KATEGORI KEWENANGAN

Kewenangan klinis diberikan untuk memberikan pelayanan pengelolaan bidang Bedah Urologi di
RSUD Dr. H. Soewondo (Kendal) berdasarkan pelayanan yang dibutuhkan pasien
KATEGORI REKOMENDASI
KEWENANGAN MITRA
JENIS PELAYANAN
1 2 3 4 BESTARI

OPERASI ADRENAL
1. Adrenalektomi (abdominotorakal)
2. Adrenalektomi

OPERASI GINJAL
1. Nefrotomi dan nefrostomi
2. Nefrotomi, deroofing/unroofing cyst.
Pielonefrolitotomi
3. Nefrostomi
4. Nefrostomi perkutan tanpa fragmentasi
Bivalve/anatropic nephrolithotomy
5. Nefrostomi perkutan dengan fragmentasi
6. Pielostomi dan pielostomi
7. Pielostomi. Pielolitotomi
8. Pielostomi. Extended pyelolithotomy
9. Prosedur diagnostik ginjal. Pielokalikotomi
10. Nefroskopi
11. Pieloskopi. Diseksi kelenjar getah bening pelvis
per laparoskopi
12. Closed (percutaneous) needle) biopsy of kidney
13. Open biopsy of kidney
14. Eksisi atau destruksi lokal lesi atau jaringan
ginjal
15. Marsupialisasi lesi ginjal
16. Open ablation of renal lesion or tissue
17. Ablasi perkutan lesi atau jaringan ginjal
18. Ablasi laparoskopik lesi atau jaringan ginjal
19. Eksisi atau destruksi lokal lesi atau jaringan
ginjal lainnya
20. Nefrektomi parsial: Kalisektomi, Wedge
resection of kidney
21. Complete nephrectomy
22. Nephrectomy of remaining kidney. Removal of
solitary kidney
23. Removal of transplanted or rejected kidney.
Nefrektomi radikal
24. Removal of transplanted or rejected kidney.
Nefrektomi radikal
25. Nefrektomi bilateral
26. Transplantasi ginjal
27. Auto-transplantasi ginjal
28. Transplantasi ginjal lainnya. Transplantasi
resipien
29. Nephropexy, fixation or suspension of movable
(floating) kidney
30. Other repair of kidney
31. Jahit laserasi ginjal/renorafi
32. Penutupan nefrostomi dan pielostomi
33. Penutupan fistula ginjal lainnya
34. Reduksi torsio pedikel ginjal
35. Symphysiotomy for horseshoe kidney. Koreksi
horseshoe kidney
36. Anastomosis ginjal: Nefropieloureterostomi,
anastomosis pieloureterovesika, anastomosis
ureterokaliseal
37. Correction of uteropelvic junction. Pieloplasti
38. Dekapsulasi ginjal. Kapsulektomi ginjal.
Dekortikasi ginjal. Nefrektomi untuk transplan
donor
39. Aspirasi perkutan ginja (pelvis). Aspirasi kista
ginjal. Renipuncture. Punksi dan sklerosing kista
ginjal
40. Replacement of nephrostomy tube
41. Replacement of pyelostomy tube
42. Perfusi lokal ginjal
43. Other injection of therapeutic substance into
kidney injection to renal cyst
44. Implantation or replacement of mechanical
kidney
45. Removal of mechanical kidney
46. Reconstruction of renovascular

