Doddy M. Soebadi
Department of Urology, Faculty of Medicine/Airlangga University, Soetomo Hospital, Surabaya, Indonesia.

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CORRELATION OF ROUTINE URINE CULTURE AND STONE CULTURE TO POST-OPERATIVE SIRS Indrawan, Taufik; Hardjowijoto, Sunaryo; Soebadi, Doddy M.; Juniastuti, Juniastuti; Budiono, Budiono
Indonesian Journal of Urology Vol 21, No 1 (2014)
Publisher : Indonesian Urological Association

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Abstract

Objective: This study evaluated the correlation between preoperative urine culture and intraoperative stone culture and the impact of stone culture findings on post-operative systemic inflammatory response syndrome. Material & Method:Patients with kidney stones who underwent percutaneous nephrolithotomy (PCNL) from February to May 2012 were prospectively analyzed. A pre-operative urine culture was obtained in the morning before the operation, fragmented stone collected were cultured in Departement of Microbiology. Patients were monitored closely in the postoperative period for signs of systemic inflammatory response syndrome (SIRS). Results:A total of 33 patients underwent PCNL and examined for urine cultures, stone culture and postoperative SIRS, 15 (45.45%) patients with positive urine culture, 18 patients (54.54%) with positive stone culture but only 1 patient (3.03%) had same pathogen (p = 0.629). Ten patients (55.6%) with positive stone cultures had evidence of systemic inflammatory respose syndrome postoperatively. The calculated stone culture value for sensitivity, specificity, positive predictive value and negative predictive value were 100%, 65.2%, 55.6%, and 100%. Preoperative hydronephrosis (p = 0.003) and operative time (p = 0.001) are identified as the key risk factors for SIRS after PCNL.Conclusion: Positive stone culture are better predictors for SIRS after PCNL. Stone culture examination is an essential in directing the proper antibiotic therapyin patients with SIRS after PCNL.  Keywords: Percutaneous nephrolithotomy (PCNL), urine culture, stone culture, systemic inflammatory response syndrome after PCNL.
ESWL FOR RENAL AND URETERAL STONES Ridha, Muhammad; Soebadi, Doddy M.
Indonesian Journal of Urology Vol 21, No 1 (2014)
Publisher : Indonesian Urological Association

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Abstract

Objective: To report patient characteristics and results of Huikang HK-V extracorporeal shockwave lithotripsy (ESWL) machine for renal and ureteral stones. Material & methods: We retrospectively analyzed medical records of all patients treated with ESWL using HK-V deviceat Department ofUrology Soetomo Hospital from May2011 - February 2012. Results: There were 241 selected patients, consisted of 148 men (61.4%) and 93 women (38.6%). Mean age was 47.8 years (range 7-87). ESWL was conducted to 130 single stones and 111 multiple stones, using fluoroscopy as guidance for 166 patients, ultrasound for 31 patients (12.9%) and both for 44 patients (18.3%). Stone location was 109 in lower pole(41%), 69 in middle pole(26%), 41 in proximal ureter (16%), 28 in upper pole (11%), 14 at renal pelvis (5%), 1 at distal ureter(0.3%) and 2 staghorn stone (0.7%).There were 130 patients with stone less than 10 mm (53.9%), 102 with stone 10-20 mm (42.3%), and 9 more than 20 mm (3.7%). There were slightly more left-sided treatment was 141 patients (58.5%). Of 181 patients with hydronephrosis (75%), 104 had DJ stent inserted (43.2%). Overall, we found 158 patients (65.5%) were stone free after treatment, 49 patients (20.3%) with residual stones less than 4 mm and 34 patients (14.1%) had more than 4 mm residuals. Conclusion: ESWL is the treatment of choice for simple renal and ureteral stones less than 20 mm (opaque and non opaque).Keywords:Extracorporeal Shockwave Lithotripsy, renal stones, ureteral stones.
THE DIFFERENCE OF PAIN PERCEPTION BETWEEN KETOPROFEN SUPPOSITORY AND 1% PERIPROSTATIC LIDOCAINE INJECTION Azis, Abdul; Djatisoesanto, Wahjoe; Soebadi, Doddy M.; Hakim, Lukman; Budiono, Budiono
Indonesian Journal of Urology Vol 19, No 2 (2012)
Publisher : Indonesian Urological Association

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Abstract

Objective: To compare the pain control results of ketoprofen suppository and periprostatic injection of lidocaine 1% for prostate biopsy. Material & Method: A total of 30 patients who underwent transrectal ultrasound guided prostate biopsy were randomized into 2 groups. Group 1 consisted of 15 patients received 200 mg of ketoprofen suppository. Group 2 received 1% periprostatic lidocaine injection. A visual analog scale was used to assess the pain score during prostate biopsy. Statistical analysis of pain scores was performed using independent t-test and Pearson correlation test. Results: The 2 groups were homogenous in age and prostate volume. There was significant difference in pain score among groups 1 and 2 during prostate biopsy (mean VAS ± SD 0,8 ± 0,8 and 4,5 ± 1,6 respectively, p < 0,0001). There was no significant correlation between pain perception with age (p = 0,779), or prostate volume (p = 0,389) in both groups. Conclusion: Periprostatic lidocaine injection is more effective for decreasing the pain for prostate biopsy compared to ketoprofen suppository. Keywords: Prostate biopsy, pain, transrectal ultrasonography, periprostatic nerve block, visual analog scale.
ANTIBIOTIC PROPHYLAXIS WITH DIFFERENT ANTIBIOTIC REGIMEN IN PROSTATE BIOPSY PATIENTS Wibisono, Dimas Sindhu; Soebadi, Doddy M.; Soetojo, Soetojo; Budiono, Budiono
Indonesian Journal of Urology Vol 20, No 1 (2013)
Publisher : Indonesian Urological Association

