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All Journal Indonesian Journal of Urology
Doddy M Soebadi
Departemen/SMF Urologi, FK Universitas Airlangga/RSU Dr. Soetomo, Surabaya
Health Professions Medicine & Pharmacology Public Health

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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. 
RELATIONSHIP BETWEEN OBESITY, PSA, AND PROSTATE VOLUME IN PATIENTS WITH BPH WITHOUT URINARY RETENTION Ambeng, Yudi Y; Alif, Sabilal; Soebadi, Doddy M
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.v18i1.65

Abstract

Objective: To study the relationship between obesity, prostate specific antigen (PSA) level, and prostate volume in patients with benign prostate hyperplasia (BPH) without urinary retention.Material & Method: Twenty two BPH patients without urinary retention were enrolled in this study. Patients were classified into 2 groups based on body mass index (BMI). The first group consisted of 11 patients with obesity (BMI ≥ 27 kg/m2), the second group consisted of 11 non obese patients (BMI <  27 kg/m2). Each patient underwent measurement of PSA, prostate  volume and hematocrit. We performed tests for correlation between all variables in both groups. Results: From correlation testing there was a significant relationship between obesity and PSA. With increasing BMI, a lower PSA level was observed (p< 0,05). There was no significant relationship between prostate volume and hematocrit (p > 0,05).Conclusion: There is a significant negative correlation between obesity and PSA in BPH patients without urinary retention
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.
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.
DIAGNOSTIC VALUE OF NON-CONTRAST HELICAL CT-SCAN AND INTRAVENOUS UROGRAPHY IN UROLITHIASIS EVALUATION Hasan, Fadhli; Soebadi, Doddy M; Hardjowijoto, Sunaryo; Soebadi, Mohamad Ayodhia; Pria, Triyono Karmawan Sukmana; 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.v22i1.99

Abstract

Objective: To evaluate the diagnostic value of Non Contrast Helical Computed Tomography (NCHCT) scanning as the first choice diagnostic modality for detecting urolithiasis cases in Soetomo General Hospital Surabaya and evaluate the feasibility as alternative to Intravenous Urography (IVU). Material & Methods: Seventeen patients with clinical manifestation of suspected urolithiasis underwent NCHCT and IVU to evaluate suspected urolithiasis. Reformatted three-dimensional CT was performed in all patients. The images were correlated with findings from surgical procedure (ureteroscopy, percutaneous nephrolithotomy, and open surgery). Sensitivity, specificity, positive predictive value, negative predictive value, and diagnostic accuracy were determined for NCHCT and IVU. Results: The diagnosis of urolithiasis was defined as unequivocal evidence of urolithiasis on either NCHCT or IVU. Sixteen of seventeen patients evaluated were diagnosed with urolithiasis. NCHCT established the diagnosis in 16 of 17 patients while IVU was positive in 11 of 17 patients. IVU was negative in 6 of the 17 cases. The sensitivity, specificity and accuracy of NCHCT was 100%, 100%, and 100% respectively (p = 0.05) and the sensitivity, specificity, and accuracy of IVU was 68%, 100% and 70% respectively (p = 0.35). There was no statistically significant difference between IVU and NCHCT using Fisher’s exact test. Conclusions: NCHCT accurately diagnosed urolithiasis in patients with suspected urolithiasis. Considering that NCHCT is more effective and efficient than IVU as diagnostic modality in determining the presence of urolithiasis, it may be considered to replace IVU as the first line diagnostic tool for urolithiasis in Soetomo General Hospital Surabaya. Keywords: Non Contrast Helical CT Scan, Intravenous Urography, Urolithiasis.
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.
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

Abstract

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.
TOTAL CHOLESTEROL AND C-REACTIVE PROTEIN LEVELS AS A PROGNOSTIC MARKERS OF UROSEPSIS wahyudi, septa surya; Hardjowijoto, Sunaryo; Soebadi, Doddy M; Soetojo, Soetojo; Djojodimedjo, Tarmono; Budiono, Budiono
Indonesian Journal of Urology Vol 23 No 1 (2016)
Publisher : Indonesian Urological Association