OPERASI URETER
1. Transurethral removal of obstructions from
ureter and renal pelvis
Removal of: blood, clot, calculus, foreign body,
From ureter or renal pelvis without incision.
URS
2. Meatotomi ureter
3. Ureterotomi
Incision of ureter for: drainage, exploration,
removal of calculus
Ureterolitotomi
4. Ureterolitotomi proksimal
5. Ureterolitotomi distal
6. Prosedur diagnostik ureter
7. Ureteroskopi
8. Closed percutaneous biopsy of ureter
9. Closed endoscopic biopsy of ureter
10. Open biopsy of ureter
11. Endoscopy of ileal conduit: sistoskopi,
loposkopi
12. Ureterektomi
13. Ureterectomy, NOS
14. Ureterektomi parsial. Eksisi lesi ureter.
Shortening or ureter with reimplantation.
Reimplantasi ureter bilaterall
15. Ureterektomi total
16. Contaneous uretero-ileostomy
17. Formation of cutaneous uretero-ileostomy. Ileal
conduit (Bricker)
18. Revision of cutaneous uretero-ileostomy
19. Diversi urine eksternal lainnya
20. Formation of other cutaneous ureterostomy.
Anastomosis ureter ke kulit.
Ureterostomy NOS. ureterokutaneostomi
21. Revisi ureterostomi kutan lainnya
22. Other anastomosis or bypass or ureter
23. Diversi urine ke intestinum
24. Revisi anastomosis ureterointestinal
25. Nephrocystanastomosis, NOS
26. Ureteroneocystostomy, Replacement of ureter
with bladder flap
Anastomosis ureterovesikal. Reimplantasi ureter
unilateral
 Psoas Hitch/Boari flap
27. Transuretero-ureterostomi. Uretero-ureterostomi
28. Other. Anastomosis end to end ureter
29. Repair of ureter
30. Lisis adesi intraluminal ureter
31. Jahit laserasi
32. Closure of other fistula of ureter
33. Ureteropeksi
34. Removal of ligature from ureter
35. Other repair of ureter. Tailoring ureter
36. Dilatasi meatus uretra
37. Implantation of electronic ureteral stimulator
38. Replacement of electronic ureteral stimulator
39. Removal of electronic ureteral stimulator
40. Ligasi ureter
41. Pelepasan DJ stent

OPERASI KANDUNG KEMIH

1. Transurethral clearance of bladder
Drainase buli tanpa insisi
Removal of (blood clots, calculus, foreign body)
from bladder without incision
Litotripsi batu buli
2. Sistostomi
3. Aspirasi perkutan kandung kemih
Lisis adesi intraluminal dengan insisi ke dalam
4. kandung kemih
5. Sistostomi perkutan
Closed cystostomy, percutanrous suprapubic
 cystostomy
Sistostomi suprapubik lainnya. Railroading
6. rupture uretra
7. Sistostomi lainnya. Lithopalaksi. Seksio
alta/vesikolitotomi
8. Vesikostomi
9. Revisi atau penutupan vesikostomi
10. Sistoskopi melalui stoma buatan. Sistoskopi
ODS
11. Sistoskopi lainnya. Sistoskopi transuretra
12. Closed (transurethral) biopsy of bladder. TUR
tumor buli
13. Open biopsy of bladder
14. Eksisi/destruksi transuretra jaringan kandung
kemih
15. Lisis tansuretra adesi intraluminal
16. Eksisi/destruksi transuretra lesi/jaringan buli
lainnya
Reseksi endoskopi lesi kandung kemih
17. Eksisi/destruksi jaringan kandung kemih lainnya
18. Eksisi urakus. Eksisi sinus urakus kandung
kemih
19. Open excision/destruction of other lesion/tissue
of bladder
Endometrektomi kandung kemih. Eksisi
suprapubik lesi kandung kemih
Divertikulektomi kandung kemih
20. Partial cystectomy excision of bladder dome,
trigonectomy, wedge resection of bladder.
Reduksi sistoplasti
21. Sistektomi total. Sistektomi total dengan
uretrektomi
 Sistektomi radikal
22. Sistektomi total lainnya
23. Other repair of urinary bladder
24. Jahit laserasi kandung kemih
25. Penutupan sistostomi
26. Repair of fistula involving bladder and intestine
Fistulektomi: (rektovesikovagina,
vesikosigmoidovagina)
Repair fistel enterovesika. Repair fistel
vesikorektal
27. Repair of other fistula of bladder
Fistulektomi: servikovesika,
uretroperineovesika, uterovesika, vaginovesika
Repair fistel vesikokutan
28. Cystourethroplasty and plastic repair of bladder
neck
Placation of sphincter of urinary bladder
Reconstruction/V-Y plasty of bladder neck
29. Repair of bladder extropy
30. Rekonstruksi kandung kemih
Anastomosis of bladder with isolated segment of
ileum, augmentation of bladder, replacement of
bladder with ileum.sigmoid (closed ileal
bladder)
31. Anastomosis of bladder to intestine NOS,
cystocolic anastomosis
32. Other repair of bladder. Neobladder
33. Sphincterotomy of bladder Devision of bladder
neck
34. Dilation of bladder neck
35. Control of (post-operative) hemorrhage of
 bladder
36. Insertion of indwelling urinary catheter
37. Replacement of indwelling urinary catheter
38. Implantation of electronic bladder stimulator
39. Replacement of electronic bladder stimulator
40. Removal of electronic bladder stimulator

