Fernandi Moegni
Department Of Obstetrics And Gynecology, Faculty Of Medicine Universitas Indonesia, Cipto Mangunkusumo Hospital, Jakarta

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Comparison of the Levator Hiatal Area Juniarto, Muhammad E; Moegni, Fernandi
Indonesian Journal of Obstetrics and Gynecology Volume 4, No. 4, October 2016
Publisher : Indonesian Socety of Obstetrics and Gynecology

Show Abstract | Download Original | Original Source | Check in Google Scholar | Full PDF (86.867 KB) | DOI: 10.32771/inajog.v4i4.450

Abstract

Objective: To determine the relationship of the levator hiatal area among nulliparous, primiparous, and multiparous women so that we can assess the prevalence of avulsion. Method: A cross-sectional study design was used by evaluating the transperineal ultrasound results of all nulliparous, primiparous, and multiparous women in the Obstetrics and Gynecology Clinic of Dr. Cipto Mangunkusumo hospital from May to December 2015. We analyzed the data through SPSS using one way ANOVA to compare the levator hiatal dimension among the groups of women during Valsava maneuver and at rest. Result: There were significant differences in levator hiatal area among nulliparous, primiparous, and multiparous women during Valsalva maneuver and at rest, which the mean (SD) was 22.26 (5.45) cm2 (p=0.028) and 10.70 (2.26) cm2 (p=0.012), respectively. Levator ani muscle avulsion was occurred in 1 out of 46 (2.2%) women from the primiparous and multiparous group. onclusion: There are significant differences in levator hiatal area during Valsalva and at rest among the groups. [Indones J Obstet Gynecol 2016; 4-4: 208-211] Keywords: avulsion, levator hiatal area, multiparous, nulliparous, primiparous
Prevalence of Lower Urinary Tract Symptoms in Women Based on Bahasa Indonesia Validated ICIQ-FLUTS Long Form Moegni, Fernandi; Retnoningrum, Endah
Indonesian Journal of Obstetrics and Gynecology Volume. 3, no. 2, April 2015
Publisher : Indonesian Socety of Obstetrics and Gynecology

Show Abstract | Download Original | Original Source | Check in Google Scholar | Full PDF (131.512 KB) | DOI: 10.32771/inajog.v3i2.35

Abstract

Objective: To obtain the prevalence of women with lower urinary tract symptoms (LUTS) in Dr. Cipto Mangunkusumo National Hospital, Indonesia. Method: We conducted a descriptive and analytic study with questionnaire- based data collection. All subjects were interviewed using the conventional method and International Consultation on Incontinence Questionnaire (ICIQ) Female LUTS long form validated in Indonesian language in the gynecology outpatient clinic in Dr. Cipto Mangunkusumo Hospital. Result: Using the conventional method, proposing only one question of urinary disturbance without asking the detailed symptoms, a low prevalence of LUTS was obtained (17.3%). On the other hand, with a well-structured questionnaire using ICIQ-FLUTS long form, the prevalence of LUTS was 95.3%. This result revealed that LUTS was a common condition among Indonesian women in the study population with vaginal delivery as the common risk factor. Conclusion: Screening for LUTS using a structured questionnaire identified a significantly higher prevalence of LUTS than the conventional method. The ICIQ-FLUTS long form validated in Indonesian language is a robust questionnaire that can be recommended for use in epidemiological research as well as routine clinical practice. Keywords: ICIQ FLUTS long form, Indonesia, LUTS, prevalence, women
The Degree of Cystocele and Rectocele with Hiatal Area Levator Ani Moegni, Fernandi; Santoso, Hari
Indonesian Journal of Obstetrics and Gynecology Volume. 5, No. 4, October 2017
Publisher : Indonesian Socety of Obstetrics and Gynecology

Show Abstract | Download Original | Original Source | Check in Google Scholar | Full PDF (206.803 KB) | DOI: 10.32771/inajog.v5i4.566

