Ginanda Putra Siregar, Ginanda Putra
Department of Urology, Faculty of Medicine/Indonesia University, Cipto Mangunkusumo General Hospital, Jakarta.

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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.
UROLOGY RETROPERITONEOSCOPY: INITIAL EXPERIENCE IN CIPTO MANGUNKUSUMO HOSPITAL Siregar, Ginanda Putra; Wahyudi, Irfan; Mochtar, Chaidir Arif; Hamid, Agus Rizal Ardy Hariandy
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.v23i1.178

Abstract

Objective: This study was conducted to evaluate the initial experience of retroperitoneoscopy surgery. Material & method: This is a descriptive study with cross-sectional design. Data was collected from medical records of Urology Department in Cipto Mangunkusumo General Hospital Jakarta, from March 2013 until February 2014. Subjects were all patients who performed retroperitoneoscopic surgery between the time periods. Results: Patients consisted of 9 males (42.85%) and 11 females (57.14%). Mean age was 38.95 + 21.88 years old. Proportion based on diagnosis were 5 renal failures (23.8%), 5 ureteral stones (23.8%), 3 renal cysts (14.3%), 2 PUJOs (9.5%), double 3 collecting systems (14.3%), 1 tumor (4.8%), 1 ureteral tumor (4.8%), and 1 renal diverticle (4.8%). Proportion based on kind of retroperitoneoscopy were ureterolithotomy (23.8%), nephrectomy 3 (14.3%), nephroureterectomy 3 (14.3%), renal cyst unroofing 3 (14.3%), heminephrectomy 3 (14.3%), pyeloplasty 2 (9.5%), partial nephrectomy 1 (4.8%), and diverticle coagulation 1 (4.8%). Mean operating time was 178.81 + 55.72 minutes with mean length hospitalization 8.05 + 4.4 days. Mean amount of bleeding was 98 + 69.47 cc, wound operation infection 0 (0%), peritoneal perforation 1 (4.76%), open surgery conversion 2 (9.52%), and transperitoneal laparoscopy conversion 1 (4.76%). Conclusion: In this study, total number of retroperitoneoscopy surgery cases still less than others abroad. Demographic characteristic showed variety than other study. Compared to other studies, the operating time was comparable but the length of stay was longer. We had higher open surgery conversion rate, while another complication was relatively the same.
PROGNOSTIC FACTORS OF RENAL CANCER Kurnia, Riyan Adi; Warli, Syah Mirsya; Siregar, Ginanda Putra
Indonesian Journal of Urology Vol 24 No 2 (2017)
Publisher : Indonesian Urological Association

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.32421/juri.v24i2.326

Abstract

Objective: Course of the disease of kidney cancer may be unpredictable. For example, between 4.2–7.1% of patients with tumours ≤4 cm that are usually slow-growing may have metastases at diagnostic and are at an elevated risk of disease-specific mortality. Conversely, as many as 40% of patients with lymph node metastases were diagnosed at nephrectomy are alive 5 year after surgery. Several approaches have been proposed to help predict the course of disease of kidney cancer and to distinguish between poor and favourable risk patients. In this study, we review the existing prognostic factors and compared with established prognostic models. Material & methods: This is an analytic descriptive study of all kidney cancer patients treated at Haji Adam Malik Hospital between 2011 and 2015. Individual patient data was collected from medical record and compiled. Results: The number of samples analyzed in this study were 38 patients. We found seven patients remain alive of the entire sample. From the results of the univariate test, the factors that have a significant relationship with the mortality rate were low KPS (<80), weight loss, and nephrectomy. From the results of multivariate analysis, nephrectomy is the only prognostic factor in patients with kidney cancer. Mortality rate was 0.056x lower in patients who underwent nephrectomy compared with patients who did not underwent nephrectomy. Conclusion: Despite the high mortality rate that is found in this study, nephrectomy still has a place in kidney cancer management, even in patients with advanced stage.
Blood cell count is not a significant predictor of survival in bladder cancer after radical cystectomy Andy, Andy; Prapiska, Fauriski Febrian; Siregar, Ginanda Putra; Warli, Syah Mirsya; Sihombing, Bungaran
Universa Medicina Vol. 40 No. 2 (2021)
Publisher : Faculty of Medicine, Universitas Trisakti

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.18051/UnivMed.2021.v40.151-159

Abstract

BackgroundRadical cystectomy (RC) is the gold standard treatment for muscle-invasive bladder carcinoma. A predictive factor is needed for the aggressive approach as it could lead to overtreatment. Elevated blood cell count (BCC) markers are reported to have a significant association with poor outcomes in several types of malignancy. Neutrophil-to-lymphocyte-ratio (NLR) and platelet-to-lymphocyte ratio (PLR) are well-known inexpensive and effective representative markers of inflammatory conditions. This study aimed to determine the BCC as a predictive factor of overall survival (OS) in patients with bladder carcinoma (BC) after RC. MethodsA retrospective cohort study was conducted involving 26 patients who had undergone RC. The demographic characteristics and BCC markers such as hemoglobin (Hb). NLR, PLR and lymphocyte/monocyte ratio (LMR) were collected. The patients were categorized based on the BCC marker value (³ median and < median). Kaplan–Meier survival analysis was done to determine overall survival (OS) on BCC markers. The association between patient demographics and one-year survival was also determined using Mantel-Cox (Log-rank) method. ResultsAmong the 26 patients, the mean age was 55.6 ± 12.9 years. On univariate analysis, none of the demographic characteristics was found to be a significant predictor of one-year and overall survival (p>0.05). Hemoglobin, NLR, PLR and LMR were not significant predictors of one-year survival and OS (p>0.05). ConclusionsThe BCC was not a significant predictive factor of survival in patients with bladder cancer after radical cystectomy.
FIVE YEARS SURVIVAL AND QUALITY OF LIFE AFTER RADICAL NEPHRECTOMY: A DESCRIPTIVE SINGLE CENTER STUDY Can, Adryansyah; Siregar, Ginanda Putra; Sihombing, Bungaran
Indonesian Journal of Urology Vol 29 No 1 (2022)
Publisher : Indonesian Urological Association

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.32421/juri.v29i1.726

Abstract

Objective: This study aims to evaluate five years of survival rate, and quality of life of the patient after radical nephrectomy in our center. Material & Methods: This descriptive longitudinal study included thirty patients who were diagnosed as having renal mass in the Urology division H. Adam Malik General Hospital between January 2014 and December 2015. All patients were completely followed-up for 5 years or the patient died during the observation. We used a translated and validated Indonesian written European Organization for Research and Treatment of Cancer Quality of Life Questionnaire Version 3.0 (EORTC QLQ-C30) questionnaire to assess the patient’s quality of life. Results: Overall 5-years survival of kidney tumor patients was 100%, 66.67%, 50%, 8.33%, respectively for stage 1 to 4. We found a sharp decrease in the cumulative survival rate of stage IV group in the first 24 months compared to the first 12 months, from 66.67% to 25%. This pattern of decrease was not found in the other group of stage. Overall, the quality of life of patients has increased in the first three years postoperatively and decreased in the two years afterward. These fluctuations consistently occur in all groups. All of the groups had reached the maximum quality of life at the third year postoperatively. Conclusion: Stage I renal cell carcinoma patient shown the best five-years survival rate and quality of life among others. The quality of life for all groups inclined for the first three years after surgery and decline consistently afterward. These findings are in accordance with many studies that have been published previously.