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Improving pelvic floor muscle strength in women with postpartum stress urinary incontinence using electromagnetic stimulation therapy: A randomized controlled trial Roziana, Roziana; Chan, Muhammad SN.; Santoso, Budi I.; Sjusad, Suskhan; Priyatini, Tyas; Hakim, Surahman; Moegni, Fernandi; Mutia, Alfa P.; Kurniawan, Andrew P.; Armita, Nurdarlila
Narra J Vol. 5 No. 1 (2025): April 2025
Publisher : Narra Sains Indonesia

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.52225/narra.v5i1.2015

Electromagnetic stimulation (EMS) has emerged as a potential alternative for managing urinary incontinence in women. However, research directly comparing EMS to Kegel exercises in cases of postpartum stress urinary incontinence (SUI) is limited. The aim of this study was to assess the effectiveness of EMS (improvement of the symptoms, incontinence severity and pelvic floor muscle strength) and patient compliance with the therapy in postpartum women with SUI. A single-blind randomized clinical trial was conducted involving postpartum women diagnosed with SUI at least three months after delivery. The EMS group received the therapy three times a week for five weeks, while the Kegel group was instructed to perform daily exercises for eight weeks. Improvement of the symptoms and incontinence severity were evaluated using the Urogenital Distress Inventory-6 (UDI-6) and a 1-hour pad test, respectively, while pelvic floor muscle strength was measured with a perineometer. Both groups showed significant improvements in UDI-6 scores, 1-hour pad test results and pelvic floor muscle strength compared to before treatment. However, the EMS group had significantly greater muscle strength than the Kegel group (16.5 vs 8.0 cmH2O, p=0.006). The UDI-6 scores, 1-hour pad test results and patients’ compliance were not significantly different between EMS and Kegel groups. EMS demonstrated a greater ability to enhance pelvic floor muscle strength than Kegel exercises. These findings suggest that EMS may be a more effective option for enhancing pelvic floor muscle strength in postpartum women.

Profil Sosiodemografi Wanita Hamil dengan Infeksi Saluran Kemih: Sebuah Tinjauan Sistematis dari Penelitian Saat Ini: Analisis Fitriyadi Kusuma; Kemal Akbar Suryoadji; Adib Kamil Putra Kadarusman; Geraldus Sigap Gung Binathara; Salsa Billa As’syifa; Surahman Hakim
Cermin Dunia Kedokteran Vol 52 No 1 (2025): Obstetri & Ginekologi
Publisher : PT Kalbe Farma Tbk.

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.55175/cdk.v52i1.1250

Introduction: Untreated UTIs during pregnancy can lead to complications for both the mother and the fetus, highlighting the importance of appropriate management. Understanding the sociodemographic profiles of pregnant women with UTIs can aid in tailored interventions and care. Methods: This systematic review followed a protocol registered in the International Prospective Register of Systematic Reviews (PROSPERO ID: CRD42024507145). Cohort cross-sectional studies focusing on the sociodemographic profiles of pregnant women with UTI were systematically searched and selected from databases such as ScienceDirect, Cochrane, Scopus, and PubMed. Eligibility criteria included relevance to sociodemographic profiles, clear extraction and statistical analysis methods, and publication in English. Data extraction and study selection were conducted independently by six researchers, with any discrepancies resolved through discussion. Results: Three studies met the inclusion criteria and were included in the systematic review. The studies conducted in the United States, Cameroon, and Bangladesh, which included 46,398 pregnant women, revealed diverse sociodemographic factors associated with UTI risk among pregnant women. Factors such as low educational attainment, low household income, and racial/ethnic disparities were identified as significant contributors to UTI prevalence in the United States. In Cameroon, although a high UTI prevalence was observed, no significant risk factors were identified. In Bangladesh, maternal undernutrition, primiparity, and low paternal education were significant risk factors for UTIs among pregnant women. Antibiotic sensitivity was varied, indicating the complexity of UTI management. Conclusion: The systematic review emphasizes the importance of considering sociodemographic factors in understanding and addressing UTI risk among pregnant women. Socioeconomic status, cultural disparities, and health-related factors play significant roles in UTI prevalence and management. An intervention to target specific sociodemographic characteristics may be necessary to effectively prevent and manage UTIs in pregnant women across different geographical and socioeconomic contexts.

