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All Journal Medical Journal of Indonesia Indonesian Journal of Urology Cermin Dunia Kedokteran Makara Journal of Health Research
Arry Rodjani
Department of Urology, Faculty of Medicine/Universitas Indonesia, Cipto Mangunkusumo General Hospital, Jakarta.
Health Professions Medicine & Pharmacology Public Health

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RETROPERITONEOSCOPIC HEMINEPHRECTOMY: INITIAL EXPERIENCE IN CIPTO MANGUNKUSUMO HOSPITAL JAKARTA Irdam, Gampo Alam; Wahyudi, Irfan; Rodjani, Arry; Situmorang, Gerhard Reinaldi
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.v22i2.174

Abstract

Objective: To explain efficacy and feasibility of heminephrectomy laparoscopic with retroperitoneal approach in double collecting system patients with non-functional upper moiety. Material & methods: Three cases in Cipto Mangunkusumo Hospital’s urology outpatient clinic from July 2013 - January 2014 with double collecting system and non-functional upper moiety. Laparoscopic heminephrectomy with retroperitoneal approach were done to these patients. Results: Surgery was done within 200 - 240 minutes with minimal bleeding and no significant complication. There was no significant hemodynamic disturbance observed during surgery. Patients were able to mobilize and to get immediate oral intake. Pains were minimal and can be treated with first-line analgesics. The patients were discharged on the fourth and fifth day of hospitalization. Conclusion: We are reporting our initial experience doing retroperitoneoscopic heminephrectomy in double collecting system patient. This procedure was feasible and produced good outcomes for the patients.
PARTIAL VERSUS TOTAL UROGENITAL MOBILIZATION IN UROGENITAL RECONSTRUCTION: A META-ANALYSIS Putra, Prima Ciko Ade; Widia, Fina; Alam, Gampo; Wahyudi, Irfan; Rodjani, Arry
Indonesian Journal of Urology Vol 27 No 1 (2020)
Publisher : Indonesian Urological Association

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.32421/juri.v27i1.577

Abstract

Objective: Urogenital sinus, cloacal malformation and congenital adrenal hyperplasia are some of the congenital anomalies which comprehensive management should be done to achieve better outcomes. Total Urogenital Mobilization (TUM) and Partial Urogenital Mobilization (PUM) are the most widely used in term of surgical management. However, many researches showed different outcomes of those procedures. This meta-analysis aims to compare the outcome of TUM and PUM in urogenital reconstruction. Material & Methods: Studies were collected from five different search engines (PubMed, EBSCO, ProQuest, Science Direct, Google Scholar) with keyword as mentioned in the methods section of this paper. All full text articles were included. Critical appraisal for each study was done using the Oxford Center of Evidence Based Medicine Worksheet for therapy. Data were analyzed by Cochrane's Review Manager 5.3 for charts and plots builder. Results: Three studies were found with 81 participants divided into PUM or TUM group. All studies were analyzed by using the Mantel-Haenszel test to produce Forest plot. Overall, urinary incontinence event was more common found in patient who underwent TUM compare with PUM (OR 8.21; 95%CI: 1.1-61.11; p=0.04). Conclusion: PUM has a better urinary outcome in comparison with TUM. Further study with a better study design, follow-up and standardized evaluation is needed to achieve a better understanding on urogenital reconstruction and management.
PENILE PARAFFINOMA RECONSTRUCTION WITH SCROTAL FLAP AND SURGICAL OUTCOME: A CASE REPORT Putra, Ida Bagus Oka Widya; Wahyudi, Irfan; Rodjani, Arry
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.v26i1.436

Abstract

Objective: To present a case of penile paraffinoma reconstructed with scrotal flap. Case presentation: We report a case of 33-year-old male patient with penile paraffinoma. The patient had a history of injecting liquid paraffin into his penis two times – at 6 months and 2 months prior to his admission to the hospital. His IIEF-5 was 10 (moderate erectile dysfunction). The penile shaft was circumferentially enlarged. There was ulceration on the ventral aspect with signs of inflammation on the surrounding skin. Discussion: We perform a complete excision of paraffinoma. The raw surface was repaired with a one-stage scrotal flap. At six-month follow up, the wound was good, and the patient was able to micturate normally. He was able to achieve painless erection, and IIEF-5 score was improved. Conclusion: A one-stage scrotal flap may offer a good choice in defect closure in penile paraffinoma reconstruction.
UNPALPABLE UNDESCENDANT TESTES MANAGEMENT EVALUATION IN CIPTO MANGUNKUSUMO HOSPITAL Siregar, Ginanda Putra; Rodjani, Arry; Wahyudi, Irfan
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.v22i2.177