Abstract

Objective: To investigate the degree of cystocele and rectocele with a maximum of levator hiatal area (AHL) during Valsava. Methods: Secondary data analysis of 90 patients with uterine prolapse January 2012 to November 2013 in the clinic Uroginekologi RSCM, Jakarta. 3D/4D ultrasound measurement and pelvic organ prolapse system Quantification (POP-Q) stage I-IV cystocele and rectocelestage I-IV. All statistical analyses were analyzed using Stata 20 for Windows. Results: Significant difference cystocele stage I-II (n = 25) with stage III-IV (n = 65), the maximum AHL with a difference of 4.33 cm2 (p = 0.040). In rectocele stage I-II (n = 64) and stage III-IV (n = 26) of 3.85 cm2 (p = 0.130). AUC values for stage I-II and III-IV cystocele was 0.607 (IK95% from 0.467 to 0.738), and the ROC for rectocele was 0.603 (IK95% from 0.472 to 0.734). The ROC optimal cut point for cystocele stage I-II with III-IV with the highestsensitivity and specificity is 29 cm2 (0.523 sensitivity, specificity 0.520), the rectocele is 30 cm2 (0.538 sensitivity, specificity 0.584). Conclusion: There is a significant relationship between the degree of cystocele and area of the levator ani muscles when Valsava, but there is no relationship at rectocele. The value of maximum area under the curve (AUC) hiatal area of the levatorani muscle in distinguishing stage I-II and III-IV cystocele are relatively similar to rectocele stage I-II and III-IV. Optimal cut point hiatal area of the levatorani muscle in distinguishing stage I-II and III-IV cystoceleis 29 cm2, while for rectocele is 30 cm2 with sensitivity and specificity values were quite good. Keywords: cystocele, levatorani hiatal area, pelvic organ prolapse, rectocele
Comparison of the Levator Hiatal Area Juniarto, Muhammad E; Moegni, Fernandi
Indonesian Journal of Obstetrics and Gynecology Volume 4, No. 4, October 2016
Publisher : Indonesian Socety of Obstetrics and Gynecology

Show Abstract | Download Original | Original Source | Check in Google Scholar | Full PDF (86.867 KB) | DOI: 10.32771/inajog.v4i4.450

Abstract

Objective: To determine the relationship of the levator hiatal area among nulliparous, primiparous, and multiparous women so that we can assess the prevalence of avulsion. Method: A cross-sectional study design was used by evaluating the transperineal ultrasound results of all nulliparous, primiparous, and multiparous women in the Obstetrics and Gynecology Clinic of Dr. Cipto Mangunkusumo hospital from May to December 2015. We analyzed the data through SPSS using one way ANOVA to compare the levator hiatal dimension among the groups of women during Valsava maneuver and at rest. Result: There were significant differences in levator hiatal area among nulliparous, primiparous, and multiparous women during Valsalva maneuver and at rest, which the mean (SD) was 22.26 (5.45) cm2 (p=0.028) and 10.70 (2.26) cm2 (p=0.012), respectively. Levator ani muscle avulsion was occurred in 1 out of 46 (2.2%) women from the primiparous and multiparous group. onclusion: There are significant differences in levator hiatal area during Valsalva and at rest among the groups. [Indones J Obstet Gynecol 2016; 4-4: 208-211] Keywords: avulsion, levator hiatal area, multiparous, nulliparous, primiparous
The Role of Genital Hiatus (Gh), Perineal Body (Pb), Summation (Gh+Pb) of POP-Q Examination in Maximum Levator Hiatal Area of Women with Symptomatic Pelvic Organ Prolapse Kustarto, Kukuh W; Moegni, Fernandi
Indonesian Journal of Obstetrics and Gynecology Volume 7 No. 2 April 2019
Publisher : Indonesian Socety of Obstetrics and Gynecology