MEAN URGE INCONTINENCE EPISODES COMPARISON AFTER SOLIFENACIN AND MIRABEGRON TREATMENT IN OVERACTIVE BLADDER PATIENTS: A CASE REPORT Fuady, Dzicky Rifqi; Hakim, Surahman
Mandala Of Health Vol 17 No 2 (2024): Mandala of Health: a Scientific Journal
Publisher : Fakultas Kedokteran Universitas Jenderal Soedirman

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.20884/1.mandala.2024.17.2.12741

Latar Belakang: Overactive bladder (OAB) merupakan sindrom yang mengganggu kualitas hidup, khususnya kualitas hidup wanita. Pilihan terapi farmakologis untuk OAB adalah agen antimuskarinik (80%), seperti solifenacin. Agen agonis beta-3 juga merupakan pilihan terapi farmakologis baru untuk OAB, seperti mirabegron. Inkontinensia urin urgensi merupakan gejala OAB yang paling mengganggu, sehingga perlu dilakukan penilaian apakah solifenacin dan mirabegron memberikan perbaikan gejala yang berbeda. Kasus: Seorang wanita berusia 50 tahun dengan diagnosis overactive bladder (OAB) dengan gejala urgensi, frekuensi berkemih 20 kali/hari, nokturia 3 – 4 kali/malam, dan inkontinensia urgensi tanpa tanda-tanda peradangan saluran kemih. Pembahasan: Pencarian literatur dilakukan melalui Google Scholar, Pubmed, Embase, clinicaltrials.gov dan Cochrane library. Ditemukan total 532 artikel dengan hanya dua artikel meta analisis yang dicocokkan dan dinilai. Validitas, kepentingan dan penerapan meta-analisis dianalisis menggunakan tinjauan sistematik alat Oxford CEBM. Meta analisis menunjukkan bahwa solifenacin dan mirabegron tidak memiliki perbedaan yang signifikan dalam hal jumlah rata-rata episode inkontinensia urgensi. Kesimpulan: Solifenacin dan Mirabegron mempunyai pengaruh yang sama terhadap jumlah episode inkontinensia urgensi pada pasien OAB.

PENDEKATAN DIAGNOSIS SINDROM OHVIRA PADA FASILITAS KESEHATAN TERBATAS: SEBUAH TINJAUAN SISTEMATIS Hakim, Surahman; Kadarusman, Adib Kamil Putra; Fadhly, RM Ali; Suryoadji, Kemal Akbar; Hadinata, Valencia; Zahra, Reihana; Abdullah, Muhammad Raoul Taufiq; Kusuma, Fitriyadi
Jurnal Ilmiah Kesehatan Vol 23 No 03 (2024): Jurnal Ilmiah Kesehatan terbitan Desember Volume 23 Nomor 03 Tahun 2024
Publisher : UIMA Press

