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INDONESIA
Indonesian Journal of Urology
Published by Universitas Airlangga
ISSN : 0853442X     EISSN : 23551402     DOI : 10.32421
Core Subject : Health,
Health Professions Medicine & Pharmacology Public Health
The aim of Indonesian Journal of Urology is to encompass the whole spectrum of urology. The journal publishes papers on a wide range of urological issues such as oncology, functional urology, reconstructive urology, laparoscopy, robotic surgery, endourology, female urology, andrology, pediatric urology, and sexual medicine. We welcome authors for original article (research), review article, interesting case reports, special article, clinical practices, and medical illustrations that focus on the clinical area of urology.
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Articles 408 Documents
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LAPAROSCOPIC LIVING DONOR NEPHRECTOMY IN INDONESIA Mochtar, Chaidir Arif; Wahyudi, Irfan; Baskoro, Bagus
Indonesian Journal of Urology Vol 21 No 2 (2014)
Publisher : Indonesian Urological Association

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.32421/juri.v21i2.28

Abstract

Objective: To evaluate and analyze variables related to the surgical and direct post-operative outcomes of our initial experience of laparoscopic living donor nephrectomies (LLDN). Material & methods: This retrospective analysis describes the first 10 laparoscopic nephrectomies in living donors performed in Cipto Mangunkusumo Hospital. All surgeries were performed by the same surgical team. Variables related to the surgical and post-operative outcome and complications in donors were evaluated and analyzed.Results: The average age of the donors was 31.8 years with male : female ratio of 7 : 3. Thirty percent of them were family related to the recipient. The left kidney was extracted from all patients and multiple renal vessels were found in one cases. The mean operation time was 321.9 ± 27 min, first warm ischemia time was 9.37 ± 3.34 min and estimated blood loss was 270 ± 182.87ml. The hospital stay was 4.1 ± 1.3 days, VAS in the first day post surgery was 3 ± 1 with epidural analgesia needed for 1.8 ± 0.6 days, and drain was kept in for 2.8 ± 1.2 days while urethral cathether for 2.4 ± 1.2. Time to return to work was 16 ± 8.4 days. Conclusion: LLDN results in acceptable blood loss,less post-operative pain, short hospital stay and short time to return to work for the donors, therefore promising to be the gold standard among living donor nephrectomy surgical options.Keywords: Laparoscopic living donor nephrectomy,renal transplantation, Indonesia.
ONE-YEAR EVALUATION OF OVERALL URETHRAL STRICTURE MANAGEMENT USING QUESTIONNAIRES AND UROFLOWMETRY Mediana, Ervita; Wahyudi, Irfan; Rodjani, Arry
Indonesian Journal of Urology Vol 21 No 2 (2014)
Publisher : Indonesian Urological Association

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.32421/juri.v21i2.29

Abstract

Objective: To evaluate the overall outcomes of patients who get definitive treatment of urethral stricture. Material & Method: All patients who underwent various urethral stricture management in Cipto Mangunkusumo Hospital were evaluated over 1 year period. Patient demographics, type of surgery, International Prostate Symptoms Score (IPSS), quality of life (QoL) score, flow rate (FR) and post void residual urine (PVR) of all patients were evaluated at 3 months, 6 months and 1 year after surgery. Results: Out of 230 urethral stricture patients, 65 patients were eligible this study. Mean patient age was 41.19 ± 20.44 years. 37Direct Vision Internal Urethrotomy (DVIU), 20 end-to-end anastomosis, and 8 graft urethroplasties were performed. All patients underwent urethral stricture management showed improvement of IPSS (-22.64, p < 0.001), QoL (-3.36, p < 0.001), FR (16.72 ml/s, p < 0.001) and PVR (-126.23 ml, p < 0.001). Compliant patients showed better improvement of IPSS and FR than non compliant patient after DVIU procedure. Overall, open surgery give better improvement of IPSS and FR than DVIU procedure. These differences were more pronounced in recurrent and long (≥ 2 cm) urethral stricture disease. In open surgery group, end-to-end anastomosis give better improvement in FR compared to graft urethroplasty. Conclusion: Patients undergoing urethral stricture management experienced a significant improvement in self-reported outcomes and functional uroflow studies. Overall, open surgery gives better improvement in FR and IPSS than DVIU procedure. In open surgery group, end-to-end anastomosis give better improvement compares to graft urethroplasty.Keywords: International Prostate Symptoms Score, quality of life, flow rate, post void residual urine, urethral stricture.
TRANSPLANTATION OF ALLOGENIC ADIPOSE-DERIVED STEM CELL IMPROVE URETHRAL MUSCLE-COLLAGEN RATIO AFTER VAGINAL DISTENSION Yudiana, I Wayan; Hardjowijoto, Sunaryo; Alif, Sabilal; Purwati, Purwati; Sandhika, Willy; Budiono, Budiono
Indonesian Journal of Urology Vol 21 No 2 (2014)
Publisher : Indonesian Urological Association

