Papers by Pande Made Wisnu Tirtayasa
Archivio italiano di urologia, andrologia, Dec 4, 2023
SYSTEMATIC REVIEW hemodialysis, PD has the advantage to be performed in a continuous ambulatory s... more SYSTEMATIC REVIEW hemodialysis, PD has the advantage to be performed in a continuous ambulatory setting, called Continuous Ambulatory Peritoneal Dialysis (CAPD). Other advantages are less risk to induce hemodynamic instability due to less pro-inflammatory effect involved with the procedure, providing nutritional support via dextrose in the dialysate, lower cost in long-term treatment due to minimal hospital visits or home-care hemodialysis, especially in a remote or rural setting where long-term dialysis is hardly obtained (2-4). The mortality risk for patients treated with PD is better than with hemodialysis in the short-term and long-term survival is better (1). Even though CAPD treatment was less common than hemodialysis, CAPD has recently become the preferred mode of treatment for pediatric patients with ESRD (1, 5). Despite these facts, CAPD is related to several mechanical complications related to catheter placement, including catheter obstruction by omentum, clot, or fibrin, and catheter migration out of the pelvis. Other complications are hypoalbuminemia, hyperglycemia, and infection, which can lead to peritonitis. All complications can lead to catheter failure, needing catheter removal or reinsertion (2, 6). According to ISPD Guidelines, the insertion of catheters in pediatric patients had an 18% of complication rate, including peritonitis, block of catheter, and catheter leakage (7). The omentectomy procedure, partial or total, was hypothesized for lowering the complication incidence. However, the role of the omentectomy procedure on CAPD catheter placement in pediatric patients has been differently evaluated in the literature, with some studies showing improvement while others showing no difference (6, 8-11). Our study aims to define the advantages of omentectomy as a prophylactic procedure in pediatric patients. METHODS The systematic review was conducted following the Preferred Reporting Items for Systematic Reviews and Meta-Analysis (PRISMA) (12). Our protocol was registered in the PROSPERO database (CRD42023412846). Introduction: The role of the omentectomy procedure on Continuous Ambulatory Peritoneal Dialysis (CAPD) catheter placement in pediatric patients has been differently evaluated in the literature, with some studies showing improvement while others showing no difference. Our study aims to define the advantages of omentectomy compared to a procedure without omentectomy. Methods: The literature searching in online databases (PubMed/MEDLINE, Cochrane Library, EMBASE, Scopus, and ClinicalTrial.gov) following the Preferred Reporting Items for Systematic Reviews and Meta-Analysis (PRISMA) guidelines, has been registered on PROSPERO (CRD42023412846). The protocol was performed through April 2023 and focused on pediatric patients treated with an omentectomy procedure and related complications. The risk of bias in each study was assessed using the risk of bias for the non-randomized control trials (ROBINS-I). The effect estimates were extracted as risk ratios with 95% confidence intervals (CI). The heterogeneity of the studies was considered as high heterogeneity if I2 values above 50% or p < 0.05. Results: In the total of 676 articles identified in the database searching for screening, nine studies with 775 patients met the criteria for inclusion. The omentectomy procedure significantly showed a lower incidence of catheter obstruction compared to the control group, (OR 0.24 [95% CI, 0.12-0.49], p < 0.0001, I 2 = 0%). Moreover, omentectomy demonstrated a similar trend in the rate of removal or reinsertion of the catheter with high heterogeneity, OR 0.25 [95% CI, 0.12-0.51), p = 0.0002, I 2 = 70%). Conclusions: The omentectomy procedure showed a lower incidence of catheter obstruction and complications leading to removal or reinsertion of the catheter.
DergiPark (Istanbul University), Oct 23, 2022
Enlarged prostate, either in benign prostatic hyperplasia or prostate cancer is the predominant u... more Enlarged prostate, either in benign prostatic hyperplasia or prostate cancer is the predominant urological disease affecting older men. Metabolic syndrome including high blood glucose was considered to take part in the development of prostate enlargement, although their association is still unclear. This study aims to investigate the correlation between blood glucose with prostatic-related parameters. A cross-sectional study was conducted involving 91 men with prostate enlargement from Urology Polyclinic, Tabanan Hospital, Bali Province, Indonesia. Prostatic-related parameters collected include patient's international prostate symptoms score using the questionnaire, prostate-specific antigen and random blood glucose analysis from serum blood sample, and prostate volume determined with transabdominal ultrasonography. Patient's mean age was 65.4 ± 10 years, mean prostate volume 52.7 ± 26 ml, mean prostate-specific antigen (PSA) 9.2 ± 17 ng/ml, mean international prostatic symptoms score (IPSS) 14.31 ± 7.1, mean random blood glucose 121.1 ± 40.5 mg/dl. This study found weak positive correlation between random blood glucose and prostate volume (r=0.269; p=0.01). PSA and prostate volume showed moderate positive correlation (r=0.365; p<0.001). No correlation between random blood glucose with PSA or IPSS was found in this study. This study found random blood glucose has positive correlation with prostate volume. We recommend enhancing blood glucose control to prevent the progress of prostate enlargement.
