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Background: Bladder stone accounts for 5% of all cases of urolithiasis. Bladder stones management has evolved over the last decades from open bladder surgery (sectio alta) to intracorporeal cystholithotripsy as well as extracorporeal shock wave lithotripsy (ESWL). ESWL presents to be a promising modality in the management of bladder calculi due to its simplicity and well tolerability. This study is thus conducted to present data on the safety and effectiveness of ESWL in the management of bladder stone patients.Methods: This is a retrospective study evaluating the medical records of 92 bladder calculi patients admitted to Cipto Mangunkusumo General Hospital (RSCM) from January 2011 to April 2015. Patient’s age, gender, type of stone and procedure being done, status of stone disintegration, length of hospital stay, and any complications that may occur are noted down and statistically analyzed using SPSS v. 20.Results: Majority of the patients underwent ESWL (49 out of 92, 53.3%). The stone free rates for ESWL, intracorporeal lithotripsy, and sectio alta are 93.9%, 97.0% and 100% respectively. One patient had to repeat ESWL. The ESWL group had the smallest stone size average compared to the intracorporeal lithotripsy and section alta group (2.5 cm±2.0 cm vs 4.8 cm±3.7 cm vs 7.4 cm±5.4 cm respectively). The ESWL sessions were conducted in the outpatient clinic, and thus no hospital stay was required.Conclusion: ESWL can be suggested as an effective non-invasive approach in the disintegration of bladder stone of ≤25 mm with a promisingly high stone-free rate (93.9%) Furthermore, ESWL can be performed on an outpatient basis with minimal complications.

Objective: The aim of this study is to describe the characteristic of patients with Erectile Dysfunction (ED) and results of Nocturnal penile tumescence and rigidity (NPTR) based on Rigiscan® examination in patients with ED in Jakarta. Material & Methods: Descriptive-prospective study of patients with ED in Cipto Mangunkusumo Referral Hospital, Bunda General Hospital Jakarta, and ASRI-Siloam Urology Hospital are recorded during 2015. Patients’ age (in years), marital status (yes/no), duration of ED (in months), and International Index of Erectile Function-5 (IIEF-5) were recorded. NPTR examination were performed while patients were sleeping. Number of events, duration of each event (in minutes) as well as the rigidity (in percentage) and tumescence (in cm) were recorded. The elevation of tip and base penile circumference (in cm) during erection were also noted. Results: There were 34 patients who agreed to perform NPTR test. Most patients were married with the average age of 40.94 ± 10.81 years old. The duration of ED were varied from 5 to 96 months with average duration of 33.7 ± 44.34 months and IIEF-5 score was 6.38 ± 5.14. In general number of erections was 4 ± 3 with 23.4% of them had normal erection. The comparison between organic and psychogenic ED showed that the increment of circumference was significantly less in organic ED patients. Other parameters showed insignificant difference in statistical results. Conclusion: NPTR examination is an objective, effective, and easy-to-use measurement in order to differentiate between organic and psychogenic ED. One third of patients who complained with ED suffered from psychogenic ED and needed referral to other specialists.

Male infertility is a major problem in infertility. It can be caused by obstructive azoospermia. Sperm retrieval surgery (SRS) is the best approach to gain the sperm used Intra Cystoplasmic Sperm Injection (ICSI). However, the success rate of pregnancy after SRS and ICSI in Cipto Mangunkusumo National Hospital has not yet been defined. There were 123 patients had SRS with most of them performed PESA. Sperm were found in more than 77% of patients with most of them directly performed ICSI. Only 40 patients could be contacted with average age of husband, wife, and duration of marriage were 40.3 + 8.2, 33.2 + 5.1, 7.6 + 4.6 years old respectively. Most of patients were suffered from primary infertility. The success rate of pregnancy is 72.5%, with success rate of birth is 30.0%. There are 2 patients waiting for delivery date. Sperm retrieval surgery such as PESA/TESE is the best approach to gain sperm in obstructive azoospermia patient. The success rate of pregnancy after PESA/TESE and ICSI is high with almost half of patients have succeed in giving birth.