Show Abstract | Download Original | Original Source | Check in Google Scholar | Full PDF (135.933 KB) | DOI: 10.32771/inajog.v7i2.540

Abstract

Abstract Objective: to provide data on the correlation of levator hiatus area measurements in symptomatic POP using 3D / 4D Ultrasound with clinical examination of Gh, Pb and summation (Gh+Pb). Methods: Secondary data analysis of 160 POP patients examined from January 2012 to April 2017 at the Urogynecology Clinic RSCM, Jakarta. Taken data on patient characteristics, maximum 3D / 4D Ultrasound measurement of Levator Hiatus Area, and clinical measurement results using pelvic organ prolapse quantification system (POP-Q) Results: There was a positive correlation between clinical examination and measurement of hiatal area area using ultrasound with r = 0.43 for Gh length, and the medium correlation on the sum of Gh and Pb with r = 0,51. No correlation for Pb length with r = 0.23. The optimal cut to differentiate degrees 2 by 3 is 7.5 cm / 29.7 cm2 and degree 3 by 4 is 8.3 cm / 32.1 cm2. Conclusion: Clinical examination by summing the lengths of Gh and Pb may be consider reflects the examination of the hiatal area by using transperineal ultrasound to see the strain on levator ani called “ballooning” in an area with limited resources. Keywords:  genital hiatus, levator hiatus area, pelvic organ prolapse, perineal body.   Abstrak Tujuan: untuk memberikan data mengenai korelasi pengukuran area hiatus levator pada POP simtomatik mengunakan Ultrasonografi 3D/4D dengan pemeriksaan klinis yaitu panjang Gh, panjang Pb dan penjumlahannya. Metode : Analisa data sekunder sebanyak 160 pasien POP yang diperiksa dari Januari 2012 hingga April 2017 di poliklinik Urogynecology RSCM, Jakarta. Diambil data karakteristik pasien, pengukuran Ultrasonografi 3D/4D maksimal Area Hiatal Levator, dan hasil pengukuran secara klinis dengan menggunakan pelvic organ prolapse quantification system (POP-Q) Hasil : Terdapat korelasi positif antara pemeriksaan klinis dengan pengukuran luas area hiatal menggunakan USG dengan r = 0,43 untuk panjang Gh, dan korelasi pada penjumlahan Gh dan Pb dengan r=0,51 termasuk kategori sedang, sedangkan untuk panjang Pb dengan r = 0,23 tidak didapatkan adanya korelasi. Didapatkan titik potong optimal untuk membedakan derajat 2 dengan derajat 3 adalah 7,5 cm / 29,7 cm2 dan derajat 3 dan derajat 4 adalah 8,3 cm / 32,1 cm2 Kesimpulan : Pemeriksaan klinis dengan menjumlahkan panjang Gh dan panjang Pb dapat dipertimbangkan untuk mencerminkan pemeriksaan area hiatal dengan mengunakan USG 3 / 4 dimensi transperineal pada daerah dengan sarana terbatas untuk melihat regangan pada levator ani atau yang disebut sebagai “ballooning Kata kunci : badan perineum, genital hiatus, hiatal levator ani, prolaps organ panggul.
Comparison of Postpartum Urinary Retention Healing between Groups with Methods of Residual Urine Measurement Four Hours versus Six Hours Post-Delivery Moegni, Fernandi; Hani, Ummu
Indonesian Journal of Obstetrics and Gynecology Volume 7, No. 1 January 2019
Publisher : Indonesian Socety of Obstetrics and Gynecology

Show Abstract | Download Original | Original Source | Check in Google Scholar | Full PDF (58.306 KB) | DOI: 10.32771/inajog.v7i1.838

