Trisula Utomo
Division of Urology/Department of Surgery, Faculty of Medicine/Gadjah Mada University, Sardjito General Hospital, Yogyakarta.

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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

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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.
THE INCIDENCE OF ED AFTER TURP AND TVP ON BPH PATIENTS Alpendri, Aries; Utomo, Tjahyo Kelono; Utomo, Trisula; Singodimedjo, Prawito
Indonesian Journal of Urology Vol 19, No 1 (2012)
Publisher : Indonesian Urological Association

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Objective: The aim of this study was to know the incidence of erectile dysfunction (ED) after transurethral resections of the prostate (TURP) and transvesical prostatectomy (TVP). Material & method: Data were collected in 1 year period from January until December 2005 with cross sectional study design. There were 60 patients who met the inclusion and exclusion criteria and patient who participated in this study underwent TURP and TVP and divided in TURP group and TVP group. Erectile Dysfunction measured by International Index of Erectile Function-5 (IIEF-5) data was analyzed by statistic chi-square and independent t-test. Results: Sixty patients include this study with 30 patients in each group. The mean age of TURP was 64 ± 5,68 and TVP was 63,23 ± 4,83 with age ranging from 50 – 70 years. The incidence of ED after TURP and TVP was 36,67% and 16,70% respectively with p = 0,08. The IIEF-5 scores for TURP and TVP was 19,40 ± 3,95 and 21,03 ± 2,57 respectively and by statistical analysis the differences was not significant. Conclusion: The incidence of ED after TURP showed higher than TVP and by statistical analysis the differences was not significant. Keywords: Benign prostatic hyperplasia, erectile dysfunction, transurethral resection of the prostate, transvesical prostatectomy.
PREOPERATIVE KETOROLAC EFFECT ON POSTOPERATIVE PAIN ON TURP PATIENTS Hadi, Choirul; Utomo, Trisula
Indonesian Journal of Urology Vol 20, No 2 (2013)
Publisher : Indonesian Urological Association

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Objective: The aim of this study is to study the effect of preoperative Ketorolac on postoperative pain after transurethral prostatectomy at Sardjito Hospital Yogyakarta. Material & Methods: This is a cross sectional, analytic, prospective study. We divided benign prostatic hyperplasia patients, from October 2011 until February 2012 into two groups. Group I was given Ketorolac 30 mg intravenously twice daily starting one day before operation and in the morning before procedure. Group II did not receive Ketorolac preoperatively. Patients underwent transurethral operation with spinal anesthesia. We assessed postoperative pain at 24 hours using Visual Analogue Scale (VAS). Results: Twenty four patients were included in this study with mean age 66 years old with the youngest 45 years old and the oldest 80 years old (SD 8,77744). Group I (17 patients), VAS score 1 to 7 with median 3 and mean 3,4118 (SD 1,66053). Group II (7 patients) VAS score 1 to 8 with median 3 and mean 3,8571 (SD 2,8357). We count it using Mann-Whitney U (p = 0,951). Conclusion: There is no significance difference in post-operative pain after transurethral prostatectomy with preoperative ketorolac administration.Keywords: Ketorolac, bupivacaine, visual analogue scale, transurethral prostatectomy.
CONTINUOUS AMBULATORY PERITONEAL DIALYSIS USING STRAIGHT TYPE VS COILED TYPE TENCKHOFF CATHETER IN END-STAGE RENAL DISEASE PATIENTS AT SARDJITO HOSPITAL Rahman, Eka Yudha; Rochadi, Sungsang; Utomo, Trisula
Indonesian Journal of Urology Vol 18, No 1 (2011)
Publisher : Indonesian Urological Association