International Journal of Medical Reviews and Case Reports, 2018
Introduction. Extracorporeal shockwave lithotripsy (ESWL) has shown to induce acute kidney injury... more Introduction. Extracorporeal shockwave lithotripsy (ESWL) has shown to induce acute kidney injury due to vascular and tissue damage. As real-time glomerular filtration rate is not available in developing countries, promising biomarkers are needed to prevent further tubular kidney damage. Methods. This systematic review design follows the PRISMA guidelines and the Cochrane Handbook for Systematic Reviews of Interventions guidelines. With the keyword of acute kidney injury biomarkers following ESWL, all articles in Medline and Pubmed are analysed for inclusion in this systematic review. Results. There was serum creatinine (SCr), cystatin C (Cys C), kidney injury molecule-1 (KIM-1), N-acetyl-β-D-glucosaminidase (NAG), neutrophil gelatinase-associated lipocalin (NGAL), interleukin-18 (IL-18), and homocysteine that have been studied in acute kidney injury following ESWL. Post-ESWL, SCr increased 0.26-fold (p = 0.006), Cys C has area under the curve (AUC) of 0.49, KIM-1 increased 3-fold (p 0.05). Moreover, IL-18 increased post-ESWL mainly on slower shockwave. Discussion. It has shown that the potential acute kidney injury biomarker following ESWL including SCr, KIM-1, homocysteine, and NAG. However, as mentioned above, SCr and homocysteine have the high possibility of bias due to the presence of other diseases. KIM-1 and NAG urine could be promising biomarkers as both biomarkers increased significantly in an early stage. Conclusion. From many biomarkers studied following ESWL, KIM-1 and NAG were seemed to be the most potential biomarkers compared to others.
Medical Journal of Indonesia, Apr 18, 2023
European Journal of Case Reports in Internal Medicine, Apr 26, 2022
Background: Chyluria is usually associated with parasitic disease caused by Wuchereria bancrofti ... more Background: Chyluria is usually associated with parasitic disease caused by Wuchereria bancrofti and is rare in non-endemic regions. The management of chyluria varies according to the severity of the condition. This report describes a case of mild chyluria and successful treatment using sclerotherapy. Case description: A 44-year-old man presented with a first episode of painless milky urine. The diagnosis of chyluria was established following retrograde pyelography showing a fistula between the right pelviocalyces and the retroperitoneal lymphatic systems. The patient had not travelled to any endemic regions. Sclerotherapy using povidone-iodine was carried out resulting in closure of the fistula. Conclusion: Sclerotherapy using povidone-iodine as the sclerosing agent was effective and safe for the management of a patient with mild chyluria. However, the best treatment for chyluria should be tailored to the patient's condition. KEYWORDS Chyluria, management, sclerotherapy, povidone-iodine LEARNING POINTS • Treatment of chyluria with instillation of povidone-iodine as a sclerosing agent provides an excellent outcome. • The treatment of chyluria is should be tailored to disease severity. of Case Reports in
PubMed, Apr 1, 2016
Aim: to evaluate the effect of a 3-day course antibiotic post-urodynamic study (UDS) to prevent u... more Aim: to evaluate the effect of a 3-day course antibiotic post-urodynamic study (UDS) to prevent urinary tract infection (UTI). Methods: this was a randomized double blind clinical trial on the proportion of UTI in patients who received levofloxacin 500 mg once a day for 3 days after UDS compared to nontreated patients. The outcome of this study was the incidence of lower UTI in levofloxacin group and placebo group. Lower UTI was defined as patient with one or more clinical symptoms of lower UTI and one or more urinalysis parameter of UTI. Chi-square was used to evaluate the association between the lower UTI and treatment group. Results: a total of 126 patients were enrolled in this study from two outpatient urology clinics in Jakarta: Cipto Mangunkusumo Hospital and Asri Hospital. Overall, 26 patients (20.6%) had UTI post UDS (8 out of 63 patients from levofloxacin arm (12.7%) and 18 out of 63 patients from placebo arm (28.6%); p=0.028). The most common isolate found was E. coli (n=18 patients; 69.2%). The most common indications to perform UDS were Lower Urinary Tract Symptoms (LUTS) with failure of therapy (n=43 patients; 25%), LUTS after invasive treatment (n=29 patients; 16.9%), and overactive bladder with failure of therapy (n=22 patients; 12.7%). Conclusion: the use of antibiotic post-UDS can prevent incidence of lower UTI.