OPERASI URETRA
1. Uretrotomi
Eksisi septum uretra, pembentukan fistula
uretrovagina, uretrostomi perineal, removal of
calculus from urethra by incision
2. Meatotomi uretra
3. Uretroskopi perineal
4. Uretroskopi lain. PER (Primary Endoscopic
Realignment)
Uretroskopi/uretrosistoskopi
5. Biopsi uretra
6. Biopsi jaringan peri-uretra
7. Eksisi/destruksi lesi atau jaringan uretra
8. Eksisi endoskopik: destruksi lesi atau jaringan
uretra
Fulgurasi lesi uretra
Kauterisasi
9. Eksisi/destruksi lokal lesi atau jaringan uretra
lainnya
Excision of: (congenital valve, lesion, stricture)
of urethra
Uretrektomi. Divertikulum uretra. Insisi
posterior urethral valve
10. Repair of urethra
11. Jahit laserasi uretra
12. Penutupan uretrostomi
13. Penutupan fistula uretra lainnya.
Fistulektomi/repair fistel urethra
14. Reanastomosis uretra. Anastomosis uretra
Reseksi-anastomosis uretra
15. Repair of hypospadias/epispadias
16. Rekonstruksi uretra lainnya. Urethral
construction. Johanson
17. Meatoplasti uretra
18. Other repair of urethra
Rotasi Benenenti uretra bulbosa. Repair of old
obstetric laceration of urethra.
Urethral placation. Uretroplasti
19. Release of urethral stricture.
Cutting of urethral spincter. Internal urethral
Sphincter. Urethrolysis. Uretrotomi interna
(Sachse)
20. Dilatasi uretra
Dilation of urethrovesical junction
Passage of sound throught urethra
Removal of calculus from urethra without
incision
Businasi/dilatasi uretra
21. Insisi jaringan peri-uretra. Drainase glandula
bulbouretra
22. Eksisi jaringan peri-uretra
23. Implantation of artificial urinary sphincter
24. Kalibrasi uretra
25. Insersi kateter
 OPERASI LAIN DI SALURAN KEMIH
1. Diseksi jaringan retroperitoneal
2. Retroperitoneal dissection, NOS
Limfadenektomi retroperitoneal/RPLND
3. Ureterolisis dengan pembebasan/reposisi ureter
untuk fibrosis retroperitoneal
4. Lisis adesi perirenal/periureter lainnya
Ureterolisis
5. Lisis adesi perirenal/periureter laparoskopik

6. Insisi jaringan perirenal/periureter lainnya

Eksplorasi area perinefrik. Insisi abses perirenal
7. Insisi jaringan perivesika

8. Lisis adesi perivesika lainnya

9. Lisis laparoskopik adesi perivesika

10. Insisi jaringan perivesika lainnya

11. Prosedur diagnostik jaringan perirenal dan

perivesika
12. Biopsi jaringan perirenal atau perivesika

13. Prosedur diagnostik lain pada jaringan perirenal,

jaringan perivesikal, dan retroperitoneum
14. Placation of urethrovesical junction

