wahjoe djatisoesanto
Department of Urology, Faculty of Medicine/Airlangga University, Soetomo Hospital, Surabaya.

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FAKTOR PREDIKTOR KEGAGALAN KEMOTERAPI BLEOMYCIN, ETOPOSIDE DAN CISPLATIN PADA PASIEN DENGAN SEMINOMA TESTIS PENELITIAN KOHORT RETROSPEKTIF Putra Pramana, Ida Bagus; Hakim, Lukman; Djatisoesanto, Wahjoe
E-Jurnal Medika Udayana Vol 8 No 6 (2019): Vol 8 No 6 (2019): E-Jurnal Medika Udayana
Publisher : Universitas Udayana

Show Abstract | Download Original | Original Source | Check in Google Scholar | Full PDF (234.34 KB)

Abstract

Di Amerika serikat sekitar 8400 orang mengalami kanker testis dan 280 orang meninggal karena penyakit ini. Germ cell tumor meningkat diseluruh dunia. Di Amerika angka prevalensinya pada pasien usia 15 – 49 tahun meningkat dari 2,9 per 100.000 pada tahun 1975 menjadi 5,1 per 100.000 pada tahun 2004. Prevalensinya meningkat dari 55 % pada tahun 1973 menjadi 73 % pada tahun 2001. Insiden kasus seminoma lebih tinggi dibandingkan dengan non-seminoma. Untuk mengetahui faktor – faktor prediktor kegagalan kemoterapi bleomycin, etoposide dan cisplatin (BEP) pada pasien dengan seminoma testis yang mendapat terapi di Rumah Sakit dr Soetomo Surabaya. Penelitian ini merupakan penelitian kohort retrospektif. Karakteristik pasien seperti umur, stadium, kadar serum tumor marker, adjuvant kemoterapi, efek samping dari kemoterapi dan respon kemoterapi didapatkan dari rekam medis pasien di RSUD dr Soetomo Surabaya pada Januari 2008 – Desember 2015. Data dianalisis dengan deskriptif analitik, faktor faktor yang mempengaruhi kegagalan kemoterapi seperti patologi staging tumor (pT), penyebaran regional lymph node (N), metastasis (M), dan level serum tumor marker preoperatif seperti Lactic Dehydrogenase (LDH), human chorionic gonadotrophin (hCG), dan Alpha-Fetoprotein (AFP) dianalisis dengan menggunakan Binary Logistic Regression.Terdapat 55 pasien dengan seminoma testis dengan rata rata umur 32,43±13,3 tahun. Dari 55 pasien hanya 41 pasien yang hanya mendapat adjuvant kemoterapi BEP. Faktor faktor seperti pT, N dan M yang signifikant secara statistik sebagai faktor prediktor kegagalan kemoterapi. Pasien dengan staging pT3 dan pT4 memiliki 8,25 kali faktor resiko yang lebih besar dibandingkan pT1 dan pT2 untuk terjadinya kegagalan kemoterapi (OR=8,250, p=0,005 dan IK95%=1,87 – 36,38). Pasien dengan N2 dan N3 memiliki resiko 4,812 kali lebih besar untuk mengalami kegagalan kemoterapi dibandingkan N0 dan N1 (OR = 4,812, p=0,036, IK95% = 1,105 – 20,95). Pasien dengan M1 (M1a atau M1b) memiliki resiko 6,4 kali lebih besar mengalami kegagalan kemoterapi jika dibandingkan dengan M0 (OR = 6,40, p = 0,015, CI = 1,44 – 28,443). Seminoma testis merupakan tumor yang kemo-sensitif. Staging tumor primer (pT), regional lymph nodes (N) dan Metastasis (M) dapat digunakan sebagai faktor prediktor kegagalan kemoterapi pada pasien dengan seminoma testis. Keywords : Germ Cell Tumors, Testicular Seminoma, Kemoterapi BEP.
COMPARISON OF EFFICACY AND SAFETY SILODOSIN 8 MG ONCE DAILY AND SILODOSIN 4 MG TWICE DAILY IN BPH PATIENTS WITH LUTS Diansyah, Ramzie Nendra; Renaldo, Johan; Djatisoesanto, Wahjoe; Hakim, Lukman
Indonesian Journal of Urology Vol 26 No 1 (2019)
Publisher : Indonesian Urological Association