Journal of Experimental and Clinical Medicine
Enlarged prostate, either in benign prostatic hyperplasia or prostate cancer is the predominant u... more Enlarged prostate, either in benign prostatic hyperplasia or prostate cancer is the predominant urological disease affecting older men. Metabolic syndrome including high blood glucose was considered to take part in the development of prostate enlargement, although their association is still unclear. This study aims to investigate the correlation between blood glucose with prostatic-related parameters. A cross-sectional study was conducted involving 91 men with prostate enlargement from Urology Polyclinic, Tabanan Hospital, Bali Province, Indonesia. Prostatic-related parameters collected include patient’s international prostate symptoms score using the questionnaire, prostate-specific antigen and random blood glucose analysis from serum blood sample, and prostate volume determined with transabdominal ultrasonography. Patient’s mean age was 65.4 ± 10 years, mean prostate volume 52.7 ± 26 ml, mean prostate-specific antigen (PSA) 9.2 ± 17 ng/ml, mean international prostatic symptoms sco...
Asian Journal of Research and Reports in Urology, Oct 5, 2021
Urological Science, 2019
Indwelling Double-J ureteral stenting is commonly used in urological practice and has various com... more Indwelling Double-J ureteral stenting is commonly used in urological practice and has various complications. This study aimed to assess the frequency of bacterial stent colonization and stent-associated bacteriuria after indwelling it for different time durations and to evaluate the significance of urinary cultures for identification of colonizing microorganisms. A prospective cross-sectional study was conducted. Midstream urine from 72 patients undergoing J stent insertion was investigated microbiologically before stent insertion and on the day of stent removal. The stents were removed by aseptic manipulation, and 1-3 cm of the tip located in the bladder was collected for microbiological study. The urine and stent samples were cultured, and the bacterial pathogens were identified using standard microbiological methods followed by Phoenix automated system. Antimicrobial susceptibility testing was performed by Kirby-Bauer disc diffusion method. Bacterial colonies were found in 47.2% (34 of 72) of the stents. Of the multiple pathogens identified, Escherichia coli (20%) was the most common, followed by Streptococcus sp. (17.5%) and Pseudomonas sp. (12.5%). The bacteria did not colonize within the first 2 weeks of stent placement. Results showed that 55% of the isolates were resistant to erythromycin, 52.5% to ampicillin, 42.5% to piperacillin, and least resistant being 17.5% for tetracycline and imipenem. However, 81.3% and 66.7% of the stents were colonized when placed for 90-120 days and 60-90 days, respectively. High prevalence of bacterial isolates and risk of bacteriuria and colonization was found in the DJ stent tips, with E. coli being dominant colonizer. Most of the bacteria were resistant to different classes of antibiotics. Bacteriuria and stent colonization gradually increases with the duration of stent retention in the body.
E Jurnal Medika Udayana, 2014
Penyandang cacat meliputi suatu individu dengan berbagai tingkat kemampuan yang berbeda dan memil... more Penyandang cacat meliputi suatu individu dengan berbagai tingkat kemampuan yang berbeda dan memiliki suatu persyaratan agar bisa berpergian dengan baik.Orang-orang yang mengalami gangguan fungsi pada tubuh atau penuaan menyebabkan kecacatan akan mencoba untuk melawan cacat tersebut dengan memakai bantuan yang ada disekitarnya. Fasilitas yang tersedia di hotel dibuat untuk pengunjung dengan kondisi normal pada umumnya. Tujuan dari penelitian ini untuk mengetahui apakah hotel Komaneka sudah dilengkapi dengan fasilitas khusus yang memadai dan pengaruh aspek ergonomi terhadap wisatawan yang cacat. Penelitian ini menggunakan kuisioner modifikasi dari Westcott Accessibility Factsheet untuk mendapatkan data yang dibutuhkan. Sampel pada penelitian ini adalah 70 orang tamu yang menginap.Sebanyak 91,43% merasa nyaman saat memakai meja resepsionis hotel dan 8,57% merasa kurang nyaman. Sebanyak 98,57% mudah mengakses tombol lampu kamar hotel dan 1,43% mengalami kesulitan. Sebanyak 85,71% mengatakan jalan antara kursi satu dengan lainnya di restoran sudah cukup lebar dan 14,29% tidak sependapat. Sebanyak 90% mengatakan sudah terdapat jalur khusus dalam keadaan darurat dan 10% mengatakan belum. Hotel Komaneka sudah membuat fasilitas yang membantu wisatawan cacat fisik untuk menjalani aktivitas dengan mudah setiap hari tetapi masih kurang maksimal.
