Andi Rinaldi
Departemen Obstetri Dan Ginekologi, Fakultas Kedokteran, Universitas Padjadjaran/ RSUP Dr. Hasan Sadikin Bandung

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Journal : Indonesian Journal of Obstetrics

Perbandingan Nilai Female Sexual Function Index pada Wanita Primipara Berdasarkan Metode Persalinan Rena Nurita; Andi Rinaldi; Wiryawan Permadi
Indonesian Journal of Obstetrics & Gynecology Science Volume 4 Nomor 2 September 2021
Publisher : Dep/SMF Obstetri & Ginekologi Fakultas Kedokteran Universitas Padjadjaran

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.24198/obgynia/v4n2.257

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Tujuan: Untuk membandingkan fungsi seksual pada wanita primipara dengan metode persalinan pervaginam dan seksio sesarea.  Metode: Penelitian ini adalah penelitian observasional analitik secara cross-sectional. Penelitian ini dilakukan selama tujuh bulan di RS Hasan Sadikin dan Rumah Sakit Khusus Ibu dan Anak Kota Bandung, dimulai pada September 2019 sampai Mei 2020. kriteria inklusi primipara, berusia 18-35 tahun, 3-6 bulan postpartum sebelum pengambilan data, aktif secara seksual dalam 6 bulan setelah persalinan dan melakukan hubungan seksual dalam empat minggu terakhir. Fungsi seksual dinilai dengan Female Sexual Function Index (FSFI).Hasil: Subjek penelitian ini terdiri dari 98 subjek dengan dibagi menjadi dua kelompok, yakni persalinan pervaginam (n=56) dan seksio sesarea (n=42). Subjek penelitian mengisi kuesioner FSFI versi Bahasa Indonesia. Dari 98 subjek, disfungsi seksual didapatkan 95% pada wanita dengan persalinan pervaginam dan 90% dengan seksio sesareaKesimpulan: Tidak terdapat perbedaan yang signifikan antara persalinan pervaginam dan seksio sesarea terhadap disfungsi seksual. The Comparison of Female Sexual Function Index Score in Primiparous Women According to Delivery MethodsAbstractObjective: to compare the sexual function of primiparous woman with spontaneous delivery and cesarean section.Method:  This research is an analytic observational study with cross-sectional method. This study is a 7 months study at Dr. Hasan Sadikin Central General Hospital and Rumah Sakit Khusus Ibu dan Anak Kota Bandung, started from September 2019 to May 2020. The inclusion criteria were primiparous, aged 18-35 year-old, 3-6 months postpartum before data collection, sexually active within 6 months after delivery and had sexual intercourse in the last four week. Sexual function was assessed by the Female Sexual Function Index (FSFI).Result: We obtained 98 subjects and divided them into two groups, spontaneous delivery (n = 56) and cesarean section (n = 42). Subject then filled out the Indonesian version of the FSFI questionnaire. From 98 subjects, sexual dysfunction was found in 95% subject with spontaneous delivery and 90% with cesarean section.Discussion: Using comparative chi square test (p = 0.43), there is no significant difference between each method of delivery on sexual dysfunction. Interestingly sexual dysfunction found in tremendous percentage compared to previous studies, either in spontaneous delivery (95%) or cesarean section (90%).Key word:cesarean section, Female Sexual Function Index, primiparous, sexual function, spontaneous delivery
Effect of Methotrexate on Anti-Mullerian Hormone Levels, β-hCG and Tumor Size in Women with Low-Risk Gestational Trophoblast Disease Madjid, Tita Husnitawati; Masitoh, Imas; Harsono, Ali Budi; Purwara, Benny Hasan; Rinaldi, Andi; Mose, Johannes Cornelius; Sunardi, Sunardi
Indonesian Journal of Obstetrics & Gynecology Science Volume 7 Nomor 1 Maret 2024
Publisher : Dep/SMF Obstetri & Ginekologi Fakultas Kedokteran Universitas Padjadjaran