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.32421/juri.v21i2.30

Abstract

Objective:To investigate the effects of allogenic adipose-derived stem cell (ADSC) transplantation on urethral tissue regeneration after vaginal distension in a rat model.Material & Method:32 female wistar rats underwent vaginal distension (VD) for 4 h. Subsequently, PKH-labeled ADSCs (2 x 105 in 200 µl PBS, ADSC group, n = 18) or PBS (200 µl, placebo group, n = 18) were injected into periurethral tissue. Two and four weeks following transplantation (ADSC or PBS), voiding behavior (frequency) and muscle-collagen ratio of urethral tissue were measured to evaluate urethral sphincter regeneration. Data were analysed by paired-t test, one-way ANOVA and post hoc LSD.Results:Mean voiding frequency was significantly different in the ADSC group at two weeks (p<0.0001), but not significantly different at four weeks (p=0.448) when compared with the placebo group.Masson’s trichrome staining revealed that the muscle-collagen ratio of urethral tissue was not significantly different between study groups at two or four weeks (p=0.053 or p=0.166 respectively). Muscle-urethral ratio was more specific showing a significant difference at two weeks (p=0.043). There were significant differences about muscle-collagen or muscle-urethral ratio between control and placebo groups (p<0.05), whereas between control and ADSC groups no significant difference was observed (p>0.05).Conclusion:ADSC transplantation promotes urethral muscle-collagen ratio with development of striated muscle after vaginal distension, so that can improve voiding behavior in a rat model.Keywords:Adipose-derived stem cell, vaginal distension, rat-SUI model, muscle-collagen ratio, voiding stain on paper.
PROFILE OF BLADDER TRANSITIONAL CELL CANCER IN SOETOMO HOSPITAL SURABAYA Abdih, M. Asro; Djatisoesanto, Wahjoe; Hardjowijoto, Sunaryo
Indonesian Journal of Urology Vol 21 No 2 (2014)
Publisher : Indonesian Urological Association