Abstract

Objective: This study is to evaluate imaging modalities used in unpalpable undescended testes (UDT) patient at our centre. We evaluate the data descriptively. Material & methods: This is a descriptive and retrospective study. Data was taken from medical record in Cipto Mangunkusumo Hospital from January 2010 until June 2014. Sampling method is total sampling. Inclusion criteria for this study was unpalpable UDT patients at Urology Department Cipto Mangunkusumo Hospital, whereas patients with incomplete data and have XX chromosomes were excluded. Results: Mean ages in this study was 9.35 years old (7 month to 41 year old). Diagnostic tools was not performed in half of the patients. Abdominal ultrasound was performed in 9 patients (34.6%), and 4 patients with CT-Scan. We found that most of patients were unilateral UDT (57.7%). Bilateral UDT was found in 11 patients (42.3%). Twenty one patients undergo laparoscopic orchidopexy (80.8%). There were 7 patients undergo full laparoscopy orchidopexy. Fowler Stephen technique applied to 4 patients, and eleven patients underwent inguinal exploration and orchidopexy. Laparoscopic biopsy was performed in 4 patients and agenesis of the testis was found in one patient. There are 13 cases with other abnormalities; hypospadias (38.5%), DSD 46 XY (53.8%), and testicular tumor (7.7%). Conclusion: Unpalpable UDT is adequately diagnosed by history and physical examination. Half of our patient in this study were not performed additional examination such as ultrasound, CT-Scan, and MRI for diagnostic tools and directly underwent laparoscopic orchidopexy. The best management of unpalpable UDT is laparoscopic orchidopexy.
ROBOTIC-ASSISTED KIDNEY TRANSPLANTATION: A REVIEW Prasetyo, Dimas Tri; Birowo, Ponco; Hamid, Agus Rizal Ardy Hariandy; Wahyudi, Irfan; Rodjani, Arry; Mochtar, Chaidir; Rasyid, Nur
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.v25i1.394

Abstract

Objective: To discuss about kidney transplantation (KT), primarily on robotic-assisted kidney transplantation (RAKT) and to present the current updates on RAKT techniques performed by different centres worldwide. Material & methods: We searched and compiled various literatures on RAKT, focussing on different techniques used to perform the procedure. All the references cited in this review are indexed in PubMed or Scopus. Results: Since the first successful kidney allograft transplantation in human was performed in 1954, KT has become the preferred treatment modality for patients with end-stage renal disease (ESRD) seeking a more definitive outcome and better quality of life. Over the years, newer techniques of KT have been introduced, including minimally-invasive laparoscopic KT. However, laparoscopic KT has its own limitations, which include loss of hand-eye coordination and poor ergonomics for the surgeon. RAKT offers the same benefits as laparoscopic KT without its limitations. There are several transplantation centres worldwide performing RAKT regularly. The differences in RAKT technique between these centres are regarding patient’s position during surgery, location of incision for graft placement, use of regional hypothermia, and techniques of graft placement and ureteric reimplantation. Conclusion: The invention of RAKT as a minimally-invasive KT technique has enabled surgeon to perform surgeries when the operative field is deep and narrow and when fine dissection and microsuturing are required.
TESTICULAR TORSION: CAUSATIVE FACTOR IN DELAYED MANAGEMENT Abshari, Fatan; Wahyudi, Irfan; Rodjani, Arry
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.v25i1.382

Abstract

Objective: Analyzing the factors causing delays in the management of patients with testicular torsion in Dr. Cipto Mangunkusumo General Hospital Jakarta. Material & methods: This research is a retrospective research using questionnaire from patients as primary data and from Dr. Cipto Mangunkusumo General Hospital medical records or urologic reports as secondary data from 1st January 2011 to 30th April 2015. Results: 4 patients diagnosed with left testicular torsion admitted to hospital with >4 hours onset (as a prehospital factor). 3 of 4 patients were adult, who came with left testicle pain. The minimum VAS score perceived is 2. 3 of 4 patients had 540o medial left testicle rotation intraoperatively while all patients left testicles were unvital. Conclusion: Further examination is required to diagnose testicular torsion in adult-geriatric. Non-specific complaints, such as lower abdominal pain or painful testicles and mild pain in scrotum  were some of the most important factors, thus causing delays in testicular torsion management. However, a comprehensive education to all health workers, especially for doctors is still required, because the complaints of pain in patients with testicular torsion does not always appear acutely. This becomes important for early identification of patients with testicular torsion, in order to prevent delay in management.
CONGENITAL HYDRONEPHROSIS: PROBLEMS IN DIAGNOSIS AND MANAGEMENT Hutasoit, Yonas Immanuel; Wahyudi, Irfan; Rodjani, Arry
Indonesian Journal of Urology Vol 17 No 2 (2010)
Publisher : Indonesian Urological Association