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.32421/juri.v23i1.198

Abstract

Objective: To investigate whether total cholesterol and C-reactive protein levels could be use as a prognostic factor for outcome in patients with urosepsis. Material & Methods: An analytic observational study using 30 patients assigned for total cholesterol and CRP level at the day of admission, three days later, and on the last day of sepsis or on the dead day. All subjects were managed according to standard urosepsis therapy. At the 14th day of treatment, patients were evaluated with a clinical severity score. Then we classified the outcome as improve/good condition, worse, and died. The variables were statistically tested using Spearman’s rho test with software SPSS 20. P < 0.05 was consider significant. Result: From 30 subjects with urosepsis, we found 15 patients in septic condition, 14 patients had severe sepsis and one patient had septic shock. The mean of total cholesterol level in patient with died and worse was lower than that in patient with good outcome. Day-1 (63.25 mg/dl and 101.38 mg/dl vs 119.5 mg/dl), day-3 (56.0 mg/dl and 93.6 mg/dl vs 128.6 mg/dl) and last day/died day (51.0 mg/dl and 82.25 mg/dl vs 154.8 mg/dl). The mean of CRP level in patient with died and worse was higher than that in patient with good outcome. Day-1 (177.18 mg/l and 146.74 mg/l vs 88.1 mg/l), day 3 (127.1 mg/l and 148.8 mg/l vs 56.2 mg/l) and last day/died day (141.88 mg/l and 88.71 mg/l vs 31.58 mg/l). These were statistically significant between total cholesterol and CRP levels in determining the outcome of urosepsis patient. Day-1 (p 0.000 vs 0.011), day-3 (p 0.000 vs 0.002), and last day/died day (p 0.000 vs 0.000). The coefficient correlation total cholesterol was better than CRP in day-1 (rho -0.633 vs 0.459), day-3 (rho -0.755 vs 0.543), and last day/died day (rho -0.874 vs 0.686). Conclusion: Low total cholesterol and high C-reactive protein levels can be used as poor prognostic in urosepsis patients. Total cholesterol level was better than CRP as a prognostic marker.
BODY MASS INDEX RELATIONS WITH THE DIFFICULTIES AND COMPLICATIONS OF PERCUTANEOUS NEPHROLITHOTOMY Prapiska, Fauriski Febrian; Hardjowijoto, Sunaryo; Soebadi, Doddy M; Djojodimedjo, Tarmono
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.v23i2.255

Abstract

Objective: To identified outcomes and complications of percutaneous nephrolithotomy (PCNL) in patients of various body mass indices (BMI) to determine the safety of this procedure in patients with elevated BMI.Material & methods: The analytic observational prospective study of patients who underwent PCNL between February to July 2015 in the operating room Soetomo General Hospital Surabaya. Specifically, BMI, stone-free rates, difficulties duringsurgery, complications, and Clavien score were assessed. We evaluate the independent contribution of BMI as a predictor of outcomes. Results: There were 35 selected patients with kidney stone and planned to PCNL, 20 patients were included and 15 patients were excluded from this study. The patients consisted of 10 men (50%) and 10 women (50%). Mean age was 47.55 years (range 33-75). There were 4 patients with diabetes (20%), and 10 patients with hypertension (50%). Mean stone size was 23.30 mm. Stone location was 11 patients (55%) in the right kidney, and 9 patients (45%) in the left. There were 12 patients (60%) with a single stone, and 8 patients (40%) with multiple stones. BMI values were distributed as follows,underweight 1 patient (5%), normoweight 7 patients (35%), overweight 6 patients (30%), obesity 6 patients (30%). Mean skin to stone distance (SSD) was 87.56 mm. Stone free rate was 55%, and difficulties during surgery only seen in 1 patient (5%) bleeding profusely and open surgery was performed. Clavien score in these patients were grade I in 11 patients (55%), grade II in 7 patients (35%), and grade IIIB in 2 patients (10%). The BMI had no significant effect with Intra operative and postoperative difficulties (0.390. p <0.05. CI 95%). However the lower stone free rate had significant effect (0.040. p <0.05. CI 95%).Conclusion: BMI had no significant effect with Intraoperative and postoperative difficulties in PCNL.However, the lower stone-free rate risk associated with elevated BMI was significant.
PERBANDINGAN ANGKA BEBAS BATU PADA PASIEN BATU KALIK DENGAN PEMBERIAN DIURESIS DAN TANPA DIURESIS SELAMA ESWL Budiyono, Nur Budiyono; Soebadi, Doddy M; P, Widodo J
Indonesian Journal of Urology Vol 16 No 2 (2009)
Publisher : Indonesian Urological Association