Journal of the Korean Orthopaedic Association, 2012
Journal of Advances in Medical and Pharmaceutical Sciences, 2015
African Journal of Urology
Background Sickle cell disease (SCD) is a prevalent genetic blood disorder with a high global inc... more Background Sickle cell disease (SCD) is a prevalent genetic blood disorder with a high global incidence rate. Individuals with SCD experience lifelong complications; one such recurrent complication is priapism. Given the unfavorable prognosis and the limited knowledge of patients regarding priapism, healthcare professionals need to identify factors that can aid in diagnosing priapism in SCD patients. Main body of the abstract A comprehensive literature search was conducted using four databases, namely MEDLINE, The Cochrane Library, ScienceDirect, and Google Scholar, following the PRISMA guidelines. The quality and risk of bias assessment were performed using the ROBINS-I tool (Risk Of Bias in Non-Randomized Studies of Interventions) according to guidelines by the Cochrane Collaboration. The literature search yielded a total of 4434 studies, out of which six studies met the eligibility criteria. Short conclusions The findings from the selected studies revealed that advancing age and ...
International Journal of Surgery Case Reports
Indonesia Journal of Biomedical Science
Introduction: Lower urinary tract symptoms (LUTS) due to Benign Prostatic Hyperplasia (BPH) is a ... more Introduction: Lower urinary tract symptoms (LUTS) due to Benign Prostatic Hyperplasia (BPH) is a common condition in the ageing male. The first-line treatment of LUTS due to BPH is medical management with α-blockers or 5α-reductase inhibitors (5-ARIs). This study aims to analyze the effectiveness of tamsulosin to improve patients symptoms with LUTS due to BPHMethods: A cohort retrospective study was conducted among 62 respondents with BPH at dr. Soetomo Hospital and Airlangga University Hospital from 2014-2016. The data collected related to characteristics of patients were age, prostate volume, Prostate-Specific Antigen (PSA), IPSS score, IPSS voiding score, IPSS storage score, IPSS quality of life, Qmax, voided volume and post voiding residual urine (PVR). All of the data were analyzed using SPSS version 17.0 for Windows.Results: There were 62 samples with a mean age of 62.28 ± 7.3 years old. The average prostate volume was 36.09 ± 8.3 cc, and the PSA level was 2.8 ± 1.45 ng/d...
Open Access Macedonian Journal of Medical Sciences, Feb 28, 2022
BACKGROUND: Percutaneous nephrolithotomy (PCNL) is considered as a gold standard management for t... more BACKGROUND: Percutaneous nephrolithotomy (PCNL) is considered as a gold standard management for treating large kidney stones. However, laparoscopic approach has been considered as an alternative management to treat such cases. AIM: The goal of this study is to assess the safety and efficacy of laparoscopic stone removal or laparoscopic pyelolithotomy and PCNL for patients with large kidney stone/s whether they were single or multiple. METHODS: Authors searched literatures from Medline, EMBASE, Science Direct, Cochrane Library, and Google Scholar published from inception to March 2019. The studies related to laparoscopic pyelolithotomy regardless of the approach and PCNL for the treatment of kidney stones. Meta-analysis was performed following data extraction and quality assessment. Data analysis was performed using Review Manager 5.3. RESULTS: Sixteen studies with a total of 1044 patients comprised of 501 and 543 patients treated with laparoscopic pyelolithotomy and PCNL, respectively. Operative time was longer in laparoscopic group (Mean difference [MD], 35.45 (95% confidence interval [CI] 13.12-57.79), p = 0.002, I 2 = 98%). Stone free rate was higher in laparoscopic than PCNL (RR, 1.17 (95% CI 1.09-1.25), p < 0.0001, I 2 = 59%) group. Moreover, patients in laparoscopic group benefited from lesser overall complication (RR, 0.71 (95% CI 0.55-0.93), p = 0.01, I 2 = 0%), drop in hemoglobin (MD, −0.89 (95% CI −1.14-(−0.65)), p < 0.00001, I 2 = 53%), blood transfusion rate (Risk ratio [RR], 0.33 (95% CI 0.16-0.66), p = 0.002, I 2 = 0%), post-operative fever (RR, 0.45 (95% CI 0.28-0.72), p = 0.0009, I 2 = 15%), and the need for additional intervention (RR, 0.35 (95% CI 0.19-0.62), p = 0.0004, I 2 = 0%). In addition, there were no significance in post-operative hospital stay (MD, 0.45 (95% CI −0.14-1.03), p = 0.13, I 2 = 90%) and prolonged urine leakage (RR, 1.76 (95% CI 0.90-3.42), p = 0.10, I 2 = 0%) between two groups. CONCLUSION: Laparoscopic stone removal provided higher stone free rate and lower post-operative complications than PCNL. Laparoscopic approach could stand as a main treatment option in large kidney stone/s beside PCNL. Moreover, further Randomized controlled trial studies needed to justify the outcomes of this study.
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Papers by Pande Made Wisnu Tirtayasa