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Overcoming the learning curve — one plane at a time.Honored to have shared “Prostate Enucleation: How I Overcame the Lea...
04/09/2026

Overcoming the learning curve — one plane at a time.

Honored to have shared “Prostate Enucleation: How I Overcame the Learning Curve” at — a story that started in 2020 with a pandemic, an online training screen, and six bipolar cases (three converted to TURP).

What changed everything wasn’t a new device. It was going back to the drawing board and making the approach systematic:
📍 “The surgeon should mentally reproduce the three-dimensional configuration of the adenoma.”
📍 “Find the white, follow the fibers, trust the push.”

The curve is real, but it is climbable:
✅ 2021 — first TUERP case, 90 cc
✅ 2022 — 20 cases, zero conversions
✅ 2023 — first gland above 100 cc (196 cc)
✅ 2024 — SNUH fellowship, 60 cases, 10+ large glands
✅ 2025 — AEEP instructor at InaSER, URETER, BUS & JUMP

With structured proctorship, competency in EEP can come in as few as 5–7 procedures. Mentorship shortens the curve — no one should have to climb it alone.

To the Urological Association of Asia and our gracious hosts — thank you for the warm hospitality, a wonderfully run congress, and discussions that were as vibrant as they were generous. I leave with more questions than I arrived with, which is exactly the point.

Is AEEP the next gold standard? My answer: YES.

Mabuhay! Salamat po. 🇵🇭




Obstructive Azoos***mia: Fix the Blockage or Go Straight to IVF?When a man has Obstructive Azoos***mia (OA), s***m produ...
01/09/2026

Obstructive Azoos***mia: Fix the Blockage or Go Straight to IVF?

When a man has Obstructive Azoos***mia (OA), s***m production is completely normal—there is just a physical blockade in the way. Because the “factory” is healthy, s***m retrieval rates reach nearly 100%!

So, what is the best path to fatherhood? It comes down to two options:

The Two Pathways
1️⃣ Microsurgical Reconstruction (Fixing the Pipeline)
    What it is: Reconnecting the blocked tubes (e.g., vasectomy reversal).
    Pros: Restores natural fertility so couples can conceive naturally at home.
    Cons: Takes 1–18 months for s***m to reappear in the ej*****te.

2️⃣ S***m Retrieval + ICSI (Bypassing the Pipeline)
    What it is: Retrieving s***m directly via a minor procedure for use in IVF.
    Pros: Quick results; essential if the blockade cannot be repaired surgically.
    Cons: Requires the female partner to undergo IVF treatment cycles.

How to Choose?
Choose Reconstruction if: The female partner is $< 35$ years old, you want multiple children, or you prefer natural conception.

Choose Retrieval + ICSI if: The female partner is $\ge 37$ years old, ovarian reserve is low, or the blockage isn’t repairable.

The Bottom Line: OA is highly treatable! The right choice balances male surgical options with the female partner’s age and family goals.

Thank you to the Indonesian Society of Andrological Urology (InaSAU) InaUA Section of Andrological Urology for the opportunity to present another topic at the 9th Jogja Urology Forum 2026 2026 and be part of this amazing yearly event focusing on men’s health! 🙏✨



***mia

A big thank you to my teachers, friends, and the organizing committee of the 9th Jogja Urology Forum 2026 2026 for invit...
31/08/2026

A big thank you to my teachers, friends, and the organizing committee of the 9th Jogja Urology Forum 2026 2026 for inviting me to share insights on one of the latest advanced treatment options for Benign Prostatic Hyperplasia (BPH) in Indonesia: Blue Laser Vaporization of the Prostate (BVP) 🔵⚡

During our live surgery and hands-on sessions, we successfully managed prostate cases ranging from 60 to 120 cc. The procedure demonstrated remarkable precision—our patient recovered smoothly and was safely discharged on the 2nd post-operative day! It was also a pleasure engaging in such dynamic discussions with all the interactive participants about the future of minimally invasive urological surgery.

