Indonesian Journal of Urology
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SEVERITY LEVEL IN HYPOSPADIAS PATIENTS AT HASAN SADIKIN HOSPITAL BANDUNG 2019-2023
Full text linkObjective: The aim of this study is to determine the level of severity in hypospadias patients at Hasan Sadikin Hospital Bandung from 2019—2023. Material & Methods: This is a descriptive and observational study. The data collected includes information from all patients with hypospadias who underwent treatment at the hospital from January 2019 to November 2023, meeting the inclusion criteria and selected through total sampling. The data were presented using descriptive statistics in frequency and percentage. Results: The incidence of hypospadias at Hasan Sadikin Hospital in Bandung from 2019 to 2023 was 296 patients, with an average age of 8.6 ± 6.9 years, and the age group of 0–5 years being the most affected. Out of the total, 163 patients (56%) had moderate hypospadias, 99 patients (33%) had severe hypospadias, and only 34 patients (11%) had mild hypospadias. The average scores were G (glans) 2.2 ± 0.9, M (meatus) 3.4 ± 0.9, and S (shaft) 3.1 ± 1.0. Conclusion: In conclusion, early detection and surgical intervention faced no obstacles, and public awareness of this condition is good.
Key words: Hypospadias, severity level, Hasan Sadikin
PENILE CANCER AND MULTIPLE PREPUTIAL STONE: A RARE CASE REPORT
Full text linkObjective: This paper aims to report a case of penile cancer with multiple prepuce stones in a 46-year-old non-circumcised male. Case Presentation: A 46-year-old male patient came to the clinic with complaints of a slowly enlarging penis since the last 2 months. Complaints are accompanied by difficulty and pain when urinating, sometimes there are stones that come out when urinating. Physical examination revealed an enlarged penis, irregular shape, tenderness, unclear borders. Multiple prepuce stones, pus accumulation, and suspicion of malignancy in the penis were observed. Histopathology showed squamous cell carcinoma (SCC) of the penis. The patient was discharged 4 days postoperatively and prepared for follow-up treatment. Discussion: Penile cancer and prepuce stones are very rare cases. Smegma accumulation, chronic inflammation, and urinary stasis are the pathophysiology of penile cancer and prepuce stones. Conclusion: Penile cancer and preputial stones are very rare. We performed a surgical procedure to divert urine by urethral catheterisation, treated the infection and took penile tissue for biopsy, after which he was referred for further treatment.
Keywords: Penile cancer, multiple prepuce stone, a rare case report
COMPLICATIONS OF PERCUTANEOUS CYSTOSTOMY AT TERTIARY HOSPITAL
Full text linkObjective: This study aims to identify the complications associated with percutaneous cystostomy performed at tertiary hospital. Material & Methods: This study employed a retrospective descriptive design involving patients who underwent percutaneous cystostomy at Saiful Anwar General Hospital from January 2019 to December 2024. Data were collected by reviewing patient medical records, including information on average age, gender, diagnosis, and complications related to the procedure. Complications were classified into intra-procedural and post-procedural categories. This study was approved by the Health Research Ethic Commission of Saiful Anwar General Hospital No: 400/050/K.3/102.7/2025. Results: A total of 72 patients were included in the study (71 males, 1 female), with an average age of 58.58 years. Early complications observed in 7 patients included catheter obstruction in 6 patients (8.3%) and hematuria in 1 patient (1.4%). Late complications limited to surgical site infection, which occurred in 3 patients (4.2%). Conclusion: Percutaneous cystostomy is a safe and effective procedure with a low complication rate, making it a viable routine practice in clinical urology.
Keywords: Percutaneous cystostomy, urinary retention, complication
LATERAL PERCUTANEOUS NEPHROLITHOTOMY IN HORSESHOE KIDNEY: AN ALTERNATIVE APPROACH WITH HIGH SUCCESS RATE
Full text linkObjective: This case report was aimed to present a lateral percutaneous nephrolitotomy (PCNL) approach for a patient with horseshoe kidney, few comorbidities, and the outcome of this procedure. Case(s) presentation: A 70 years old obese male came into our hospital with pain in the left flank. Upon CT scan examination, we found that the patient has Horseshoe kidney with left hydronephrosis. The hydronephrosis resulted from obstruction caused by left kidney pelvic stone with a size of 25 x 20 mm. We decided to do lateral PCNL for this case with an excellent result. Discussion: With newer advancements in urology, different minimally invasive treatment modalities are available to manage stone disease in HSKs. PCNL has shown the better result with fewer complications to remove calculi from HSKs and is accepted as a routine treatment of large calculi in HSK, showing a high SFR ranging from 71% to 88%. Lateral percutaneous access of the renal collecting system is safe, as it is gained on the opposite side to where the renal blood vessels enter the kidney. Conclusion: Stone management in patients with horseshoe kidneys is a challenging procedure in endourology, however percutaneous nephrolithotomy is considered a safe and effective treatment option in patients with renal stones in a horseshoe kidney with acceptable result.