Abstract

Abstract Objective: To know the difference of recovery time and the urinary residual volume between group of patient with different time of  urinary residual collecting. Method: A randomized controlled trial was held at Dr. Cipto Mangunkusumo central general hospital and central Karawang hospital between March and Desember 2017. Postpartum women with urinary retention risks, willing to contribute to the trial, and diagnosed as post partum urinary retention were divided into 2 groups. Urinary residual volume was measured in 4th hour and 6th hour in each group. Patient then treated according to RSCM guideline, and the time of recovery was documented. Result: Both group have similar characteristic. The median length of recovery in the group which the urinary residual was measured in 4th hour was 30 hours, 21 hours shorter than 6th hour group, 51 hours (p< 0.001). The median of urinary residual volume of the 4th hour group was 600 ml, 400 ml lesser than the 6th hour group, 1000 ml (p< 0.001) Conclussion: time of recovery are shorter in the 4th  hour group and the urinary residual volume are less in the 4th hour group compared to the 6th hour group. Keywords: post partum urinary retention, urine residual, urinary residual collecting time   Abstrak Tujuan: untuk mengetahui lama pemulihan dan volume residu urin pada kelompok pasien dengan retensio urin pascapersalinan dengan beda waktu pengukuran, Metode: Penelitian ini menggunakan desai uji klinis acak di RSUPN Dr. Cipto Mangunkusumo dan RSUD Karawang bulan Maret-Desember 2017. Perermpuan pascasalin dengan risiko retensio urin pasca persalinan, bersedia mengikuti penelitian, dan terdiagnosis retensio urin dibagi menjadi dua kelompok. Kelompok pertama diukur residu urinnya dalam 4 jam, kelompok kedua dalam 6 jam. Pasien lalu diberikan tatalaksana retensio urin sesuai protokol RSUPNCM dan dicatat waktu pulihnya. Hasil: Karakteristik pasien pada kedua kelompok dianggap setara. Median lama pemulihan pasien retensio urin yang diukur residu urin 4 jam adalah 30 jam, berbeda 21 jam dengan pasien yang diukur resiudnya 6 jam, yaitu 51 jam (p<0.001).  Median jumlah  residu urin pada kelompok pengukuran residu urin 4 jam adalah 600 ml, berbeda 400 ml dengan kelompok pengukuran 6 jam, yaitu 1.000 ml (p<0.001). Kesimpulan: Lama pemulihan lebih singkat pada kelompok pasien dengan waktu pengukuran residu urin 4 jam dibandingkan dengan 6 jam. Jumlah residu urin lebih sedikit pada pengukuran residu 4 jam dibanding 6 jam Kata kunci: retensio urin pasca persalinan, residu urin, waktu pengukuran residu urin
Benign Tumor in Labia Minora Putra, Hadrians Kesuma; Anggraeni, Asih; rinaldi, andi; moegni, fernandi
Sriwijaya Journal of Medicine Vol. 1 No. 2 (2018): Sriwijaya Journal of Medicine
Publisher : Fakultas Kedokteran Universitas Sriwijaya

Show Abstract | Download Original | Original Source | Check in Google Scholar | Full PDF (181.897 KB)

Abstract

Vulva tumors are generally a rare disease encountered in gynecological clinical practice, especially at a young age. Vulvar tumors, more common in the labia major and rarely in the labia minor, clitoris, vestibulum, and posterior comicura. The most common vulvar benign tumors are fibroma, papilloma, lipoma, angioma, and others. A 39-year-old woman, at RSCM Urogynecology Jakarta clinic with chief complain mass or swelling in right labia minor. Size of mass increases in period of one year. Mass began to grow at 8 months of pregnancy. By 2014, patients have same mass in the right and left labia minor, and tumor excision has been performed. Conclusions of the specimens sent for pathological assessment are fibroepithelial papillomas. Gynecological and palpation examinations show 2 solid papilloma masses, in right labia minor, 8x4x2 cm and 3x2x2cm, painless, and firmly defined. In mons pubis area, skin looks coarse, thickened, hyperkeratotic. Speculum examination showed no abnormality. Patient diagnosed as a recurrent minor armored labia tumor. On December 5, 2017 an excision and reconstruction operation was conducted. Obtained pathological exam on December 20, 2017 with results stromal fibroepithelial polyps. Among all tumors in the vulva, tumors in labia minor appear less frequently. Biopsy should be performed for histologic examination to exclude malignant allegations. Furthermore, because of the location and size of the tumor, it can cause severe interference symptoms in the patient and therefore early diagnosis and treatment is essential.
Comparison of the Levator Hiatal Area Muhammad E Juniarto; Fernandi Moegni
Indonesian Journal of Obstetrics and Gynecology Volume 4, No. 4, October 2016
Publisher : Indonesian Socety of Obstetrics and Gynecology