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.32421/juri.v26i1.552

Abstract

Objective: This study was aimed to compare the efficacy and side effect of silodosin 8mg once daily and silodosin 4mg twice daily in BPH-LUTS patients after 4 and 12 weeks. Material & Methods: Single blind randomized controlled trials in 60 male patients aged ≥45 years with BPH-LUTS from July 2017 to October 2017 was divided into groups who received 8mg of silodosin once daily and those who received 4mg of silodosin twice daily. Efficacy and adverse events were evaluated after 4 and 12 weeks of treatment. Results:  There was no significant difference of mean age of the two groups was 67.93 ± 6.49 years and 69.07 ± 6.28 years respectively (p 0.49). Both doses of this drug decreased the International Prostate Symptom Score (IPSS) and significantly increased the maximum urinary flow (Qmax) (p<0.05) but there was no significant differences between the two groups (p>0.05). Ejaculation disorder was the most common side effect in all groups (6.7% and 5%) and there was no significant difference between the two groups (p>0.05). Conclusion: The administration of 8mg of once daily silodosin has similar efficacy as 4mg twice daily silodosin. There were no adverse events differences in the two groups. Ejaculation disorder is the most common adverse event of silodosin administration.
EFFECT OF VITAMIN E (α TOCOPHEROL) ADMINISTRATION ON APOPTOSIS OF GERMINAL CELLS EPITHELIUM TESTIS IN SPRAGUE DAWLEY WHITE STRAIN RATS AFTER EXPOSED BY CISPLATIN Nugroho, Achmad; Djatisoesanto, Wahjoe; Soebadi, Doddy M
Indonesian Journal of Urology Vol 26 No 1 (2019)
Publisher : Indonesian Urological Association

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.32421/juri.v26i1.546

Abstract

Objective: To determine the differences of germinal epithelial testicular cell apoptosis in white Sprague Dawley strain rat that received combination of cisplatin and vitamin E compared to Sprague Dawley strain rat that received cisplatin only. Material & Methods:  Twenty four Sprague Dawley rats were divided into 4 groups randomly. Group 1 Negative Control (NC) was given an injection of 1 cc 0.9% normal saline intraperitoneally as a placebo, group 2 Positive Control (PC) was given 5 mg/kgBW cisplatin intraperitoneally, group 3 (P1) was given cisplatin injection 5 mg/kgBW intraperitoneally + vitamin E (α tocopherol) 50 mg/kgBW by gavage and group 4 (P2) was given cisplatin injection 5 mg/kgBW intraperitoneally + vitamin E (α tocopherol) 200 mg/kgBW by gavage. Vitamin E (α tocopherol) was given 3 weeks before up to 4 weeks after cisplatin injection. Observation of the germinal epithelial cells apoptosis was carried out by calculating germinal epithelial cells apoptosis in the cross-section preparations of the seminiferous tubule which gave a positive reaction to the apoptag staining, using a 400x magnification light microscope. Results: Apoptosis on positive control (PC) group was different significantly compared to the negative control (NC) group (p<0.05). There was a significant difference in the apoptosis of germinal epithelial testicular cells in the cisplatin + vitamin E 50 mg/kgBW compared to the PC group (p<0.05). The cisplatin + vitamin E 200 mg/kgBW group; had a lower number of apoptosis compared to the cisplatin + vitamin E 50 mg/kgBW (p<0.05). Conclusion: Vitamin E provides a protective effect on decreasing the amount of apoptosis due to cisplatin exposure. The protective effect of vitamin E is dose-dependent.
THE ROLE OF VITAMIN E (α-TOCOPHEROL) ON TESTOSTERONE LEVEL IN SPRAGUE DAWLEY RATS FOLLOWING CISPLATIN TREATMENT Rezia, Dian Kartika; Hakim, Lukman; Djatisoesanto, Wahjoe
Indonesian Journal of Urology Vol 26 No 1 (2019)
Publisher : Indonesian Urological Association

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.32421/juri.v26i1.545

Abstract

Objective: To observe the difference of testosterone levels in adult male Sprague Dawley rats treated with combination of cisplatin and vitamin E compared to those treated with cisplatin only. Material & Methods: We used 24 adult male Sprague Dawley rats weight 200–300 grams and randomly assigned into 4 groups (n=6). Rats in negative control group (NC) were given intraperitoneal normal saline injection, while the positive control (PC) group were injected with cisplatin 5 mg/kgBW at the end of the 3rd week. Two other groups, P1 and P2, were injected with cisplatin 5 mg/kgBW and given vitamin E orally 50 mg/kgBW and 200 mg/kgBW, respectively. Cardiac blood was aspirated at the end of the 7th week and processed for analysis of testosterone levels. Results: We recorded a significantly lower testosterone levels in rats treated only with cisplatin 5 mg/kgBW (CP) compared to those in CN group (p=0.006), and those receiving combination of cisplatin and vitamin E 50 mg/kgBW (p=0.003) and 200 mg/kgBW (p=0.001). Though not significant, testosterone levels were higher in P2 group than in P1 group (p=0.702). Conclusion: Exposure to cisplatin can lower testosterone levels in white rats, and the administration of vitamin E gives protection against such effect. 
URINARY RETENTION EFFECT IN THE INCREASED OF PSA EXPRESSION WITHIN PROSTATIC TISSUE Djatisoesanto, Wahjoe; Soebadi, Doddy M; Sudiana, I Ketut
Indonesian Journal of Urology Vol 22 No 2 (2015)
Publisher : Indonesian Urological Association