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Objective: The purpose of this study was to compare straight type versus coiled type Tenckhoff catheter for continuous ambulatory peritoneal dialysis (CAPD) in end stage renal disease. Material & method: A prospective cohort study enrolled end-stage renal disease patients undergoing CAPD for renal replacement therapy in Urology and Nephrology Department, Sardjito Hospital from January to December 2007. Identity and type of Tenckhoff catheter were recorded. Patients were grouped into two groups who used straight type catheter and coiled type catheter for CAPD, then observed for post-operative complication. Statistical analysis was done using SPSS 14.0 with chi-square test. Results: There were 27 patients included in this study. The cause of end-stage renal disease was mostly DM and hypertension. The most common complication after  operation  was catheter  obstruction  (9 patients). Another complication was intraabdominal bleeding (1 patient), and catheter migration (1 patient). In patients with straight catheter (20 patients), there were 8 patients (40%) with complication. In patients with coiled catheter (7 patients), there were 3 patients (42%) with complication. There was no significant difference in complications between straight and coiled catheter groups (p = 0,895). Conclusion: The result of this study revealed that no significant difference in complication between straight and coiled catheter for CAPD in end-stage renal disease patients
COMPARISON OF SERUM SODIUM, SERUM POTASSIUM, AND BLOOD HEMOGLOBIN CHANGES AFTER TRANSURETHRAL RESECTION OF THE PROSTATE BETWEEN IRRIGATION WITH NORMAL SALINE AND STERILE WATER Kurniawan, Wikan; Utomo, Trisula
Indonesian Journal of Urology Vol 18, No 2 (2011)
Publisher : Indonesian Urological Association

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Objective: This study aims to know whether there are significant differences of blood sodium, potassium and hemoglobin level among patients post TURP who was irrigated by using normal saline and the sterile water. Material & Method: This is a single blind randomized clinical trial study performed from September 1, 2008 until August 31, 2009. Thirty-one subjects participated in this study. The subjects were divided into two groups, 14 subjects for normal saline (group I) irrigation and 17 subjects for sterilized water irrigation (group II). Results: There are statistically differences (p < 0,05) between hemoglobin concentrations changes in group I, and hemoglobin and sodium concentration changes in group II. There were no statistically differences (p > 0,05) in sodium and potassium changes in group I and potassium in group II. There are no statistically differences in hemoglobin, sodium, and potassium changes among two groups. Conclusion: Normal saline irrigant for irrigation after TURP give more stable post operative electrolyte profile compared to sterilized water. Keywords: TUR prostate, irrigation, serum sodium, potassium level differences.
EFFICACY OF INTRAVESICAL INSTILLATION OF NETILMICIN ON MANAGING UTI Praba, Barry Arief; Utomo, Trisula
Indonesian Journal of Urology Vol 22, No 1 (2015)
Publisher : Indonesian Urological Association

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INTRODUCTION Urinary tract infections (UTIs) are common, affect men and women of all ages, and vary dramatically in their presentation and sequelae. They are a common cause of morbidity and can lead to significant mortality. New antimicrobial agents that achieve high urinary and tissue levels, that can be administered orally, and that are not nephrotoxic have significantly reduced the need for hospitalization for severe infection. Shorter-course therapy and prophylactic antimicrobial agents have reduced the morbidity and cost associated with recurrent cystitis in women. Intravesical instillation of aminoglycoside has been used empirically as prophylaxis and to treat bacilluria in spinal-cord-injured patients undergoing clean intermittent catheterization.METHODS In a prospective clinical trial performed in the urologic ward of Dr. Sardjito Hospital, yogyakarta, Indonesia, we studied 56 patients who has indwelling urethral catheter more than 4 days. Patients were divided into two groups. In group 1 (28 patients) one-time intravesical instillation of Netilmicin 25 mg was administred, and in group 2 (28 patients) none were given any treatment. Urinalysis was evaluated before and after instillation of Netilmicin. Statistical data and results were studied using descriptive statistics as median (minimum and maximum). To compare the response to treatment, Chi-Square test was used in two groups. Consequently, the data were analyzed using the SPSS 17 software.RESULTS Urinalysis were evaluated in two groups 4 days after intravesical instillation of 50 mg netilmicin. The patients we studied, the median age 59 years old (min. 29; max. 81). In the first group we found 22 (78,5 %) patients still without UTI, 6 (21,5 %) patients with UTI, in the second group we found 4 (14,3 %) still without UTI, 24 (85,7 %) patients with UTI. The difference was statistically significant (p=0.0001)CONCLUSIONS Intravesical instillation of netilmicin on patients with indwelliing urethral catheter were effective on preventing catheter-related UTI.Keywords : UTI, indwelling catheter, netilmicin, intravesical antibiotic instillation.
FACTORS ASSOCIATED WITH INTRACYTOPLASMIC SPERM INJECTION OUTCOME IN MEN WITH AZOOSPERMIA AND SEVERE OLIGOZOOSPERMIA putra, donny eka; Utomo, Trisula
Indonesian Journal of Urology Vol 23, No 1 (2016)
Publisher : Indonesian Urological Association