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.33221/jikes.v23i03.3631

Sindrom OHVIRA merupakan kelainan kongenital yang langka terjadi pada saluran reproduksi wanita. OHVIRA merupakan salah satu kelompok kelainan duktus mullerian yang terdiri dari trias uterus didelfis, obstruksi hemivagina, dan agenesis renal. Diagnosis menjadi sebuah tantangan, terutama pada fasilitas kesehatan yang memiliki keterbatasan sarana prasarana dikarnakan tingkat prevalensi yang rendah dan menifestasi klinis yang beragam. Tinjauan sistematis dilakukan dengan pencarian menggunakan kata kunci yang terstruktur pada beberapa database seperti PubMed, Cochrane, ScienceDirect, dan Google Scholar , scopus, dan cochrane. Seleksi artikel dilakukan menggunakan kriteria kelayakan yang ditetapkan. Berdasarkan pencarian artikel didapatkan 6 studi yang menunjukkan manifestasi klinis dari sindrom OHVIRA. Beberapa manifestasi klinis yang ada berupa nyeri punggung belakang kronis, nyeri perut, dyspareunia, dan adanya keputihan yang berbau. Pada pemeriksaan fisik didapatkan adanya abnormalitas seperti massa kistik, benjolan pada abdomen, anomali uterus, dan kelainan dinding vagina. Beragam keluhan dan temuan tersebut dapat menjadi landasan untuk menjadikan sindrom OHVIRA sebagai diagnosis banding untuk proses rujukan segera dan tatalaksana awal. Sindrom OHVIRA memiliki manifestasi klinis yang beragam, sehingga menjadikan keadaan ini sebuah tantangan untuk didiagnosis. Dokter pada layanan terbatas berperan penting dalam mengenali keluhan khususnya keluhan ginekologi kronis, dan menjadikan sindrom ini sebagai diagnosis banding untuk melakukan perujukan kasus ke fasilitas layanan kesehatan tingkat lanjut, dan memberikan tatalaksana untuk meringankan gejala.

Profil Sosiodemografi Wanita Hamil dengan Infeksi Saluran Kemih: Sebuah Tinjauan Sistematis dari Penelitian Saat Ini: Analisis Kusuma, Fitriyadi; Suryoadji, Kemal Akbar; Kadarusman, Adib Kamil Putra; Binathara, Geraldus Sigap Gung; As’syifa, Salsa Billa; Hakim, Surahman
Cermin Dunia Kedokteran Vol 52 No 1 (2025): Januari 2025
Publisher : PT Kalbe Farma Tbk.

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.55175/cdk.v52i1.1250

Introduction: Untreated UTIs during pregnancy can lead to complications for both the mother and the fetus, highlighting the importance of appropriate management. Understanding the sociodemographic profiles of pregnant women with UTIs can aid in tailored interventions and care. Methods: This systematic review followed a protocol registered in the International Prospective Register of Systematic Reviews (PROSPERO ID: CRD42024507145). Cohort cross-sectional studies focusing on the sociodemographic profiles of pregnant women with UTI were systematically searched and selected from databases such as ScienceDirect, Cochrane, Scopus, and PubMed. Eligibility criteria included relevance to sociodemographic profiles, clear extraction and statistical analysis methods, and publication in English. Data extraction and study selection were conducted independently by six researchers, with any discrepancies resolved through discussion. Results: Three studies met the inclusion criteria and were included in the systematic review. The studies conducted in the United States, Cameroon, and Bangladesh, which included 46,398 pregnant women, revealed diverse sociodemographic factors associated with UTI risk among pregnant women. Factors such as low educational attainment, low household income, and racial/ethnic disparities were identified as significant contributors to UTI prevalence in the United States. In Cameroon, although a high UTI prevalence was observed, no significant risk factors were identified. In Bangladesh, maternal undernutrition, primiparity, and low paternal education were significant risk factors for UTIs among pregnant women. Antibiotic sensitivity was varied, indicating the complexity of UTI management. Conclusion: The systematic review emphasizes the importance of considering sociodemographic factors in understanding and addressing UTI risk among pregnant women. Socioeconomic status, cultural disparities, and health-related factors play significant roles in UTI prevalence and management. An intervention to target specific sociodemographic characteristics may be necessary to effectively prevent and manage UTIs in pregnant women across different geographical and socioeconomic contexts.

Kegel exercises with a guidebook for stress urinary incontinence treatment Hakim, Surahman; Santoso, Budi Iman; Rahardjo, Harrina Erlianti; Setiati, Siti; Kusumaningsih, Widjajalaksmi; Prihartono, Joedo; Ibrahim, Nurhadi; Indriatmi, Wresti; Erwinanto
Medical Journal of Indonesia Vol. 33 No. 2 (2024): June
Publisher : Faculty of Medicine Universitas Indonesia