Keywords: Horseshoe kidney, percutaneous nephrolithotomy, lateral PCNL
EVALUATION OF STENOSIS AFTER LAPAROSCOPIC URETEROLITHOTOMY
Full text linkObjective: This study aims to evaluate the probability of stenosis that occurs in the ureter due to the use of electrocautery during ureteral incision procedures in Laparoscopic ureterolithotomy (LU). Material & Methods: This study was conducted in Fatmawati Hospital Jakarta, we collected the data retrospectively in 22 patients diagnosed with ureteral stones who underwent LU procedure from 2014 to 2021, are eligible and have completed the follow-up protocol. The patient was evaluated by assessing the condition of the kidney after the procedure using ultrasound and CT scan to evaluate the presence of ureteral stenosis. Result: Ureteral stenosis was found in 6 of 22 patients (27.3%). Median follow-up time was 45 months (3-4 years). All of them were asymptomatic. Conclusion: There is a 27.3% chance patient will develop ureteral stenosis after LU. Though LU is one of the best methods for extracting large ureteral stone, the late complication after LU should be considered.
Keywords: Electrocautery, laparoscopy ureterolithotomy, ureteral stenosis
THE RATIO OF UROLOGISTS FOR EACH REGENCY AND CITY IN EAST JAVA INDONESIA AND THE INDICATORS AFFECTING THEIR DISTRIBUTION
Full text linkObjective: Research on the distribution of urology in Indonesia, especially in East Java, has not been widely discussed. There are still several areas in East Java that do not have a urologist at all. We try to find out the factors underlying this distribution through several indicators. Material & Methods: Data from all hospitals in East Java were compiled with data of urologists in East Java obtained from the Indonesian Urological Association, supplemented by information from social media and the telephone of the hospital operator. The number of urologists and hospitals with urology services is then correlated with the human development index, the education index, purchasing power index, health index, and regional minimum wage. Results: The ratio of urologists in each district and city in East Java is not evenly distributed, and likewise with the hospitals that provide urology services in each district and city in East Java. The ratio of urologists and the number of hospitals providing urology services are significantly related to the human development index, the education index, the purchasing power index, the health index, and the regional minimum wage. Conclusion: The location of a urologist's practice is related to the development of an area, which in this study is assessed through indicators of human development, education, health, and economy.
Keywords: Urologist Ratio, East Java, Urology.
 
OBESITY PROFILE AS A RISK FACTOR IN RENAL CELL CARCINOMA PATIENTS: A LITERATURE REVIEW
Full text linkObjective: This study aims to determine the profile of obesity as a risk factor for developing RCC. Material & Methods: This study is a library research study with journals, articles, and opinions of related experts taken from Google Scholar and Pubmed which was uploaded in 2019-2023. Results: 7 articles met the inclusion, exclusion and topic relevance criteria. Several journals stated that obesity is a strong risk factor for the development of renal cell carcinoma (RCC), although opposite results were found in one study regarding obesity and the prognostic outcome of RCC patients. Discussion: The mechanism of obesity in increasing the risk of RCC is a complex process, which involves the process of insulin resistance, inflammation by pro-inflammatory cytokines, angiogenesis, and proliferative effects as a result of the role of insulin as one of the most important anabolic hormones capable of stimulating cell proliferation, and is exacerbated by imbalanced cell anti-apoptotic mechanisms. Conclusion: No relationship was found between the lipid profile and the incidence of RCC. Little research has been done on lipid profiles for RCC, considering that the largest RCC subtype, ccRCC, is characterized by the accumulation of lipids and glycogen, which has implications for changes in fatty acid and glucose metabolism in its etiology. Further studies are needed to examine the effect of lipid profiles on the risk of renal cell carcinoma.
