Edhi Hapsari
Department of Urology, Faculty of Medicine/Indonesia University, Cipto Mangunkusumo Hospital, Jakarta, Indonesia.

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EFFECT OF URETHRAL DILATION ON ANTERIOR URETHRAL STRICTURE RECURRENCE AFTER INTERNAL URETHROTOMY IN MALES Hapsari, Edhi; Hamid, Agus Rizal AH; Rodjani, Arry; Firdaoessaleh, Firdaoessaleh; HR, Danarto
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.v20i1.38

Abstract

Objective: The aim is to evaluate the effect of urethral dilation on anterior urethral stricture recurrences after direct vision internal urethrotomy (DVIU). Material & Method: Patients were classified into 2 groups after internal urethrotomy for urethral dilation or observation. All strictures included were anterior, single, and causing partial obstruction. Urethral dilation was performed using a metal sound. This procedure was performed every 1 or 2 weeks in the first and second month after operation and then once a month for 1 year or in case of voiding complaints or low flow rate (< 10 mL/s). Follow up at least until 1 year after DVIU. Results: A total of 32 cases could be reviewed, of which are 21 had urethral dilation and 11 observation only. In the urethral dilation group, we found 4 recurrences (19%) with mean time to recurrence 10,52 months. In the observation group, we found 7 recurrent cases (63,63%) with a mean time to recurrence of 8,09 months. P value is 0,02 which means urethral dilation significantly decreased the chance of stricture recurrence. By Kaplan Meier survival analysis, urethral dilation had a better and longer time to recurrence. Conclusion: In this study, regular meatal dilation is proven to prolong the time to recurrence of an anterior urethral stricture after DVIU. Keywords: Urethral dilation, anterior urethral stricture, stricture recurrence.
EVALUATION OF COSMETIC AND SATISFACTION RATE AFTER URETHROPLASTY PROCEDURE USING PPPS Hapsari, Edhi; Wahyudi, Irfan; Rodjani, Arry
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.v19i1.48

Abstract

Objective: To evaluate patients or parents cosmetic satisfaction rate after urethroplasty procedures in patients with hypospadia. Material & Method: We prospectively collected data from parents whose children underwent urethroplasty procedures in Cipto Mangunkusumo Hospital since early 2001 until mid 2009, within 18 years old age. Data collected were age, first and last time of operation, type of hypospadia, characteristic of hypospadia, technique used for urethroplasty and time of operation. We also asked questionnaire about parental background and Pediatric Penile Perception Score (PPPS) questions, which contains (1) Satisfaction in shape and position of the urethral meatus, (2) Satisfaction in penile glans appearance, (3) Satisfaction in penile skin appearance, (4) Satisfaction in overall penile appearance. Each question has 4 types of score: very satisfied is 3, satisfied is 2, unsatisfied is 1, and very unsatisfied is 0. Using Kruskal Wallis and Mann Whitney statistical analysis, we analyzed the association between parental background, type of hypospadia, and technique used for urethroplasty with PPPS. Results: From 178 patients, 76 can be contacted. Mean age of first operation is 5,67 ± 3,66; mean PPPS for meatal appearance is 1,88 ± 0,46; mean PPPS for glans is 2,02 ± 0,32; mean PPPS for penile skin is 1,95 ± 0,39; mean PPPS for general appearance is 1,89 ± 0,45 and mean PPPS is 7,75 ± 1,31. Total PPPS based on type of hypospadia: distal hypospadia 8,1 ± 1,19; medial hypospadia 7,31 ± 1,10 and for proximal hypospadia 7,75 ± 1,32. Total PPPS based on operation technique: TIP 7,72 ± 1,17; Duckett 7,14 ± 1,35 and Onlay Island Flap 8,4 ± 1,8. Using Kruskal Wallis statistic analysis, parents satisfaction rate is significantly associated with monthly income and type of hypospadia (p