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Objective: This study is assigned to evaluate factors that associated with intracytoplasmic sperm injection (ICSI) outcome. Material & methods: A retrospective study design is used to evaluate couples who seeking help for infertility problems at Permata Hati Infertility Clinic, Sardjito General Hospital Yogyakarta. The outcome measures were fertilization and clinical pregnancies rates. All analyses were performed with SPSS statistical software, version 20.0. Result: Forty-five couples participated in this study with mean age 33.69 ± 5.38 years for men and 30.53 ± 4.79 years for women. Of 56 ICSI cycles, there were 43 successful fertilizations (95.6%) and 14 clinical pregnancies (31.1%). In multivariate analysis, factors associated with successful clinical pregnancies were women’s age (p = 0.034, 95% CI 0.005-0.8), number of ICSI cycle (p = 0.045, 95% CI 0.001-0.93), and sperm morphology (p = 0.019, 95% CI 1.648- 253). In bivariate analysis, only men’s age is significantly associated with successful fertilization (p = 0.006, 95% CI 7.22-16.43). Conclusion: Factors associated with outcome of ICSI are women’s age, number of ICSI cycle, and sperm morphology.
FACTORS ASSOCIATED WITH TUMOR RECURRENCE IN STAGE 1 BLADDER TRANSITIONAL CELL CARCINOMA IN SARDJITO HOSPITAL YOGYAKARTA putra, donny eka; Utomo, Trisula
Indonesian Journal of Urology Vol 23, No 2 (2016)
Publisher : Indonesian Urological Association

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Objective: This study is assigned to evaluate factors associated with tumor recurrence in patients with superficial transitional cell carcinoma (TCC) of bladder in Sardjito General Hospital Yogyakarta. Material & methods:A prospective observational study design is conducted to evaluate patients with T1 TCC of bladder between 2011 and 2012. Inclusion criteria was patients with T1 TCC of bladder from pathological report. The independent variables are ages, hemoglobin, albumin, creatinine level, urine cytology, tumor grade, tumor diameter, number of tumor, and intravesical chemotherapy. The outcome measure is tumor recurrence during cystoscopy at 3, 6, 9, and 12 month after first resection. This study used chi-square and logistic regression analysis as statistical methods with p < 0.05 and a = 5% are considered significant. All analyses were performed with SPSS statistical software, version 20.0. Result: Sixty-two patients were participated in this study with mean age 60.62 ± 12.15 years. There were 32 patients (51.6%) who had tumour recurrence during first year that need to be resected. Of these patients, 9 patients (14.5%) had tumour recurrence more than one time during first year. In multivariate analysis, factors associated with tumour recurrence were tumour grade (p = 0.041, CI = 0.008-0.908), number of tumor (p = 0.003, CI = 0.003-0.293), and intravesical chemotherapy (p = 0.022, CI = 0.015-0.719). Conclusion: Degree of tumor differentiation, number of tumor and intravesical chemotherapy are factors affecting recurrence of stage 1 transitional cell carcinoma of the bladder.