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All Journal Andalas obstetrics and gynecology journal
D. Irsat Syafardi
Department of Obstetrics and Gynecology, Faculty of Medicine, University of Lampung/Abdul Moeloek General Hospital, Bandar Lampung, Indonesia
Biochemistry, Genetics & Molecular Biology Immunology & microbiology Nursing Public Health

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Double Approach Technique for Cervicovaginal Agenesis: A Case Report Tyas Priyatini; D. Irsat Syafardi
Andalas Obstetrics And Gynecology Journal Vol. 10 No. 1 (2026)
Publisher : Fakultas Kedokteran Universitas Andalas

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.25077/aoj.10.1.170-178.2026

Abstract

Introduction: Cervicovaginal agenesis is rare female congenital anomalies. The patients usually present with primary amenorrhoea, cyclical abdominal pain, or primary infertility. A conservative surgical approach has been proposed to alleviate obstructive symptoms, construct, and maintain the patency of the genital tract, while still preserving fertility. Case Report:  A Ms. 14 year old was referred with primary amenorrhea and cyclical abdominal pain for 5 months. Physical examination and ultrasound revealed cervical dysgenesis with proximal vaginal dygenesis. Cervical canalization using double approach (laparotomy and trasnvaginally) was done to restore the normal anatomical integrity, maintain the functional cervical canal with a theoretical advantage of protection from ascending infection, and preservation of fertility. Discussion: Obstructed menstrual blood, causing symptoms such as primary amenorrhea, could be a sign of female congenital anomalies. Hysterectomy has been the mainstay treatment for many decades, due to the risk of reoperation. Advances in surgical technique of conservative treatment marked the overall success rate up to 60% with few cases are reported to have pregnancy. Conclusions: Double approach technique could be a feasible option for conservative surgery in cervicovaginal agenesis.  
Learning Curve Analysis of Pelvic Organ Prolapse Surgery Among Urogynecology and Aesthetic Reconstruction Trainees D. Irsat Syafardi; Tyas Priyatini; Alfa Muthia
Andalas Obstetrics And Gynecology Journal Vol. 10 No. 2 (2026)
Publisher : Fakultas Kedokteran Universitas Andalas

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.25077/aoj.10.2.248-261.2026

Abstract

Background: Pelvic organ prolapse (POP) is a condition in which pelvic organs descend into the vaginal canal due to weakened muscles and tissues. It represents a significant global health burden with a worldwide prevalence of 30.9% and 26.4% in Jakarta. As the female life expectancy in Indonesia continues to rise, the prevalence of POP estimated to increase by 40%, further affecting women’s quality of life. The need for POP surgery is projected to reach 48.1% by 2050. Given the complexity of POP reconstruction, adequate training and evaluation of urogynecology subspecialists are essential to ensure patient safety and optimal outcomes. Objective: To analyze the learning curve of POP surgeries performed by urogynecology subspecialty trainees at RSCM using the Cumulative Sum (CUSUM) method in order to evaluate surgical skill development and optimize clinical training quality. Methods: This study applied a CUSUM learning curve analysis to assess the performance of three subspecialty trainees during ten POP reconstructive surgeries. Variables analyzed included operation duration and intraoperative blood loss. Result: CUSUM analysis is able to identify the point at which trainees achieve procedural competence and stable performance, reflected by plateau phase in operation time and reduced intraoperative bleeding. This method allows for early detection of learning challenges and facilitates timely corrective actions during training. Conclusions: CUSUM learning curve analysis provides a sensitive and continuous assessment tool for monitoring surgical competency of urogynecology subspecialty trainees. This approach in clinical training can enhance the standardization of education, improve patient safety, and optimize clinical outcomes in POP management.
Co-Authors Alfa Muthia Tyas Priyatini