Key Highlights from the Presentation: Redefining Prostate Management

•  Why Blue Laser (450 nm)?
◦ High Hemoglobin Absorption: Delivers superior hemostasis compared to traditional electrocautery (TURP).
◦ Shallow Coagulation Depth (~0.5 mm): Minimizes collateral thermal damage to surrounding tissue and erectile nerves, preserving postoperative sexual and ejaculatory function.
◦ High-Risk Patient Profile: Offers a safe profile for patients who cannot interrupt anticoagulation or antiplatelet therapy.

•  Blue Laser vs. Green Light vs. Standard TURP
◦  Hemostasis: Blue Laser provides precise simultaneous vaporization and coagulation with minimal bleeding risk.
◦  Recovery: Significantly reduced catheter indwelling times and faster hospital discharge.
◦  Versatility: Combines low learning curves with high precision across variable prostate volumes.

Take-Home Message: Blue Laser Vaporization stands out as an effective, minimally invasive option for BPH—balancing maximal tissue removal with minimal risk, shorter hospital stays, and preservation of quality of life.

Looking forward to seeing this innovative technology continue to shape better patient outcomes across Indonesia! 🇮🇩





Honored to have had the opportunity to present on “Konsep Urologi” at the Perioperative Urological Nursing Care Training...
28/08/2026

Honored to have had the opportunity to present on “Konsep Urologi” at the Perioperative Urological Nursing Care Training!

A heartfelt thank you to HIMPUNAN PERAWAT UROLOGI INDONESIA DKI JAKARTA Hpui Dki for inviting me to speak on this vital topic to enhance the competence of our urological nurses and drive better patient care.

Key highlights from the session:

- Scope & Anatomy: Cover the full spectrum of urology—from endourology and oncology to pediatric and reconstructive urology.

- Systematic Assessment (U.R.O.F.L.O.W): Empowering nurses with a structured approach from focused history-taking to risk monitoring.

- Diagnostics & Interventions: Understanding key labs, imaging, endourological scopes (fURS, PCNL, TURP), and surgical approaches.

- Safety & Warning Signs: Spotting red flags early (sepsis signs, severe hematuria, sudden drainage blockage) to ensure patient safety.

- Core Pillars: Grounding nursing practice in Service, Education, and Evidence-Based Research.

Together, strengthening nursing competence leads to outstanding urological care!




A big thank you to Kolegium Urologi Indonesia for inviting me to speak on this important topic in men’s health! Not all ...
24/08/2026

A big thank you to Kolegium Urologi Indonesia for inviting me to speak on this important topic in men’s health!

Not all urinary issues are as simple as an enlarged prostate! Treating LUTS requires looking beyond prostate size and tailoring treatment to the patient’s individual needs.

1. Understand the Cause
Prostate size: Tissue growth takes time to develop and responds slowly to specific medications (5-ARIs).

Muscle tension: Tight prostate muscles can cause sudden blockage, which α-blockers can relieve in days.

Bladder response: The bladder works harder to push urine past the prostate, leading to frequent or urgent trips to the bathroom.

2. Check the Details
Symptom disconnect: A larger prostate does not always mean worse symptoms.

Essential checks: Detailed history, symptom scorecards (IPSS), physical exam, and urine tests.

Urine testing: Uroflowmetry and Post-Void Residual (PVR) scans show how well the bladder empties.

3. Choose the Right Treatment
Watchful waiting: Mild symptoms often stay stable without immediate medication.

Medications: Fast relief with α-blockers; shrinkage with 5-ARIs for larger prostates.

Surgery: Options range from minimally invasive procedures to laser therapies, depending on prostate size, health risks, and personal goals.

Bottom Line: Focus on the patient’s comfort and quality of life, not just the test numbers.





Conquering complex anatomy with precision! Managing a large staghorn calculus and proximal ureteral stone in a horseshoe...
24/08/2026

Conquering complex anatomy with precision!

