, ultrasonography, urodynamics.
PSA, TZI, RI OF PROSTATE AS RISK FACTORS OF URINARY RETENTION Renaldo, Johan; Hardjowijoto, Sunaryo; Djojodimedjo, Tarmono; Budiono, Budiono
Indonesian Journal of Urology Vol 20 No 2 (2013)
Publisher : Indonesian Urological Association

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.32421/juri.v20i2.16

Abstract

Objective: To evaluate some parameters as the predictors of urine retention incident in Benign Prostate Hyperplasia (BPH) patients. Materials & Methods: From May to August 2012, a total of 24 BPH patients aged 47-69 years with lower urinary tract symptomps (LUTS) including 12 patients with urine retention  were participated in the study. Prostate specific antigen (PSA) examination was performed on all patients. For urine retention patients, PSA was performed 2 weeks after catheterization as the procedure may affect PSA levels. Transrectal ultrasonography (TRUS) was examined to assess total prostate volume (VTP), transitional zone volume (VZT), transitional zone index (IZT = VZT / VTP), and resistive index of prostate capsulary arteries. Statistic was utilized using simple and multiple logistic regression. Receiver operating characteristic (ROC) was calculated to assess the usefulness of parameters as a predictor of urine retention. Results: There was no significant difference in age between LUTS and BPH patients with urine retention (p = 0,487). There was no relationship between PSA and transitional zone index to incidence of urine retention in BPH patients (PSA; p = 0,173 and TZI; p =  0,192). Multiple logistic regression analysis showed only resistive index of prostate capsulary arteries which correlates with urine retention incidence (p = 0,014), with area under ROC 0,865 (95% CI 0,721 to 1,008) and cut-off value of > 0,675 as a predictor of urine retention incidence. Conclusion: Resistive index of prostate capsulary arteries by transrectal ultrasonography (TRUS) is a predictor of urine retention incidence in BPH patients.Key words: prostate specific antigen, transitional zone index, resistive index of prostate capsulary arteries, benign prostate hyperplasia, lower urinary tract symptoms, urine retention.
PROSTATIC CAPSULAR ARTERY RESISTIVE INDEX AND MALE BLADDER OUTLET OBSTRUCTION Soebadi, Moh. Ayodhia; Djojodimedjo, Tarmono; Wirjopranoto, Soetojo; P, Widodo J
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.v20i1.46

Abstract

Objective: This study aims to explore the relationship between resistive index (RI) with clinical parameters and degree of bladder outlet obstruction (BOO). Materials & Methods: We performed clinical examination which included IPSS, uroflowmetry, transrectal prostate ultrasonography for measurement of prostatic volume and RI of prostatic capsular artery, and pressure flow study. We enrolled patients with lower urinary tract symptoms (LUTS) and prostatic volume of more than 20 ml. Statistical analysis utilised correlation and calculation of sensitivity, specificity, and area under curve of receiver operating characteristics. Results: Twenty-six patients provided consent to enroll in this study. Mean age was 66,5 ± 6,56 years, mean IPSS was 15,9 ± 7,27, and mean prostatic volume 36,0 ± 23,78. Kolmogorov-Smirnov test showed normal distribution of all study variables. There was significant correlation between RI and IPSS, Qmax, and BOO (p < 0,05). Correlation coefficients (r) for prostatic volume and BOO was 0,392 (p = 0,048), for Qmax and BOO was -0.515 (p = 0,007), and RI with BOO was 0,414 (p = 0,035). Using cutoff values for RI ≥ 0,70 and BOO ≥ 4, we found sensitivity of 70,0%, specificity of 50,0%, positive predictive value of 46,7% and negative predictive value of 72,7%. Conclusion: Resistive index of prostatic capsular artery is correlated with BOO and has a role in diagnosis of BOO in men with LUTS related toBenign Prostatic Hyperplasia (BPH).Keywords: Resistive index, transrectal power doppler ultrasonography, lower urinary tract symptoms, bladder outlet obstruction.
THE EFFECTIVENESS OF RENALOF® COMPARED TO KALKURENAL® AND PLACEBO Kristyantoro, Benny; Alif, Sabilal; Djojodimedjo, Tarmono; 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.v19i2.61

Abstract

Objective: To compare the effectiveness after administration of Renalof to Kalkurenal and placebo in patient with renal calculus. Material & Method: We analyzed 30 patient with renal calculi less than or equal to 20 mm (2 cm) between January 2011 and March 2011. Patients were divided into 3 groups. Nine patients were treated with placebo, 8 patients were treated with Kalkurenal and the last 13 patients were treated with Renalof. After 30 days, we analyzed calcium and uric acid excretion for 24 hours and measured the stone with plain abdominal film and renal ultrasound. Results: There were decreased in excretion of calcium and uric acid all of patients but not significant statistically (p > 0,05) and there were significant decreased on stone measurement in patient treated with Renalof. Conclusion: Renalof  can be given as adjunct therapy for patient with renal calculi. Keywords: Calcium and uric acid excretion in urine 24 hours, stone measurement and stone surface area.
COMPARATIVE EFFICACY OF INTERMITTENT AND DAILY DOXAZOSIN THERAPY FOR LUTS ASSOCIATED WITH BPH Nurdianto, Heru; Alif, Sabilal; Tarmono, Tarmono
Indonesian Journal of Urology Vol 18 No 1 (2011)
Publisher : Indonesian Urological Association