Follicle-stimulating hormone(FSH) and Testosterone are important for spermatogenesis. Increased serum FSH and decreased testosterone are related to abnormal spermatogenesis. Azoospermia can be classified as obstructive and non-obstructive azoospermia. This study aims to discover cut-off value of Testosterone and FSH in predicting obstructive and non-obstructive azoospermia. From 1064 patients, 120 fulfilled inclusion and exclusion criteria. There were 66.7% in obstructive with 33.3% in non-obstructive group. No difference in terms of age (36,83 vs 36,62 y.o). Testosterone were 405.54 + 186.14 ng/dL vs 298.84 + 161.45 ng/dL (p=0.002) while FSH was 8,53 + 8,43 mIU/mL vs 20,12 + 11,89 mIU/mL (p+ 4.03 cc and 17.50 + 4.23 cc while in non-obstructive group are 12.97 + 5.18 cc and 13.37 + 5.31 cc for right and left testis respectively. FSH value above 10.36 mIU/mL has sensitivity 82.1% and specificity 79.5% for predicting non-obstructive azoospermia. Unfortunately, Testosterone could not be used in predicting azoospermia classification. Obstructive and non-obstructive azoospermia could be predicted using FSH but not testosterone serum level. Higher testosterone population should be used for further study.

Objective: The e tiology and risk factors of male infertility in huge Indonesian population has not yet been defined . This study was aim to evaluate the distribution and pattern of male infertility in Jakarta. Material & Methods : Retrospective study of Infertility database of Cipto Mangunkusumo Referral Hospital Jakarta , Bunda Hospital Jakarta, and ASRI Hospital Jakarta from 2005 until 2015 were analyzed using SPSS ver. 20. Patients’ characteristic and demography were stated. Results : There were 1062 patients with most of them suffered from primary infertility of their first time-marriage. Average age of husband, wife, and duration of marriage were 36.63 ± 7.10, 32.32 ± 4.92, and 5.7 ± 4.18 years old respectively. Smoking habit was recorded in 25% of patients while exposure and occupational hazard were only found in less than 2% of them. Coital problems occured in 17% of patients with 30% of them did not have routine sexual intercourse per week. Physical examination revealed that more than 70% of them had varicocele while USG Doppler of scrotum found varicocele in less than 50%. Only 5.13% of patients had normal sperm analysis, mostly azoospermia. Hormonal abnormality occured in more than 30% patients, varied in testosterone, FSH, and LH level. Conclusion : Male infertility was mostly caused by abnormal sperm characteristics followed by abnormal hormonal analysis. Exposure and occupational hazard did not play a big role in male infertility. Future study in risk factors of abnormal sperm characteristics could be done. Normal 0 false false false EN-US X-NONE X-NONE /* Style Definitions */ table.MsoNormalTable {mso-style-name:"Table Normal"; mso-tstyle-rowband-size:0; mso-tstyle-colband-size:0; mso-style-noshow:yes; mso-style-priority:99; mso-style-qformat:yes; mso-style-parent:""; mso-padding-alt:0cm 5.4pt 0cm 5.4pt; mso-para-margin-top:0cm; mso-para-margin-right:0cm; mso-para-margin-bottom:10.0pt; mso-para-margin-left:0cm; line-height:115%; mso-pagination:widow-orphan; font-size:11.0pt; font-family:"Calibri","sans-serif"; mso-ascii-font-family:Calibri; mso-ascii-theme-font:minor-latin; mso-fareast-font-family:"Times New Roman"; mso-fareast-theme-font:minor-fareast; mso-hansi-font-family:Calibri; mso-hansi-theme-font:minor-latin;} Normal 0 false false false EN-US X-NONE X-NONE /* Style Definitions */ table.MsoNormalTable {mso-style-name:"Table Normal"; mso-tstyle-rowband-size:0; mso-tstyle-colband-size:0; mso-style-noshow:yes; mso-style-priority:99; mso-style-qformat:yes; mso-style-parent:""; mso-padding-alt:0cm 5.4pt 0cm 5.4pt; mso-para-margin-top:0cm; mso-para-margin-right:0cm; mso-para-margin-bottom:10.0pt; mso-para-margin-left:0cm; line-height:115%; mso-pagination:widow-orphan; font-size:11.0pt; font-family:"Calibri","sans-serif"; mso-ascii-font-family:Calibri; mso-ascii-theme-font:minor-latin; mso-fareast-font-family:"Times New Roman"; mso-fareast-theme-font:minor-fareast; mso-hansi-font-family:Calibri; mso-hansi-theme-font:minor-latin;}