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.32421/juri.v22i2.189

Abstract

Objective: To determine whether the increased of PSA expression within prostatic tissue and subsequent systemic blood circulation in acute urinary retention cases of nonmalignant origin were caused by acute inflammation on the prostatic gland. Following this inflammation, PSA willincrease, producing byacinar epitelial cells in the gland and continue to capillary vessels before entering the blood circulation. Material & method: Thirty male Rattus Norvegicus were randomly allocated into 3 groups. A control group underwent urethral manipulation, treatment-1 group and -2 group underwent proximal urethral ligation. Prostatectomy was performed after 24 hours in the control and treatment-1 group. Ligation was removed after 24 hours in treatment-2 group, and prostatectomy performed after 4x24 hours. Each prostate specimen was examined for PSA expression by immunohistochemistry methods in the prostatic gland. Statistical analysis of study data was analyzed by descriptive statistics and performed ANOVA with level of significance α = 0.01.Results: Study results showed an increase PSA expression significantly after urinary retention and returned to normal values four days later after relief of retention.Conclusion: Urinary retention caused acute inflammation on the prostatic gland and increased PSA expression within prostatic tissue. Entry of PSA into stroma and subsequent systemic blood circulation occur through significant increase in PSA production by acinar epithelial cells.
Characteristics of Renal Cell Carcinoma Patients in RSUD Dr Soetomo Surabaya in 2014-2017 Djatisoesanto, Wahjoe; Erawati, Dyah; Fauziah, Dyah; Rusdhy, Ferdiansyah
Health Notions Vol 3, No 12 (2019): December
Publisher : Humanistic Network for Science and Technology (HNST)

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.33846/hn31206

Abstract

Renal Cell Carcinoma is a type of malignant renal tumour. According to GLOBOCAN 2012 data, it ranked 17th on the most common malignancy in Indonesia with an incidence rate of 1.5 per 100000 citizens. Mortality rates for men is 1.6 per 100000, while it is 0.8 per 100000 case for women. The clinical symptoms of flank pain, flank mass, and hematuria, are usually only found in patients with later stages of cancer development. This descriptive study aims to present data on characteristics of Renal Cell Carcinoma patients. Data were collected from histopathological medical records of RSUD Dr. Soetomo Surabaya. We found that 25 of 40 patients are male, with most patients aged between 50 to 59 at time of diagnosis. Majority of patients worked as a private sector worker, and had high school level education. They presented with stage 2 tumour, with Clear Cell Renal Cell Carcinoma subtype. All 40 patients were treated by Radical Nephroctomy. Keywords: renal cell carcinoma; characteristics
THE EFFECT OF THE DURATION OF INHALED NICOTINE EXPOSURE TO THE NUMBER OF LEYDIG, SPERMATOGONIUM, AND SERTOLI CELLS ON THE SPRAGUE-DAWLEY STRAIN WHITE RATS Hoesain, Fadil Pramudhya; Soebadi, Doddy M.; Djatisoesanto, Wahjoe
Indonesian Journal of Urology Vol 27 No 1 (2020)
Publisher : Indonesian Urological Association

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.32421/juri.v27i1.596

Abstract

Objective: To analyze the differences of the number of Leydig, spermatogonium, and Sertoli cells in mice, after being given nicotine inhalation, and the effect of recovery when nicotine stopped. Materials & Methods: This is experimental studies with a post-test only control group design. The sample used was 36 adult male mice (10-12 weeks) (Rattus Norvegicus) Sprague-Dawley strain, which were divided into three groups. P1 group was given nicotine inhalation at a dose of 4 mg/kg/day for 15 days, P2 group was given nicotine inhalation at a dose of 4 mg/kg/day for 15 days and was free of treatment for 15 days. The control group (NC) has no treatment at all. Histological examination and calculation of Sertoli cells, Leydig cell, and spermatogonium were processed within 1 hour after terticular sample collection. Then carried out to statistical analysis. 100x and 400x magnification is used to obtain the histopathological. Results: Post-hoc LSD test for each variable (Leydig cells, Sertoli cells, and spermatogonium), showed that the NC group had a significantly higher number compared to group P1. P2 group has a significantly higher number compared to group P1. There is no significant difference between the NC group and the P2 group. There was a structural difference in the sample testicles which exposed to nicotine. Conclusion: Nicotine exposure with a dose of 4 mg/kg/day for 15 days has a significant effect on decreasing the number of Leydig cells, spermatogonium cells, and Sertoli cells in rats and giving a free-treatment period for 15 days, giving the testis time to do recovery and regeneration (the reversible damage of testicular structure).
TESTICULAR CANCER IN SOETOMO HOSPITAL SURABAYA: RETROSPECTIVE STUDY Mukti, Ade Indra; Hakim, Lukman; Djatisoesanto, Wahjoe; Hardjowijoto, Sunaryo
Indonesian Journal of Urology Vol 25 No 1 (2018)
Publisher : Indonesian Urological Association