15. Suprapubic sling operation. MMK/sling uretra

16. Suspensi uretra retropubik

17. Suspensi parauretra

18. Other repair of urinary stress incontinence

19. Operasi muskulus levator untuk suspensi

uretrovesikal
20. Injection of implant into urethra and/or bladder
 neck
Collagen implant. Collagen implant. Collagen
implant. Endoscopic injection of implant
21. Other
Uretropeksi anterior, repair of stress
incontinence
NOS, tudor “rabbitear” urethropexy
22. Kateterisasi ureter. Drainase ginjal dengan
kateter
Insersi stent ureter/DJ stent. Ureterovesical
orifice dilation
Drainase periureter. Insersi kateter ureter untuk
RPG
23. Eksisi jaringan perirenal atau perivesikal
24. Replacement of uretorostomy tube: Change,
reinsertion
25. Replacement of cystostomy tube
26. Ultrasonic fragmentation of urinary stones.
Shattered urinary stones
27. Ureterosigmoidostomi (Coffey)

OPERASI PROSTAT DAN VESIKULA SEMINALIS

1. Insisi prostat. Drainase abses prostat.
Prostatolitotomi
2 Prosedur diagnostik prostat dan vesikula
seminalis
Biopsi prostat
3. Closed (percutaneous) (needle) biopsy of
prostate
4. Open biopsy of prostate

5. Closed (percutaneous) biopsy of seminal

vesicles
6. Open biopsy of periprostatic tissue

7. Biopsi jaringan peri-prostatika

8. Prosedur diagnostik lain di vesikula seminalis

9. Prostatektomi transuretra

10. Transurethral (ultrasound) guided laser induced

prostatectomy (TULIP) TRUS
11. Prostatektomi transuretra lainnya:
Excision of median bar by transurethral
approach, TEVAP, transurethral enucleative
procedures, transurethral prostatectomy NOS,
TURP, TUIP, BNI, TVP, TMP
12. Prostatektomi suprapubik. Prostatektomi
transvesikal
13. Prostatektomi retropubik

14. Prostatektomi radikal. Prostatovesikulektomi

15. Eksisi lokal lesi prostat. Open prostatectomy

16. Operasi di vesikula seminalis

17. Aspirasi perkutan vesikula seminalis

18. Insisi vesikula seminalis

19. Eksisi vesikula seminalis

Excision of Mullerian duct cyst,
spermatosistektomi
20. Aspirasi perkutan prostat

21. Injeksi ke dalam prostat

22. Repair or prostate

23. Eksisi lokal lesi prostat. Open prostatectomy

24. Control of (postoperative) hemorrhage of

prostate
Coagulation of prostatic bed
 Cystoscopy for control of prostatic hemorrhage
25. Transurethral balloon dilation of the prostatic
urethra
26. Transurethral destruction of prostate tissue by
microwave thermotherapy
Transurethral microwave thermotherapy
(TUMT) of prostate
27. Other transurethral destruction of prostate tissue
by other
Termoterapi. Radiofrequency thermotherapy
Transurethral needle ablation (TUNA) of
prostate
28. Masase prostat

OPERASI SKROTUM DAN TUNIKA VAGINALIS

1. Insisi dan drainase skrotum dan tunika vaginalis
2. Biopsi skrotum atau tunika vaginalis
3. Eksisi hidrokel (tunika vaginalis)
4. Eksisi/destruksi lesi atau jaringan skrotum:
fulguration of lesion reduction of elephatiasis,
partial scrotectomy
5. Repair on scrotum and tunica vaginalis
6. Jahit laserasi skrotum dan tunica vaginalis
7. Repair of scrotal fistula
8. Other repair of scrotum and tunica vaginalis
Reconstruction with rotational or pedicle flaps
Skrotoplasti
9. Other repair on scrotum and tunica vaginalis

10. Aspirasi perkutan tunika vaginalis

11. Eksisi lesi tunika vaginalis selain hidrokel

OPERASI TESTIS
1. Insisi testis. Eksplorasi testis (microsurgery)
2. Prosedur diagnostik testis
3. Closed (percutaneous) (needle) biopsy of testis
4. Open biopsy of testis
5. Prosedur diagnostik testis lainnya
6. Eksisi/destruksi lesi testis
Eksisi apendiks testis. Eksisi kista Morgagni
pada pria
7. Orkidektomi unilateral
8. Orkidektomi bilateral. Kastrasi pria.
Orkidektomi radikal bilateral
9. Removal of both testis at same operative episode
Bilat orchidectomy NOS. Extended
orchidectomy
10. Removal of remaining testis
Removal of solitary testis. Orkidektomi
subkapsular
11. Orkidopeksi (UDT, torsio testis)
12. Repair of testis
13. Jahit laserasi testis
14. Other repair of testis. Teticular graft
15. Insertion of testicular prosthesis
16. Aspirasi testis
17. Injection of therapeutic substance into testis