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.32421/juri.v21i2.31

Abstract

Objectives: To describe the characteristic of bladder transitional cell cancer (TCC). Material & methods: We reviewed the medical records of patients with bladder TCC admitted in Soetomo General Hospital Surabaya, from January 2008 until December 2012. The data regarding demographic characteristics, clinical presentation and staging, grading and staging based on pathological examinations results, and the management of the cancer.Results: The 126 cases, consisted of 102 men (81%) and 24 women (19%) with its ratio was 4.2 : 1. All male patients were heavy cigarette smokers. Mean age was 57.8 years, peak incidence was50-59 years. Hematuria was the mostfrequent clinical presentation (112 patients, 88.9%), urinary retention and other complaints (12 patients, 9.5%), and chronic dysuria (2 patients, 1.6%). Clinical staging was T1 as NMIBC in 7 patients (5.7%). MIBC consisted of T2 in 37 patients (30.3%), T3 in 35 patients (28.7%), T4 in 43 patients (35.2%). The pathological grading as an high-grade were 74 patients (64.3%). All patients had underwent TURBT for diagnosis and staging, followed by definitive treatment. It consisted of TURBT and chemotherapy bladder instillation in 7 patients (5.6%), radical cystectomy in 13 patients (10.3%), EBRT in 5 patients (4%), MVAC chemotherapy in 24 patients (19%), EBRT and chemotherapy with MVAC in 3 patients (2.4%). There were 74 patients (58.7%) underwent TURBT alone.Conclusion: Bladder TCC was in advanced stage when diagnosed, most of the patients received only TURBT and refused further treatment. Keywords: Bladder transitional cell cancer, characteristics, managements.
SENSITIVITY AND SPECIFICITY OF PROSTATIC BIOPSY RESULT BASED ON PROSTATE VOLUME Pitoyo, Joko; Safriadi, Ferry
Indonesian Journal of Urology Vol 21 No 2 (2014)
Publisher : Indonesian Urological Association

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.32421/juri.v21i2.32

Abstract

Objective: To compare the sensitivity and specificity of both types of prostate biopsies, between 6 core biopsy/sextant biopsy with volume based biopsy prostate. Material & method: The subjects were patients that have been performed prostate biopsy in Hasan Sadikin Hospital in 2006 – 2010. The data was divided into two groups, the group A (before 2009) 327 patients had performed 6 cores biopsy, group B (after 2009), the biopsy was performed based on prostate volume (volume < 40 cc : 8 cores, volume 40-60 cc : 10 coresand volume > 60 cc : 12 cores). Biopsy results confirmed by definitive results from surgery, then analyzed specificity and sensitivity between two groups. The analytical statistic test using unpaired T test and Levene’s test. Results: There were 654 patients divided in two groups. The data in both groups were similar based on analytical statistic test using unpaired t test (p = 0.28) and the data was in normal distribution (Levene’s test = p > 0.05). The group A, mean age 67.4 years, mean prostate volume 32.53 cc and mean PSA levels 29.89 ng/dl and at group B, mean age 66.7 years, mean prostate volume 30.89 cc and mean PSA levels 16.92 ng/dl. Volume based cores method in prostate biopsy have higher sensitivity and specificity compared with 6 core biopsy (97.5% vs 94.0%) and (92.2% vs 77.8%). Conclusion: The sensitivity and specificity of prostate biopsy was increased in volume based cores compared to 6 cores biopsy. Keywords: Prostate biopsy, volume based.
EFFECTIVITY OF PCNL WITH COMBINED ULTRASOUND AND FLUOROSCOPY Herwandar, Rajasa; Rochadi, Sungsang
Indonesian Journal of Urology Vol 21 No 2 (2014)
Publisher : Indonesian Urological Association

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.32421/juri.v21i2.33

Abstract

Objective: To assess the effectiveness of Percutaneous Nephrolithotomy (PCNL) at age > 65 years and its complication. Material & method: Fifty-four patients with renal and proximal ureteral stones who underwent PCNL with ultrasound techniques combined with X-Ray at Sardjito and Pantirapih hospital, during 2007 to 2012. Laboratory data is in the form of hemoglobin, leukocyte count, trombocyte, haematocrit, natrium, potassium, chloride, BUN, creatinine both pre-operative and post-operative. The samples were divided according to age < 65 years old and above. In analyzing categorical data, we used chi-square test, whereas the numeric data analysis is using independent t-test with p < 0.05. Results: We found no significant differences between the age groups < 65 years and age > 65 years in stone location, presence of hydronephrosis, its grade and location. There also no difference based on operative time, intra-operative procedure, its complication and the day of DJ stents removal and nephrostomy. Both group showed similar result on laboratory findings. However, we found that the older age group have 2 days longer in the length of hospitalization than the younger age groups (p = 0.05) and history of diabetes mellitus and hypertension with p < 0.05. Conclusion: PCNL is a safe and effective procedure with minimal complications for the treatment of kidney and proximal ureteral stone, even for patients with co-morbidity. PCNL technique with guidance of ultrasound for early access would help tomake the operating time shorter and less exposure to ionizing radiation.Keywords: Percutaneous nephrolithotomy, age > 65 years old, effectiveness, safety.
CORRELATION OF PSA, PV, AND IPP IN DETECTING BOO CAUSED BY PROSTATE ENLARGEMENT Kurnia, Indra Cahya; Ghinorawa, Tanaya; Rochadi, Sungsang
Indonesian Journal of Urology Vol 21 No 2 (2014)
Publisher : Indonesian Urological Association