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.32421/juri.v17i2.347

Abstract

Objective: To evaluate problems in diagnosis and management of congenital hydronephrosis. Material & methods: This study was retrospective. Data was collected from medical records of patients with congenital hydronephrosis, which were hospitalized or went to urologic outpatient clinic at Ciptomangunkusumo Hospital from January 1999 to December 2008 and Harapan Kita Maternal and Pediatric Hospital from January 2004 to December 2008. Data was analyzed with SPSS programme version 13.0. Statistical analysis was performed to find the relationship between age at diagnosis and kidney function (Mann-Whitney test) and between age at diagnosis and nephrectomy rate (Chi-Square test). Results: There were 15 patients who presented because of antenatal diagnosis. Of the 145 patients, we could collect antenatal history only from 63 patients.  Obstetricians provided antenatal care in 56 out of 63 patients. Antenatal ultrasound was performed in only 59 out of 63 patients and only 44,07% (26 patients) with hydronephrosis was detected antenatally. Eleven out of 26 antenatally diagnosed patients came to our clinic at a later age. Three standard studies (postnatal ultrasound, voiding cystourethrogram, and renal scintigraphy) were performed only in 12 out of 145 patients (8,27%). Ultrasound was performed in 108 patients (74,5%), voiding cystourethrogram in 79 patients (54,5%), and renal scintigraphy in only 26 ptients (17,9%). The suggested management was conducted in 115 patients; operative management in 95 patients (82,61%) and conservative treatment in 20 patients (17,39%). The most common operative procedures were ureteroneocystostomy, pyeloplasty, nephrectomy, and posterior urethral valveablation. Mean serum creatinine in below 12 months old group and above 12 months old group was 0,78±0,93mg/dl dan 1,03±0,88 mg/dl respectively(p<0,05). There was no significant difference in nephrectomy rate in both age groups (p>0,05). Nephrectomy was performed in 16 patients, with the most common indication was grade IV hydronephrosis with thin parenchyma in 11 patients (68,75%) and the most common etiology was UPJ obstruction in 10 patients (62,5%). We can only collect follow up data from 73 out of 115 managed patients (63,48%). Urinalysis, ultrasound/voiding cystourethrogram, and renal function studies were not routinely conducted during follow up. Conclusion: The management of congenital hydronephrosis in Indonesia needs improvements in antenatal care standards, particularly obstetric ultrasound, to improve early detection of congenital hydronephrosis. Better education for parents about the importance of follow up is needed, especially for antenatally diagnosed patients. A consensus regarding diagnostic tools used in managing congenital hydronephrosis must be established among urologists, pediatricians, and radiologists.
SUBURETERAL MUCOSA INJECTION WITH DETRANOMER/HYALURONIC ACID FOR VESICOURETERAL REFLUX TREATMENT: SYSTEMATIC REVIEW Tambunan, Nicholas; Rodjani, Arry; Wahyudi, Irfan
Indonesian Journal of Urology Vol 24 No 1 (2017)
Publisher : Indonesian Urological Association

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.32421/juri.v24i1.271

Abstract

Objective: The aim of this study is to search the success rate of detranomer-hyaluronic acid (Dx/HA) used as injection through endoscopy approach and grades of vesicoureteral reflux (VUR) that could affect it success rate. Material & methods: We searched the literatures from MEDLINE database and PubMed from year 2001 until 2013. The data was analyzed using Random Effects Model with the method of Mantzel-Haenzel to analyze the success rates of dextranomer/hyaluronic acid and was determined by 95% Confidence of Interval (CI) disclosure. Meta-regression was performed to adjust the success rate compared with the grade of VUR as covariate. We assessed the heterogeneity by calculating the I2 statistic. All analyses were performed with Stata Statistical Software Version 12.0 (StataCorp). Results: We identified 9 literatures in full review. Of 1105 ureters that were injected with dextranomer/hyaluronic acid, 817 (72%; CI: 67-76%) were successfully treated according to author’s definition. The success rates of Dx/HA for pediatric with grade 1 VUR reached 80% (95% CI: 66-89%), whereas in grade 5 VUR only 50% (95% CI: 34-66%; p<0.05). Conclusion: The overall success rate of dextranomer/hyaluronic acid injection treatment was 72% after 3 months, although success rates varied widely among studies. Preoperative grade of VUR was significantly associated with treatment outcome. Increased VUR grade negatively affected success rates.
RELATION BETWEEN COMPLICATING FACTORS OF HYPOSPADIA AND COMPLICATIONS AFTER TIP: A RETROSPECTIVE STUDY Aritonang, Johannes; Rodjani, Arry; Wahyudi, Irfan
Indonesian Journal of Urology Vol 23 No 2 (2016)
Publisher : Indonesian Urological Association