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.32421/juri.v25i1.386

Abstract

Objective: The aim of this study was to determine the characteristics of the testicular cancer that were managed in Soetomo Hospital. Materials & Methods: This was a retrospective descriptive study. We reviewed the medical records of patient with testicular tumor admitted in Soetomo Teaching Hospital Surabaya, from January 2008 until December 2013. The data regarding demographic characteristics, clinical presentation, grading and staging based on pathological examination result, and the management of the cancer. Data was presented in tabular and narrative in order to know the number and percentage of testicular cancer in Surabaya. Results: There were 46 patients with testicular cancer with mean age of 27.1 ± 7.9 years. Peak incidence was 15–35 years old (54%). Testicular mass was the most frequent clinical presentation in 42 patients (91%), abdominal mass and other complaints in 4 patients (9%). Most of the patients live outside Surabaya in 34 patients (72%). Location of the tumor was more frequently in scrotum, which occured in 42 patients (91%). A total of 4 patients (9%) were found to have a history of UDT. Based on the TNM staging, patients with stage pT3 were as many as 20 patients (43%), pT4 11 patients (24%), pT2 7 patients (15%) and pT1 4 patients (9%). In regional lymph nodes staging (N) N3 were as many as 26 patients (57%), N0 9 patients (20%), N2 5 patients (11%) and N1 2 patients (4%). Metastase staging (M) M0 was found in 27 patients (58%) and M1 tumor was found 42%. The major pathological finding was seminoma in 37 patients (80%), Yolk sac tumor in 4 patients (9%), Embryonal Ca in 1 patient (2%), Teratoma in 1 patient (2%) and mixed germ cell tumor in 3 patients (7%). The most widely theraphy was underwent orchidectomy followed by PEB chemotheraphy in 29 patients (64%), 3 patients (6%) underwent EBRT and PEB chemotheraphy, 5 patients (11%) underwent PEB chemotheraphy, There were 9 patients (19%) underwent orchidectomy alone. Group of seminoma tumor show normal limit of tumor marker α-FP and β-HCG and increased in non seminoma. Conclusion: Testicular cancer mostly appears in younger males. Most of testicular cancer was seminoma, diagnosed in advanced stage with metastase 42% of the patient. Most of the patients received orchidectomy followed by PEB chemotheraphy.
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.
AGE-RELATED CHANGES IN RENAL RESISTIVE INDEX AFTER ESWL Hermawan, Anton; Alif, Sabilal; djatisoesanto, wahjoe; Wulanhandarini, Tri; Budiono, Budiono
Indonesian Journal of Urology Vol 21 No 1 (2014)
Publisher : Indonesian Urological Association

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.32421/juri.v21i1.7

Abstract

Objective: To determine relation between age and resistive index (RI) changes occurring after extracorporeal shock wave lithotripsy (ESWL). Material & Method: We performed a prospective study in Soetomo Hospital Surabaya. Using duplex ultrasonography, RI was determined in 20 patients with calyceal kidney calculi and pelvic kidney calculi. RI of the interlobar renal arteries were measured in the region near the calculi (distance, less than 2 cm), one hour before ESWL and RI was measured again at 1 hour, 3 days and 7 days after ESWL. Changes in RI values and relation with age (≤ 60 years old and > 60 years old) were evaluated. Results: The renal RI increased significantly 1 hour and 3 days after ESWL, but returned to before ESWL values 7 days after ESWL in the both groups. Although there was positive correlation between age and RI before ESWL, but there was no correlation between age and RI changes after ESWL. Conclusion: Renal RI is higher with age > 60 years, after ESWL renal RI showed transient increase which returned to baseline after 7 days.Key words: Color Doppler Ultrasonography, extracorporeal shock wave lithotripsy, renal resistive index, calyceal kidney calculi, pelvic kidney calculi.