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.32421/juri.v21i2.34

Abstract

Objective: To define the relationship between intravesical prostatic protrusion (IPP), prostate specific antigen (PSA), and prostate volume (PV), and to determine which one is the best predictor of bladder outlet obstruction (BOO) due to benign prostatic enlargement. Material & method: 95 male patients > 40 years old presenting with LUTS and BPH, between January until July 2012. They were evaluated with digital rectal examination (DRE), International Prostate Symptoms Score (IPSS), total PSA serum, uroflowmetry, post-void residual urine measurement, IPP and PV using transabdominal ultrasound. Statistical analysis included Chi-square and Spearman’s Rank correlation test.Receiver Operator Characteristic (ROC) curves were used to evaluate the correlation of PSA, PV, and IPP with BOO. Results: Mean PSA was significantly higher in obstructed patients (8.6 ng/mL; 0.76-130) compared to non-obstructed patients (6.44 ng/mL; 1.0-40.6). Mean PV was significantly larger in obstructed patients (50.33 mL ± 24.34) compared to non-obstructed patients (45.39 mL ± 23.43). Mean IPP was significantly greater in obstructed patients (7.29 ± 2.78) compared to non-obstructed patients (6.59 ± 2.93). The Spearman rho correlation coefficients were 0.617, 0.721, and 0.797, for PSA, PV, and IPP, respectively. Using ROC curves, the areas under the curve for PSA, PV, and IPP were 0.509, 0.562 and 0.602, respectively. The positive predictive values of PV, PSA, and IPP were 59.7%, 55.6% and 60.2% respectively. Conclusion: PSA, PV, and IPP measured through transabdominal ultrasonography are noninvasive and accessible method that significantly correlates with BOO in BPH patients. IPP is a better predictor for BOO than PSA or PV.Keywords: Bladder outlet obstruction, intravesical prostatic protrusion, prostate specific antigen, prostate volume, transabdominal ultrasound, benign prostate hyperplasia.
CORRELATION OF FOLLICLE STIMULATING HORMONE AND LUTEINISING HORMONE WITH TESTICULAR SPERM BIOPSY RESULT Ardiyansyah, Fadhil; Utomo, Trisula
Indonesian Journal of Urology Vol 21 No 2 (2014)
Publisher : Indonesian Urological Association