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.13181/mji.oa.247142

BACKGROUND Stress urinary incontinence (SUI) is uncontrollable urine leakage when intra-abdominal pressure increases. Behavioral therapy with Kegel exercise is currently the best conservative management recommendation for treating SUI patients. This study aimed to investigate the success of supervised Kegel exercises using the Kegel exercises guidebook in women with SUI. METHODS This quasi-experimental study involved both groups being taught the same regiment of Kegel exercises, but the intervention group was given the Kegel exercises guidebook. After 12 weeks, the compliance, subjective, and objective success rates were evaluated through the patient’s notes, Urinary Distress Inventory-6, Incontinence Impact Questionnaire-7, perineometer, and pad test. RESULTS Patients with a higher level of education had lower compliance to Kegel exercises (p = 0.01; odds ratio [OR] 0.38; 0.18–0.79). No significant difference was observed in the subjective symptom improvement between the two groups. The intervention group had a significantly higher success rate based on objective success by analyzing the 1-hour pad test results. The intervention group was also more adherent (p<0.001; OR 4.78; 2.51–9.0). CONCLUSIONS Patients who received the Kegel exercises guidebook were more compliant and more objectively successful than those who did not receive the manuals.

Clinical Characteristics of Pelvic Organ Prolapse at a Nationally Referred General Hospital: A Retrospective Study (2023-2024) Djusad, Suskhan; Hakim, Surahman; Meutia, Alfa Putri; Priyatini, Tyas; Moegni, Fernandi; Hidayah, Gita Nurul; Azzahra, Kayla Rianna
Indonesian Journal of Obstetrics and Gynecology Volume 13. No. 4 October2025
Publisher : Indonesian Socety of Obstetrics and Gynecology

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.32771/inajog.v13i4.3021

AbstractObjective: To evaluate the clinical characteristics of patients with Pelvic Organ Prolapse (POP) in national referral hospitals and analyze the relationship between age, parity, and prolapse severity. Methods: This medical record–based retrospective study included 353 POP patients from 2023–2024. Variables assessed were age, parity, prolapse severity (POP-Q), sexual activity status, and type of therapy received. Correlation analysis was performed using Spearman’s rank correlation with SPSS version 26. Results: Most patients (81.3%) were postmenopausal, and 64.6% were multiparous. The majority presented with stage IV prolapse (34.8%), and operative therapy was the primary treatment choice (89.5%). Significant associations were observed between age and prolapse severity (? = 0.208, p < 0.001) and between parity and prolapse severity (? = 0.215, p < 0.001). These findings indicate that increasing age and higher parity are significantly associated with more severe POP, although the correlation strength was weak. Conclusions: POP was most commonly found in postmenopausal women, with higher severity among older and multiparous patients. These findings highlight the importance of early screening and preventive strategies to reduce POP progression. Further prospective multicenter studies are needed to evaluate the long-term impact of POP on quality of life and to compare the effectiveness of conservative versus operative therapies. Keywords: conservative therapy, degree of prolapse, parity, Pelvic Organ Prolapse, reproductive age, surgical intervention.

Patient-reported outcomes and quality of life after pelvic organ prolapse surgery in Indonesia Hakim, Surahman; Hadinata, Valencia; Wiguna, Igor Ian; Tanoto, Kevin; Amelia, Safira; Kadarusman, Adib Kamil Putra
Medical Journal of Indonesia Vol. 35 No. 1 (2026): March
Publisher : Faculty of Medicine Universitas Indonesia

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.13181/mji.oa.258009

BACKGROUND Pelvic organ prolapse (POP) is a common condition in older women that significantly impacts quality of life (QoL). Traditional surgical success measures primarily focus on anatomical outcomes, but patient-reported outcomes provide offer a more comprehensive assessment of symptom relief and overall well-being. This study aimed to evaluate patient-reported outcomes and QoL with the Pelvic Floor Disability Index (PFDI-20) and Pelvic Floor Impact Questionnaire (PFIQ-7) following POP surgery. METHODS This cross-sectional study analyzed secondary data from medical records and patient interviews at Cipto Mangunkusumo Hospital, Jakarta. Patients diagnosed with POP who underwent surgery were followed up at 1, 3, 6, and 12 months postoperatively. PFDI-20 and PFIQ-7 scores were used to assess symptom impact and QoL. RESULTS Among 34 patients, the most common surgical method was total vaginal hysterectomy (79%), followed by colpocleisis (59%), and sacrospinous hysteropexy (6%). Postoperative PFDI-20 scores showed 76% of patients experienced minimal to no impact, while PFIQ-7 scores indicated 91% reported minimal to no impact on their QoL. 2 patients reported moderate impact, particularly in the urinary domain. No patients experienced severe or very severe impairment at any follow-up interval. CONCLUSIONS Incorporating patient-reported outcomes with anatomical assessments provides a more accurate evaluation of surgical success in POP based on PFDI-20 and PFIQ-7 scores. Because POP is a multidimensional condition, assessing surgical outcomes requires a multimodal approach that considers symptom relief and QoL.