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.32421/juri.v16i2.335

Abstract

Objective: To compare effects of intravenous hydration, both with and without diuretics on the stone free rate of calyceal stones during ESWL. Materials and Methods: We analyzed 22 patients with calyceal stone, primarily treated with Sonolith Vision lithotripter, between June 2008 and October 2008. Patients were divided in 2 groups, the 11 patients in group 1 were injected with 500 ml normal saline for intravenous hydration, and 20 mg of furosemide for diuretic effect during ESWL; the 11 patients in group 2 were used as controls. The same energy settings for the shockwaves in one session were equally applied to all patients during ESWL, with a 1 Hz shockwave frequency, 100% power and 1000 shocks. After 2 weeks the stone free rate and residual fragments were evaluated on the post ESWL KUB and compared with the pre-ESWL KUB. Results: After a single ESWL treatment, the stone-free rate was 81,8% (9 of 11 patients) in group 1 and 63,3% (7 of 11 patients) in group 2. The stone free rates of group 1 was higher than that of group 2, but there was no statistical difference between groups 1 and 2. Conclusion: Intravenous hydration with normal saline with a furosemide injection for diuretic effect during ESWL would be same effective method to facilitate fragmentation and stone free of calyceal stones.
Co-Authors A.A. Ketut Agung Cahyawan W Aditya, Dimas Visa Agung Dwi Wahyu Widodo Ahmad Fajrial Fajrial Ariyo Sakso Bintoro, Ariyo Sakso Bambang Soeprijanto Boyke Soebhali, Boyke Brahmana Askandar Tjokroprawiro Dajtisoesanto, Wahjoe Djoyo M Boetoro, Djoyo M Endang Joewarini Fadhli Hasan Fathurrahman, Hasroni Fauriski Febrian Prapiska, Fauriski Febrian Halfian, Randa Hariyoto, Bangun Oktavian Hendromartono Hendromartono, Hendromartono heri budiono Holyness Nurdin Singadimedja Johan Renaldo Kartuti Debora, Kartuti Krismantoro, Rahmad Kurnia Penta Seputra Kurniawan, Andrie Rhomdhon Limantara, Ancelia Lukman Hakim Lumbangaol, Arifai Marzuki Yusuf, Marzuki Mohamad Ayodhia Soebadi Muhammad Yamin S Negara, Muhammad Surya Nindra Prasadja Nugroho, Achmad Nugroho, Ananta Cahyo Nur Budiyono Budiyono, Nur Budiyono Nursanto, Trisno Fajar Ogi Bahaurini Gumilar Pramanta, Aditya Pramesti, MP Budyandini D Rachmat Budi Prasetyo, Rachmat Budi Ramadhan, Ido Putra Rizaldi, Aril Rizaldi, Fikri Sabilal Alif septa surya wahyudi, septa surya Soebadi, M. Ayodhia Soetojo Soetojo Sunaryo Hardjowijoto Tarmono Djojodimedjo Telussa, Arley Sadra Triyono Karmawan Sukmana Pria wahjoe djatisoesanto Waskito, Dwi Widodo J P Widodo J Pudjirahardjo Widodo Pudjirahardjo Yasa, Muhammad Asro Abdih Yuanda, Rameshdo Yudi Y Ambeng