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.32421/juri.v21i2.35

Abstract

Objective: To investigate the correlation of follicle stimulating hormone (FSH) and luteinising hormone (LH) with testicular sperm biopsy result in azoospermia patients. Material & methods: This is a cross sectional descriptive analytic study. Data were collected from medical record in Klinik Permata Hati Sardjito General Hospital Yogyakarta. We divided them into two groups, sperm group and non-sperm group of sperm biopsy result. We recorded the level of FSH and LH pre-operation. The results were expressed as mean ± standard deviation (SD). The correlation coefficient (r) between various parameters was determined by analysis for Spearman’s rank correlation test. Results: We found 35 patients who met the inclusion and exclusion criteria during 2010-2012, who performed testicular biopsy, age range between 28-44 yo. The mean of FSH on sperm group (12.75 mIU/mL) was higher than non-sperm group (7.26 mIU/mL). The mean of LH on sperm group (5.8 mIU/mL)was also slightly higher than non-sperm group (5.70 mIU/mL). We found weak correlation between FSH level and testicular biopsy (r = 0.095), while on LH level was found negative correlation with testicular biopsy (r = -0.053). There were 42.85% patients with negative sperm result within normal range of FSH and 100% with normal range of LH. The Level of FSH with positive result ranged between 1.94-19.7 mIU/mL and LH level with positive result were 1.38-17.69 mIU/mL. Conclusion: FSH and LH were important plasma hormones correlated with spermatogenesis. FSH level between 1.94-19.7 mIU/mL and LH level between 1.38-17.69 mIU/mL could be used as reliable criteria for testicular sperm biopsy.Keywords: Follicle stimulating hormone, luteinising hormone, testicular sperm biopsy, azoospermia.
COMPARISON OF SEXUAL DYSFUNCTION BETWEEN END-TO-END ANASTOMOSIS AND BUCCAL MUCOSA GRAFT Yuri, Prahara; Wahyudi, Irfan; Rodjani, Arry
Indonesian Journal of Urology Vol 21 No 2 (2014)
Publisher : Indonesian Urological Association

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.32421/juri.v21i2.36

Abstract

Objective: The aim of this study was to compare long term follow-up of sexual dysfunction between end-to-end anastomosis or buccal mucosa graft in short segment bulbar urethral stricture. Material & Method: We performed a meta analysis of cohort study. The data sources was MEDLINE from 1980 through 2011. A fixed effects model with Mantel-Haenszel method was used to calculate the pooled Risk Ratio (RRs) and 95% Confidence Interval (CIs). We assessed the heterogeneity by calculating the I2 statistic. All analyses were performed with Stata statistical software, version 10.0 (Stata Corp). Results: We analyzed 6 cohort studies. End-to-end anastomosis and buccal mucosa graft patients who complained about sexual dysfunction were 24.6% (45/183) and 9.1% (11/122) respectively, with overall RR 2.54 (95% CI, 0.22-0.69, p = 0.001). Conclusion: Buccal mucosa graft showed a superior outcome compared to end-to-end anastomosis, based on sexual dysfunction in ≤ 3 cm bulbar urethral stricture treatments.Keywords: Sexual dysfunction, end-to-end anastomosis, buccal mucosa graft, anterior urethral stricture.
PERCUTANEOUS NEPHROLITOTOMY ON THE MANAGEMENT OF CALYX INFERIOR STONES Tirtayasa, Pande Made Wisnu; Birowo, Ponco; Rasyid, Nur
Indonesian Journal of Urology Vol 21 No 2 (2014)
Publisher : Indonesian Urological Association

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.32421/juri.v21i2.37

Abstract

Objectives: To compare the stone free rates of inferior calyceal stones with stone burden < 20 mm, 21-30 mm, and > 30 mm on post-percutaneous nephrolithotomy (PCNL) patients in Cipto Mangunkusumo Hospital. Material & method: The data was collected retrospectively from PCNL medical records in Cipto Mangunkusumo Hospital between January 2000 until May 2012. Patients were followed-up with plain abdominal radiography (BNO) or renal ultrasonography (USG). Stone free status was defined as no residual fragments on radiography or USG. Results: As many as 88 patients with inferior calyceal stones who underwent PCNL were included. Forty-three cases had stone burden < 20 mm, 34 cases with stone burden 21-30 mm, and 11 cases with stone burden > 30 mm. Overall, 81 (92%) cases were defined as stone free. On group < 20 mm, 21-30 mm, and > 30 mm; 41 (95%), 32 (94%), and 8 (73%) cases defined as stone free respectively (p = 0.485). Conclusion: PCNL is the primary modalityon the management of calyx inferior stones with high stone free rate. The stone free rate of these three groups showed no statistically significant difference.Keywords: Percutaneous nephrolithotomy, inferior calyx stone, stone free rate.

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