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.32421/juri.v18i1.66

Abstract

Objective: To investigate the efficacy of intermittent doxazosin therapy on LUTS associated BPH. Material  & Method: This study was performed between January to April 2010 enrolling 20 patients with LUTS associated BPH. Study subjects were randomly allocated to 2 therapeutic groups. The first group was assigned daily doxazosin therapy (11 patients), while the second group was assigned intermittent doxazosin therapy (9 patients). Initially all subjects were given doxazosin 2 mg daily for 2 weeks. Subsequently group I received doxazosin 2 mg daily therapy, while group II received doxazosin 2 mg every other day. All medications were taken up to 12 weeks. Outcomes were evaluated prior to therapy, and after 2, 4, 8, and 12 weeks of therapy. Efficacy of doxazosin therapy was measured by International Prostate Symptom Score (IPSS), peak urinary flow rate (Q max), and residual urine volume. Statistical analysis was performed to evaluate difference in efficacy between the treatment groups. Results: Daily doxazosin therapy for 2 weeks resulted in significant improvement of Q max and IPSS. After 4, 8, and 12 weeks significant improvement was maintained in both daily and intermittent groups, as measured by Q max, residual urine volume and IPSS. There were no significant differences in Q max, residual urine volume, and IPSS between the daily and intermittent groups at 4, 8, and 12 groups. Conclusion: There were significant improvements of Q max, residual urine and IPSS at 2 to 12 weeks in daily as well as intermittent doxazosin therapy groups. There were no significant differences in efficacy between daily and intermittent therapy groups
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.
ORAL PHENAZOPYRIDINE HCL FOR URETER ORIFICE IDENTIFICATION AND RETROGRADE STENTING Gumilar, Ogi Bahaurini; Soebadi, Doddy M; Djojodimedjo, Tarmono; Askandar, Brahmana; 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.v22i1.179

Abstract

Objective:  To compare the successful of the identification of the ureteral orifice at cervical cancer patients who received phenazopyridine orally and to analyze the correlation between hydronephrosis and successful rate for retrograde stenting. Material & Method: This was a comparative experimental study, using phenazopyridine hcl orally prior to cystoscopy to identify the ureteral orifice on cervical cancer patients and to perform retrograde stenting on spotted ureteral orifice. Forty samples provided consent to enroll in this study. Mean age was 49.2 ± 5.16 years. Thirty-four out of 40 samples was confirmed as squamous cell carcinoma type. Results: Chi-square test demonstrated no significant differentiation in finding ureteral orifice between treatment and control group on stage 3B (p = 0.408). However, result shown conversely on stage 4A (p = 0.046). There was no significant disparity in conducting retrograde stenting between treatment and control group on stage 2B and 3B (p = 0.221 and p = 0.197). There was no significant correlation between hydronephrosis gradation and retrograde stenting on control group (p = 0.144). Conclusion: Administration of phenazopyridine HCL orally in cervical cancer patients increase success for ureteral orifice identification and retrograde stenting, but not statistically significant. There is no correlation between hydronephrosis with a success retrograde stenting.Keywords: Cervical cancer, hydronephrosis, phenazopyridine hcl, ureteral orifice, retrograde stenting.
Co-Authors A.A. Ketut Agung Cahyawan W Addin, Sofyan Rais Aditya, Dimas Visa Agung Dwi Wahyu Widodo Ahmad Fajrial Fajrial Ahmad Nadhir Andri Kustono Anny Setijo Rahaju, Anny Setijo Anny Setijo Rahayu Aulia Nur Fadila Bambang Soeprijanto Benny Kristyantoro Brahmana Askandar Tjokroprawiro Doddy M Soebadi Doddy M. Soebadi Doddy M. Soebadi Doddy M. Soebadi Dyah Erawati Efendi, Ferdyan Rachmat Fauriski Febrian Prapiska, Fauriski Febrian heri budiono Heru Nurdianto I Dewa Gede Reza Sanjaya I Ketut Sudiana Ida Bagus Putra Pramana Johan Renaldo Johan Renaldo Khoirul Kholis, Khoirul Kusuma, Raditya Laksmana, Wisnu Lukman Hakim Lumbangaol, Arifai Moh Ayodhia Soebadi Moh. Ayodhia Soebadi Mohammad Ayodhia Soebadi Muhammad Fawzi Zulfikar Muhammad Reza Gautama Muhammad Wahyu Ali Muhammad Yamin S Nurhadi, Pradana Ogi Bahaurini Gumilar Paksi Satyagraha Permana, Wien putri, Karinda triharyu caesari Ramadhan, Ido Putra Ramandita Duta Dewangga Reza Kurniawan Rizaldi, Fikri Sabilal Alif Sawal, Zuhri Sawal, Zuhri septa surya wahyudi, septa surya Septina Rahayu, Septina Soetojo Soetojo Subkhan Subkhan Sunaryo Hardjowijoto Suryatmana, Anggana wahjoe djatisoesanto Wardhana, Sonny Andikha Widodo J P Widodo J Pudjirahardjo Widodo Pudjirahardjo Wien Permana Yacobda H Sigumonrong, Yacobda H Yufi Aulia Azmi