From Eyeball to Exact: A Meta-Analysis of an Innovation in Episiotomy with Angle-Guiding Devices Hakim, Surahman; Bimanugraha, Bimanugraha; Hadinata, Valencia; Kadarusman, Adib Kamil Putra; Mardhiyah, Tha’atam
Medica Hospitalia : Journal of Clinical Medicine Vol. 13 No. 2 (2026): Med Hosp
Publisher : RSUP Dr. Kariadi

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.36408/mhjcm.v13i2.1474

BACKGROUND: Episiotomy is a surgical incision performed to enlarge the vaginal outlet during childbirth, but an inaccurate mediolateral angle may increase the risk of obstetric anal sphincter injury (OASIS). SCOPE: This systematic review focused on randomized controlled trials evaluating dedicated angle-guiding devices for mediolateral episiotomy, including Episcissors-60, Episioguide, and the Episiometer. AIMS: To compare guided episiotomy devices with conventional eyeball technique in achieving appropriate episiotomy angles and reducing OASIS. METHOD: A systematic search of PubMed, ScienceDirect, and Wiley was conducted according to PRISMA 2020 principles. Eligible studies included women undergoing vaginal birth in whom a guided device was compared with conventional scissors or routine practice. The primary outcome was post-suture episiotomy angle. Secondary outcomes were OASIS incidence, incision characteristics, pain, practical limitations, and risk of bias. RESULT: Four randomized controlled trials involving 543 participants were included. Guided devices produced higher post-suture episiotomy angles than conventional technique (standardized mean difference 0.88, 95% CI 0.69-1.06; Z = 9.33; P<0.00001), slthough heterogeneity was substantial (I2=97%). Based on the pooled contingency table, OASIS was more frequent in the eyeball group than in guided group (OR 4.85, 95% CI 1.38-17.07; P-=0.0069) CONCLUSION: Angle-guiding devices may improve episiotomy angle accuracy and may reduce OASIS risk, but the evidence remains limited by few trials, sparse OASIS event, indirect comparisons between devices, and substantial heterogeneity.

Smartphone-Based Kegel Exercises for Stress Urinary Incontinence: A Systematic Review and Meta-Analysis of RCT Surahman Hakim; Suskhan Djusad; Adib Kamil Putra Kadarusman; Valencia Hadinata; Safira Amelia; Rizki Fauzi Suskhan; Putri Nadhira Adriansyah
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.10.1.1-15.2026

Introduction : To evaluate the effectiveness of smartphone-based applications in supervising Kegel exercises for women with Stress Urinary Incontinence (SUI), specifically in improving treatment adherence and reducing symptom severity as measured by the ICIQ-UI-SF score. Method : This study compares smartphone-based applications for supervising Kegel exercise in women with SUI. Article retrieved from 3 databases using specific keywords. ICIQ-UI-SF scores and adherence data is the main outcome in this article. Results : Five RCTs with a total of 475 participants were included. Three studies demonstrated improved adherence among intervention groups using smartphone applications. Meta-analysis revealed that application based supervision resulted in significantly better post-treatment ICIQ-UI-SF Score (SMD: -0.46, CI [-0.65,-0.28], p < 0.00001) Conclusion : Smartphone applications as a supervision tool for SUI patients who underwent Kegel exercise as a conservative treatment is proven to reduce severity and increasing adherence of the therapy.

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