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.32421/juri.v23i2.239

Abstract

Objective: This study aims to find an association between hypospadias complicating factor for complications that occurred after hypospadias reconstruction, focusing on tubularized incised plate (TIP) as reconstruction techniques are most commonly used. Material & methods: The study data was obtained from medical records of urologic hypospadias patients in Cipto Mangunkusumo General Hospital, Jakarta. Samples are those who underwent hypospadias reconstruction in Cipto Mangunkusumo General Hospital, since April 2002 until May 2014 with a total sampling method. Data were analyzed using SPSS ver 14. Results: We collected 127 patients who underwent the TIP technique with a mean patient age and treatment duration was 7.58 years and 10.95 days. Fistule is the most common complication in patients with post-TIP hypospadias accounting for as high as 32 (25.2%). Bivariate analysis showed a significant correlation between the location of the hypospadias meatus (distal) with torsion of the penis (n = 2; p 0.019). Conclusion: On the basis of the technical complications TIP, such as fistules, meatus stenosis, urethral stricture, torsion of the penis, and glans dehiscence, then the indication for TIP should be clear or selective.
INITIAL EXPERIENCES WITH THREE RENAL ARTERIES OF KIDNEY ALLOGRAFT IN KIDNEY TRANSPLANTATION: A CASE SERIES Prasetyo, Tommie; Rasyid, Nur; Rodjani, Arry
Indonesian Journal of Urology Vol 23 No 2 (2016)
Publisher : Indonesian Urological Association

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.32421/juri.v23i2.237

Abstract

Objective: This study reported a case series of our initial experiences in kidney transplantation with three renal arteries of the kidney allograft. Material & methods: The kidney allograft from all of the four cases was harvested with laparoscopic living donor nephrectomy. End-to-side anastomosis was performed from the small artery to the larger main artery before side-to-side anastomosis was performed between the two arteries of equal size. After joining the renal arteries we performed end-to-side anastomosis from the renal vein and artery to the external iliac vein and artery respectively. Results: All of the four cases respond well to the allograft kidney. Three recipients had normal serum creatinine level before 5 days after transplantation. One recipient had undergone hemodialysis once on the third day after transplantation. All of the recipients have no vascular and urologic complications. Conclusion: Multiple renal arteries are no longer considered as a relative contraindication, especially with meticulous anastomosis technique. No vascular and urologic complication was observed from this technique.
Co-Authors Agus Rizal A.H. Hamid, Agus Rizal A.H. Agus Rizal AH Hamid Agus Rizal Ardy Hariandy Hamid, Agus Rizal Ardy Hariandy Alam, Gampo Albertus Marcelino Alfarissi, Fekhaza ARIANTO, EKO Bagus Baskoro Bramono, Ikhlas A Chaidir A. Mochtar Chaidir Arif Mochtar CHAIDIR MOCHTAR, CHAIDIR Edhi Hapsari Endang Susalit Ervita Mediana Fatan Abshari, Fatan Firdaoessaleh Firdaoessaleh GAMPO ALAM IRDAM, GAMPO ALAM Gerhard Reinaldi Situmorang, Gerhard Reinaldi Ginanda Putra Siregar, Ginanda Putra H R Danarto Harrina Erlianti Rahardjo, Harrina Erlianti Hery Tiera Ilham Wahyudi Irdam, Gampo A Irfan Wahyudi Islianti, Putri Iradita Jamhari Jamhari Johannes Aritonang, Johannes Jose RL Batubara Kanadi Sumadipradja Maruhum B.H. Marbun Mohammad Fariz NICHOLAS TAMBUNAN, NICHOLAS Nur Rasyid Pande Made Wisnu Tirtayasa Ponco Birowo Prahara Yuri Prasetyo, Dimas Tri Putra, Ida Bagus Oka Widya Putra, Prima Ciko Ade Rendy Andika, Rendy Soeroto, Adhitama A. Taufik Rakhman Taher Tommie Prasetyo, Tommie Widi Atmoko Widia, Fina Yonas Immanuel Hutasoit, Yonas Immanuel Yopie T Satyawan Yopie Tjandradiguna Satyawan