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

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Pelvic Floor Muscle Strength Stress Urinary Incontinence: Kekuatan Otot Dasar Panggul dan Stres Inkontinensia Urin Asih Anggraeni; Surahman Hakim; Budi I. Santoso; Tyas Priyatini; Fernandi Moegni
Indonesian Journal of Obstetrics and Gynecology Volume 8 No. 3 July 2020
Publisher : Indonesian Socety of Obstetrics and Gynecology

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.32771/inajog.v8i3.1270

Abstract

Objective: To examine the relationship between muscle strength and muscle thickness of levator ani with stress urinary incontinence (SUI) in women.Methods: This study uses a comparative cross-sectional study design. We collected 82 women who visiting the Obstetrics and Gynecology clinic of RSUPN Dr. Cipto Mangunkusumo with the study group were subjects with positive cough tests while the control group were subjects with negative cough tests. The data obtained in the form of history taking, Questionnaire for Urinary Incontinence Diagnosis (QUID), physical examination (POPQ), cough test. perineometer, and ultrasound.Results: We found no significant difference between the levator ani muscle thickness to the incidence of SUI with the median levator ani muscle thickness 0.63 cm (range 0.31-1.02 and p = 0.897). While levator ani muscle strength against SUI has a median of 19.5 (range 4.6-88.6 and p = 0.001). In multivariate analysis it was found that purely SUI, prolapse and age had no significant effect on the strength of levator ani muscles with a p-value of 0.243; 0.844; 0.903.Conclusions: There is no significant difference in levator ani muscle thickness between women who experience SUI compared to those who do not. Women with SUI have weaker levator ani muscle strength than those who do not experience but are not statistically significant. And there is no correlation between muscle strength and levator ani muscle thickness in women with SUI.Keywords: muscle strength, muscle thickness, perineometer, stress urinary incontinence, ultrasound. Abstrak Tujuan : Untuk mengkaji hubungan antara kekuatan otot dan ketebalan otot levator ani dengan keluhan IU-T pada perempuan.Metode : Penelitian ini menggunakan desain perbandingan potong lintang dengan melibatkan 82 wanita yang berkunjung di poliklinik Obstetri dan Ginekologi RSUPN Dr. Cipto Mangunkusumo dengan kelompok studi adalah subyek dengan tes batuk positif sedangkan kelompok kontrol adalah subyek dengan tes batuk negative. Data yang diperoleh berupa hasil anamnesis, Questionnaire for Urinary Incontinence Diagnosis (QUID), pemeriksaan fisik (POPQ), tes batuk. perineometer , dan USG.Hasil: Hasil penelitian ini didapatkan tidak ada perbedaan bermakna antara ketebalan otot levator ani terhadap kejadian IUT dengan median ketebalan otot levator ani 0,63 cm (jarak 0,31-1,02 dan p=0,897). Sedangkan kekuatan otot levator ani terhadap IUT memiliki median 19,5 (jarak 4,6-88,6 dan p=0,001). Pada analisis multivariat didapatkan bukti bahwa secara murni IUT, prolap dan usia tidak mempunyai pengaruh bermakna terhadap kekuatan otot levator ani dengan nilai p masing-masing 0,243; 0,844; 0,903.Kesimpulan : Tidak terdapat perbedaan yang bermakna pada ketebalan otot levator ani antara perempuan yang mengalami IU-T dibanding yang tidak mengalami. Perempuan IU-T mempunyai kekuatan otot levator ani yang lebih lemah dibanding yang tidak mengalami, namun tidak bermakna secara statistik. Tidak terdapat hubungan korelasi antara kekuatan otot dan ketebalan otot levator ani pada perempuan yang mengalami IU-T. Kata kunci : inkontinensia urin jenis tekanan, ketebalan otot, kekuatan otot, perineometer, USG
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

Abstract

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.
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

Abstract

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.
Urethral Mobility Ultrasound: A Comparable Diagnostic Method for Urethral Hypermobility in Indonesian Women with Stress Urinary Incontinence Hidayah, Gita Nurul; Hidayat, Fery; Angelina, Jessica; Moegni, Fernandi
eJournal Kedokteran Indonesia Vol. 13 No. 3 (2025): Vol. 13 No. 3 - Desember 2025
Publisher : Faculty of Medicine Universitas Indonesia

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.23886/ejki.13.1254.1

Abstract

Urethral hypermobility is the primary mechanism of stress urinary incontinence. In Indonesia, the prevalence of SUI (stress urinary incontinence) is approximately 13% (the other 16% had mixed urinary incontinence). To diagnose urethral hypermobility, the Q-tip test is performed, but it can provoke discomfort. Urethral mobility ultrasonography (UMU) has emerged as a non-invasive, more comfortable alternative, with high accuracy. This study reports the concordance of the evaluations in Indonesian women with SUI, to evaluate the accuracy of UMU compared with the Q-tip test in diagnosing urethral hypermobility among Indonesian women with SUI. A cross-sectional study was conducted at the outpatient clinic of RSUPN Dr Cipto Mangunkusumo and at the Jakarta Urogynecology (JUN) Centre-YPK Mandiri Hospital during the January – December 2024 period. Thirty-six SUI women without symptomatic pelvic organ prolapse (POP) completed the study. Each subject underwent a Q-tip test and ultrasonographic evaluation of urethral mobility. Ultrasonographic assessment of urethral mobility demonstrated high sensitivity (92.6%) but low specificity (33.3%) compared to the Q-tip test. The positive predictive value (PPV) of UMU was 80.6%, while the negative predictive value (NPV) was 60%. The concordance value was 77.8%. 16.67% of patients reported discomfort and pain during the Q-tip test and required medication to manage their symptoms. In those women, the Qtip test was negative but may reflect bias/false negatives, which can affect ultrasound specificity. With 80.6% PPV, 60% NPV, and 77.8% concordance, UMU may serve as a practical alternative to the Q-tip test in daily clinical practice.