Show Abstract | Download Original | Original Source | Check in Google Scholar | Full PDF (86.867 KB) | DOI: 10.32771/inajog.v4i4.450

Abstract

Objective: To determine the relationship of the levator hiatal area among nulliparous, primiparous, and multiparous women so that we can assess the prevalence of avulsion. Method: A cross-sectional study design was used by evaluating the transperineal ultrasound results of all nulliparous, primiparous, and multiparous women in the Obstetrics and Gynecology Clinic of Dr. Cipto Mangunkusumo hospital from May to December 2015. We analyzed the data through SPSS using one way ANOVA to compare the levator hiatal dimension among the groups of women during Valsava maneuver and at rest. Result: There were significant differences in levator hiatal area among nulliparous, primiparous, and multiparous women during Valsalva maneuver and at rest, which the mean (SD) was 22.26 (5.45) cm2 (p=0.028) and 10.70 (2.26) cm2 (p=0.012), respectively. Levator ani muscle avulsion was occurred in 1 out of 46 (2.2%) women from the primiparous and multiparous group. onclusion: There are significant differences in levator hiatal area during Valsalva and at rest among the groups. [Indones J Obstet Gynecol 2016; 4-4: 208-211] Keywords: avulsion, levator hiatal area, multiparous, nulliparous, primiparous
The Degree of Cystocele and Rectocele with Hiatal Area Levator Ani: Derajat Cystocele dan Rectocele dengan Hiatal Area Levator Ani Fernandi Moegni; Hari Santoso
Indonesian Journal of Obstetrics and Gynecology Volume. 5, No. 4, October 2017
Publisher : Indonesian Socety of Obstetrics and Gynecology

Show Abstract | Download Original | Original Source | Check in Google Scholar | Full PDF (206.803 KB) | DOI: 10.32771/inajog.v5i4.566

Abstract

Objective: To investigate the degree of cystocele and rectocele with a maximum of levator hiatal area (AHL) during Valsava. Methods: Secondary data analysis of 90 patients with uterine prolapse January 2012 to November 2013 in the clinic Uroginekologi RSCM, Jakarta. 3D/4D ultrasound measurement and pelvic organ prolapse system Quantification (POP-Q) stage I-IV cystocele and rectocelestage I-IV. All statistical analyses were analyzed using Stata 20 for Windows. Results: Significant difference cystocele stage I-II (n = 25) with stage III-IV (n = 65), the maximum AHL with a difference of 4.33 cm2 (p = 0.040). In rectocele stage I-II (n = 64) and stage III-IV (n = 26) of 3.85 cm2 (p = 0.130). AUC values for stage I-II and III-IV cystocele was 0.607 (IK95% from 0.467 to 0.738), and the ROC for rectocele was 0.603 (IK95% from 0.472 to 0.734). The ROC optimal cut point for cystocele stage I-II with III-IV with the highestsensitivity and specificity is 29 cm2 (0.523 sensitivity, specificity 0.520), the rectocele is 30 cm2 (0.538 sensitivity, specificity 0.584). Conclusion: There is a significant relationship between the degree of cystocele and area of the levator ani muscles when Valsava, but there is no relationship at rectocele. The value of maximum area under the curve (AUC) hiatal area of the levatorani muscle in distinguishing stage I-II and III-IV cystocele are relatively similar to rectocele stage I-II and III-IV. Optimal cut point hiatal area of the levatorani muscle in distinguishing stage I-II and III-IV cystoceleis 29 cm2, while for rectocele is 30 cm2 with sensitivity and specificity values were quite good. Keywords: cystocele, levatorani hiatal area, pelvic organ prolapse, rectocele
A Preliminary Study: The Effectiveness of CO2 Laser Therapy for Stress Urinary Incontinence: Sebuah Studi Awal: Efektivitas Terapi Laser CO2 sebagai Terapi Inkontinensia Urin Tipe Tekanan Fernandi Moegni; Nadir Chan; Budi I. Santoso; Raymond Surya; Leonardo Tanamas
Indonesian Journal of Obstetrics and Gynecology Volume 8 No. 4 October 2020
Publisher : Indonesian Socety of Obstetrics and Gynecology