Managing a large staghorn calculus and proximal ureteral stone in a horseshoe kidney featuring a duplicated collecting system and bifid ureter presents an extraordinary surgical challenge. Yet, minimal invasive techniques prove once again that even the most daunting congenital anomalies can be safely and effectively treated!

Key Takeaways:
- Anatomical Complexity: A rare combination of a horseshoe kidney, duplicated collecting system, and bifid ureter with a large staghorn stone burden.

- Minimally Invasive Mastery: Managed via mini-Endoscopic Combined Intrarenal Surgery (mECIRS) using a single-tract mini-PCNL alongside flexible ureteroscopy in the Galdakao-modified supine Valdivia position.

- Superior Patient Outcomes: Achieved remarkable stone clearance, minimal blood loss (

In a rare urological case detailed in this article, a 27-year-old male was admitted to the emergency department after se...
17/06/2026

In a rare urological case detailed in this article, a 27-year-old male was admitted to the emergency department after self-inserting a 7.5 cm glass dropper pipette into his urethra in an attempt to relieve itchiness with dissolved paracetamol. The object migrated into his urinary bladder, where its sharp tip punctured and damaged the bladder’s mucosal lining. This case highlights a unique presentation within the urology field, representing the various types of self-inflicted injuries that patients might do to themselves due to medical discomfort, curiosity, or psychiatric conditions. To prevent the glass from shattering internally, doctors performed a minimally invasive endoscopic procedure, successfully retrieving the pipette completely intact using grasping forceps.

Following the procedure, a contrast imaging test confirmed that the patient’s bladder and urethral linings remained functionally intact. After a two-week recovery period with a catheter, the patient healed completely and was able to urinate normally. Because these types of self-inflicted urological injuries are often linked to underlying psychological conditions, the patient was referred for a psychiatric evaluation, diagnosed with Borderline Personality Disorder (BPD), and started on appropriate antipsychotic therapy to address the behavioral root of the injury.

Congratulation to all authors
1. Irham Kasyful
2. Ivan Maulana

Grateful and honored to be invited to the 19th Malang Continuing Urology Education (MCUE) .This opportunity let me work...
04/05/2026

Grateful and honored to be invited to the 19th Malang Continuing Urology Education (MCUE) .

This opportunity let me work directly with enthusiastic participants in live, hands-on PCNL and ECIRS sessions—where learning happens at the intersection of theory and real surgical decision-making.

During my lecture, I had the chance to share perspectives on RIRS—from where we are today to where we are heading. It’s clear we’re at the forefront of a new era in stone management—more precise, safer, and increasingly patient-centered.

Thank you to dr. , dr. , and all my seniors and colleagues at Saiful Anwar General Hospital, for the warm collaboration and commitment to advancing urology together.

“The future of stone management lies in precision, innovation, and collaboration.” DP, 2026


 
 
 


The hardest stone I’ve ever managed.A 69-year-old lady presented with persistent right flank pain and was referred to .u...
18/04/2026

The hardest stone I’ve ever managed.

A 69-year-old lady presented with persistent right flank pain and was referred to .ui . Imaging revealed a formidable challenge:

🪨 Right renal pelvis stone
📏 Size: 58 × 41 × 24 mm
⚡ Density: 2022 HU (extremely hard composition)

Despite the size and density, we proceeded with a prone PCNL, utilizing a pneumatic lithotriptor—still one of the most reliable tools when dealing with ultra-hard stones.

⏱️ Operative time: < 2 hours
📍 Complete clearance achieved
🏥 Discharged in 36 hours
✅ Patient recovered well

Cases like this remind us that success in endourology is not just about technology—but about strategy, efficiency, and ex*****on under pressure.

“In stone surgery, complexity is inevitable—but precision is a choice.” DP, 2026





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Jl. Udayana No.16, Monjok Barat, Kec. Selaparang,
Mataram
83122

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