Keywords: Carcinogenesis, obesity profile, renal cell carcinoma
INTRACAVERNOSAL INJECTION OF PLATELET-RICH PLASMA AS AN ALTERNATIVE TREATMENT OF ORGANIC ERECTILE DYSFUNCTION: A SYSTEMATIC REVIEW AND META-ANALYSIS OF RANDOMIZED CONTROLLED TRIALS
Full text linkObjective: To evaluate the effectiveness and safety of intracavernosal injections of platelet-rich plasma (PRP) as an alternative therapy for the treatment of erectile dysfunction. Material & Methods: We conducted a comprehensive literature search on Pubmed, Cochrane Library, ScienceDirect, Scopus, and Proquest databases for randomized controlled clinical trials (RCTs) until April 2023. The study protocol has been registered in the International Prospective Register of Systematic Reviews (PROSPERO CRD42023424586). Results: Our results showed that PRP could improve MCID in IIEF-EF score (OR: 4.64; 95% CI: 2.20, 9.79; p < 0.0001; I2 = 77%) and PSV (MD: 9.63; 95% CI: 1.17, 18.09; p = 0.03; I2 = 73%). In addition, PRP administration was shown to be relatively safe, and there was no significant difference in post-injection VAS pain scores when compared to controls (MD: -0.09; 95% CI: -0.49, 0.31; p = 0.66; I2 = 84%). Conclusion: This systematic review and meta-analysis showed promising results regarding the effects of PRP administration on erectile dysfunction. However, due to the lack of quality and number of studies, these findings should be interpreted carefully, and further investigations are still needed.
Keywords: Platelet-Rich Plasma, Intracavernosal Injection, Erectile Dysfunction, IIEF-EF, Meta-Analysis
VESICOCUTANEOUS FISTULA AND BLADDER INJURY IN POST HYSTERECTOMY PATIENT: A CASE REPORT
Full text linkObjective: This article presents a case of vesicocutaneous fistula and bladder injury with intraabdominal adhesion in post-caesarian section and hysterectomy patients. Case(s) Presentation: A 29-year-old woman suffering from vesicocutaneous fistula and bladder injury 10 days after having a hysterectomy due to atonic uterus in post-caesarian delivery. Discussion: Cystography and cystoscopy confirmed the bladder perforation at the posterior and dome. Exploratory laparotomy was then performed and found that a bowel adhesion had occurred following the inflammatory process after the previous procedure. A bladder reconstruction was then performed, and the patient was then catheterized for almost two weeks. Conclusion: A routine follow up then revealed the patient had no more symptom and the surgical wound was closed without any further complication.
Keywords: Vesicocutaneous fistula, bladder injury, hysterectomy, bowel adhesio
A COMPLETE DUPLICATED SYSTEM WITH INTRAVESICAL URETEROCELE IN A 60-YEARS-OLD WOMAN: A CASE REPORT
Full text linkObjective: This case report presents a 60-year-old woman with intravesical ureterocele complicated by severe right upper-moiety hydronephrosis. Case(s) Presentation: A 60-year-old woman came with the chief complaint of right flank pain radiating to the umbilicus and groin accompanied by nausea, vomiting and decreased appetite. Ultrasound examination showed severe hydronephrosis of the right kidney. Abdominal CT revealed a double collecting system with severe hydroureteronephrosis at the upper pelvicalyceal system and the presence of an intravesical ureterocele. Cystoscopy and right RPG of upper and lower moiety procedures were performed and showed right severe hydroureteronephrosis with stenosis of right upper moiety ureteral orifice and ureterocele, followed by uroterocele incision and upper moiety ureteral re-implantation. No further complaints or complications were found after discharge from the hospital. Discussion: Adult ureterocele is a rare congenital anomaly often detected incidentally or due to complications like obstruction and infection. Diagnosis relies on imaging modalities such as ultrasonography, intravenous urography, and CT urography, while treatment options range from minimally invasive endoscopic decompression to surgical excision, depending on severity and associated complications. Conclusion: Ureterocele is a rare congenital urological abnormality found in non-Caucasians. Due to the rarity of the case, a thorough examination is required to establish this dia\gnosis and the choice of the appropriate treatment procedure. The managements include incision of ureterocele and ureteroneocystostomy.
Keywords: Adult ureterocele, intravesical ureterocele, hydronephrosis, complete double collecting system, vesicoureteral reflux