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.32771/inajog.v8i4.763

Abstract

Objective: To evaluate the role of fractioned CO2 laser intravaginal as a non-invasive treatment for relieving stress urinary incontinence (SUI) symptoms.Methods: This was a prospective, quasi-experimental study in patients with SUI. The patients were treated through three different sessions in a month apart by the fractioned CO2 laser Femilift©, produced by Alma Lasers. The patients fi lled and completed questionnaires about continence assessment, quality of life, and sexuality before and after therapy based on PISQ-12 and ICIQ-UI questionnaire. Perineometry was performed to prove the outcome.Results: Twenty women were enrolled. At 4 weeks following the third treatment, there was a signifi cant improvement for continence assessment (7.70 ± 4.38 to 4.50 ± 2.88; p < 0.001), quality of life and sexuality (28.13 ± 7.06 to 33.13 ±7.80; p < 0.001), and vaginal perineometer results (37.20 ± 17.24 to 48.80 ± 16.72; p = 0.009).Conclusions: Fractioned CO2 intravaginal laser has a role in improving SUI symptoms.Keywords: fractioned CO2 laser, stress urinary incontinence, vaginal rejuvenation. AbstrakTujuan: Untuk mengetahui efektivitas terapi laser CO2 terfraksi intravaginal sebagai terapi non-invasif untuk mengurangi gejala inkontinensia urine (IU) tipe tekanan.Metode: Penelitian ini merupakan studi prospektif, quasieksperimental pada pasien dengan inkontinensia urin (IU) tipe tekanan yang mengikuti terapi laser CO2 terfraksi intravaginal tiga sesi berbeda, dengan jarak satu bulan menggunakan laser CO2 terfraksi Femilift© dari Alma Lasers. Subjek mengisi kuesioner mengenai penilaian kontinensia, kualitas hidup dan kehidupan seksual sebelum dan sesudah terapi (kuesioner PISQ-12 dan ICIQ-UI). Selain kuesioner, pemeriksaan perineometri juga dilakukan pada beberapa subjek penelitian untuk membuktikan efektivitas terapi.Hasil: Dua puluh subjek ikut dalam penelitian ini. Penilaian pada minggu keempat setelah sesi terapi ketiga, menunjukkan peningkatan yang signifi kan pada penilaian kontinensia (7.70 ± 4.38 ke 4.50 ± 2.88; p < 0.001), pada kualitas hidup dan kehidupan seksual (28.13 ± 7.06 ke 33.13 ±7.80; p < 0.001), dan pada hasil perineometri (37.20 ± 17.24 ke 48.80 ± 16.72; p = 0.009).Kesimpulan: Terapi laser CO2 terfraksi intravaginal menunjukkan kecenderungan untuk mengurangi gejalainkontinensia urine (IU) tipe tekanan.Kata kunci: inkontinensia urin tipe tekanan, terapi laser CO2 terfraksi intravaginal, vaginal rejuvenation.