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Abstract

Objective: To know the incidence of urinary tract infection (UTI) with different antibiotic prophylaxis for transrectal ultrasonography (TRUS) prostate biopsy. Material &amp; Method: The study included 34 patients at Soetomo Hospital Surabaya, who were divided into 2 groups, each group consisting of 17 patients. In the first group patients received 1000 mg of ciprofloxacin orally, in the second group cefotaxime 1000 mg iv was given prior to biopsy. The two groups were compared in terms of UTI incidence as observed from the blood levels of leukocytes, C-reactive protein (CRP) and urine culture 3 days after the procedure. Results: Based on blood leukocyte levels, there was no statistically significant difference between the two groups (p = 0,74 and p = 0,42). So was the comparison of CRP levels. There was no other significant difference found (p = 0,53 and p = 0,27). From the results of urine culture, the ciprofloxacin group had positive urine culture results lower than the cefotaxime group (29,4% : 35,3%), although it was not statistically significant (p = 1,0). Conclusion: Based on the parameters of blood leukocytes levels, CRP and urine culture, there were no differences in the incidence of UTI after biopsy in the two groups.Keywords: TRUS prostate biopsy, UTI, ciprofloxacin, cefotaxime.
THE DIAGNOSTIC VALUE OF PROCALCITONIN FOR EARLY DETECTION OF UROSEPSIS Nasution, M. Andriady S.; Hardjowijoto, Sunaryo; Soebadi, Doddy M.; Aryati, Aryati; Pujiraharjo, Widodo J
Indonesian Journal of Urology Vol 19, No 1 (2012)
Publisher : Indonesian Urological Association

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Abstract

Objective: To study procalcitonin as an early and accurate marker for urosepsis. Material & Method: We performed a diagnostic study of procalcitonin, CRP and peripheral blood leucocyte in 21 patients. Patients included 12 urosepsis patients with urosepsis, and 9 trauma patients without urosepsis. This study was conducted from September 2010 to December 2010. Results: Mean and standard deviation of procalcitonin level in urosepsis patients was 27,9 ± 30,7 ng/ml, CRP was 8,9 ± 7,9 mg/l and blood leucocyte was 15125,0 ± 8969,9 mm3. Sensitivity of procalcitonin in diagnosis of urosepsis was 83,3%, specificity was 77,8%, positive predictive value was 83,3%, negative predictive value was 77,8%, positive odds ratio was 3,75 and negative odds ratio was 0,2. Diagnostic value of procalcitonin was better compared to CRP and blood leucocyte. In the receiver operating characteristics (ROC) plot, area under the curve (AUC) for procalcitonin, blood leucocyte, and CRP were 0,806 (95% CI = 0,607 – 1,004), 0,773 (95% CI = 0,568 – 0,979), and 0,602 (95% CI = 0,341 – 0,863), respectively. Conclusion: Procalcitonin is an early marker for urosepsis cases with better diagnostic value than CRP and blood leucocyte. Keywords: Urosepsis, Procalcitonin, CRP, Blood Leucocyte.
CORRELATION BETWEEN PROSTATIC URETHRAL ANGLE WITH CLINICAL PARAMETERS AND BOO IN LUTS ASSOCIATED WITH BPH Santoso, Kristian Yoci Santoso Yoci; Soebadi, Doddy M.; Djatisoesanto, Wahjoe; Budiono, Budiono
Indonesian Journal of Urology Vol 20, No 1 (2013)
Publisher : Indonesian Urological Association

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Abstract

Objective: We investigated the correlation of the PUA on clinical parameters and bladder outlet obstruction (BOO) in men with lower urinary tract symptoms (LUTS) suggestive of benign prostatic hyperplasia (BPH). Material &amp; Method: This study was performed between January to April 2011. A cross sectional analysis of 24 men with LUTS associated BPH aged &gt; 50 years was performed. Patients underwent evaluation including International Prostatic Symptom Score (IPSS), transrectal ultrasonography, uroflowmetry, and pressure-flow study. Statistical analysis was performed to evaluate correlation of the PUA on clinical parameters and bladder outlet obstruction (BOO). Results: A total of 24 patients, aged 51 to 78 years were enrolled in this study. The mean value of total IPSS, prostate volume, PUA, and Qmax was 22 (range 7-35), 34,4 cm3 (range 21–70 cm3), 37,3° (range 25°–55°), and 10,5 mL/s (range 4,2–17,9 mL/s), respectively. Pearson’s correlation analysis showed that PUA was not significantly correlated with IPSS (p = 0,117), Qmax (p = 0,434), total prostate volume (p = 0,213). Patients with increased PUA (PUA &gt; 35°) had higher incidence and degree of BOO (p &lt; 0,05). Conclusion: PUA may be one method to assess the presence of BOO in men with LUTS associated BPH. Our investigation suggest that PUA may help in the treatment of individuals by better predicting their likely classification from a pressure-flow study.Keywords: Prostatic urethral angle, benign prostatic hyperplasia, lower urinary tract symptoms, bladder outlet obstruction.