OPERASI FUNIKULUS SPERMATIKUS, EPIDIDIMIS, DAN VAS DEFERENS

1. Prosedur diagnostik funikulus spermatikus,
epididimis, dan vas deferens
2. Biopsi funikulus spermatikus, epididimis, dan
vas deferens
3. Prosedur diagnostik funikulus spermatikus,
epididimis, dan vas deferens lainnya
4. Eksisi varikokel dan hidrokel funikulus
spermatikus
Ligasi tinggi vena spermatika. Hidrokelektomi
kanalis Nuck. Funikokelektomi
Varikokelektomi (Palomo)
5. Eksisi kista epididimis. Spermatokelektomi

6. Eksisi lesi atau jaringan lain funikulus

spermatikus dan epididimis
Eksisi apendiks epididimis
7. Epididimektomi

8. Repair of spermatic cord and epididymis

9. Jahit laserasi funikulus spermatikus dan

epididimis
10. Reduksi torsio testis atau funikulus spermatikus

11. Transplantasi funikulus spermatikus

12. Vasotomi. Vasostomi. Vasovasostomi

13. Vasektomi dan ligasi vas deferens

14. (Ligation, crushing, division) of vas deferens

15. Vasektomi

16. Repair of vas deferens and epididymis

17. Jahit laserasi vas deferens dan epididimis

18. Reconstruction of surgically divided vas

deferens
19. Epididimovasostomi

20. Removal of ligature from vas deferens

21. Operasi lain di funikulus spermatikus,

epididimis, dan vas deferens
22. Aspirasi spermatokel

23. Epididimotomi

24. Insisi funikulus spermatikus

25. Lisis adesi funikulus spermatikus

26. Insertion of valve in vas deferens

OPERASI PENIS
1. Sirkumsisi

2. Biopsi penis

3. Eksisi/destruksi lokal lesi penis

Eksisi plak (penyakit Peyronie). Excise webbed
penis
4. Amputasi penis

5. Release of chordate/chordectomy

6. Rekonstruksi penis. Eksisi fibroma

7. Replantation of penis. Reattachment of

amputated penis
8. Other repair of penis. Operasi priapismus
(prosedur Winter)
9. Koreksi priapismus

10. Dorsal or lateral slit of prepuce

11. Insisi penis

12. Division of penile adhesions

13. Fitting of external prosthesis of penis

14. Insertion or replacement of non-inflatable penile

prosthesis
Insertion of semi-rigid rod prosthesis into shaft
of penis
15. Removal of internal prosthesis of penis
16. Insertion or replacement of inflatable penile
prosthesis
Insertion of cylinders into shaft of penis and
placement of pump and reservoir
17. Operasi lain di penis. Corpora cavernosa-corpus
spongiosum shunt
Corpora-saphenous shunt. Irigasi korpus
kavernosum
18. Diseksi nodus limfatikus inguinal

19. Hidrokelektomi per inguinal/ligasi tinggi

20. Insisi abses perineum

21. Limfadenektomi ilioninguinal

22. Vasografi

23. Diseksi nodus limfatikus pelvis

24. ESWL

25. Operasi sistokel

26. Insersi kateter Tenckhoff untuk CAPD

27. Uroflowmetri

28. Infiltrasi sitostatika intravesika

29. Kemoterapi

Mitra Bestari Penelaah Kritis

dr. Herinto Himawan, SpU dr. Adhitya Fajar Prasetya, MKedKlin SpU

Direktur RSUD Dr. H. Soewondo

dr. Saikhu, MKes