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.24198/obgynia.v7i1.610

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Introduction: This study aimed to evaluate the effect of methotrexate (MTX) chemotherapy on anti-mullerian hormone (AMH) levels, human chorionic gonadotropin (HCG) levels, and tumor size in women with gestational trophoblastic disease (GTD). Method: This study was conducted at Hasan Sadikin General Hospital, Bandung, West Java, from April to October 2020. The AMH level, beta human chorionic gonadotropin (ß-hCG) and tumor size in women with a low risk of GTD prior to and after MTX chemotherapy treatment were measured and compared.Results: Our study found a reduction in mean AMH level to 0.82 ng/ml after the MTX chemotherapy. The mean AMH level after chemotherapy in women with low-risk GTD decreased to 0.82 ng / ml. In addition, ß-hCG level decreased after chemotherapy with MTX. There was a negative relationship between ß-hCG level and tumor size before and after chemotherapy. Higher ß-hCG levels and tumor size before chemotherapy resulted in a further increase in AMH after chemotherapy.Discussion: There was a decrease in AMH and ß-hCG levels after three cycles of MTX chemotherapy in women with low-risk GTD. Tumor size and ß-hCG correlated with post-chemotherapy AMH results.Pengaruh Metotreksat terhadap Kadar Hormon Anti Mullerian, β-hCG dan Ukuran Tumor pada Wanita dengan Penyakit Trofoblas Gestasional Risiko RendahAbstrakPendahuluan: Penelitian ini mengevaluasi efek kemoterapi metotreksat (MTX) terhadap kadar hormon anti-mullerian (AMH), kadar human chorionic gonadotropin (HCG), dan ukuran tumor pada wanita yang didiagnosis penyakit trofoblas gestasional (GTD) risiko rendah.Metode: Penelitian ini dilakukan di Rumah Sakit Umum Pusat Hasan Sadikin, Bandung, Jawa Barat, dari bulan April hingga Oktober 2020. Kadar AMH, beta human chorionic gonadotropin (ß-hCG), dan ukuran tumor pada wanita dengan GTD risiko rendah sebelum dan sesudah pengobatan kemoterapi MTX diukur dan dibandingkan.Hasil: Pada penelitian kami menemukan penurunan kadar AMH rata-rata menjadi 0,82 ng/ml setelah kemoterapi MTX. Rata-rata kadar AMH setelah kemoterapi pada wanita dengan GTD risiko rendah menurun menjadi 0,82 ng/ml. Selain itu, kadar ß-hCG juga menurun setelah kemoterapi dengan MTX. Terdapat hubungan negatif antara kadar ß-hCG dan ukuran tumor sebelum kemoterapi dan AMH setelah kemoterapi. Kadar ß-hCG yang lebih tinggi dan ukuran tumor sebelum kemoterapi menunjukkan peningkatan lebih tinggi pada AMH setelah kemoterapi.Kesimpulan: Terjadi penurunan kadar AMH dan ß-hCG setelah tiga siklus kemoterapi MTX pada wanita dengan GTD risiko rendah. Ukuran tumor dan kadar ß-hCG berkorelasi dengan hasil kadar AMH setelah kemoterapi.Kata kunci: Kemoterapi, Metotreksat, Hormon anti-mullerian, ß-hCG, Tumor trofoblas gestasional
Analisis Pergerakan Leher Kandung Kemih, Ukuran Genital Hiatus, Titik Aa dan Ba pada POP-Q dengan Retensio Urin pada Pasien Pasca-Perbaikan Prolaps Organ Panggul Ma'soem, Aria Prasetya; Sasotya, R.M Sonny; Achmad, Eppy Darmadi; Armawan, Edwin; Sukarsa, Rizkar Arev; Rinaldi, Andi
Indonesian Journal of Obstetrics & Gynecology Science Volume 7 Nomor 1 Maret 2024
Publisher : Dep/SMF Obstetri & Ginekologi Fakultas Kedokteran Universitas Padjadjaran

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.24198/obgynia.v7i1.607

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Pendahuluan:Retensio urin pasca-operasi merupakan kejadian yang sering terjadi setelah operasi perbaikan prolaps organ panggul (POP), dengan angka kejadian berkisar antara 2,5 – 24%. Parameter yang digunakan untuk mengevaluasi pergerakan kandung kemih dan gangguan berkemih yaitu penurunan leher kandung kemih, sudut retrovesika, dan rotasi uretra. Tujuan untuk mengetahui hubungan antara profil leher kandung kemih, ukuran genital hiatus, dan titik Aa dan Ba pada POP-Q terhadap retensio urin pasca-perbaikan prolaps organ panggul.Metode: Penelitian observasional analitik ini menggunakan pendekatan rancangan potong lintang pada wanita yang menjalani operasi POP di RSUP Dr. Hasan Sadikin Bandung pada bulan Juni–November 2023.Hasil: Penurunan leher kandung kemih, sudut retrovesika, rotasi uretra, dan ukuran genital hiatus diukur dengan ultrasonografi. Titik Aa dan Ba diukur dengan skoring POP-Q, kemudian dilakukan pengukuran post-void residual volume. Ditemukan rata-rata usia pasien adalah 60±9 tahun. Sebagian besar subjek penelitian merupakan POP stadium III.Kesimpulan:Tidak terdapat perbedaan bermakna antara karakteristik subjek penelitian (p>0,05). Tidak terdapat perbedaan bermakna antara parameter leher kandung kemih, sudut retrovesika, rotasional uretra, ukuran urogenital hiatus, skor POP-Q titik Aa dan Ba terhadap volume PVR (p>0,05). Titik Ba pada POP-Q berkorelasi signifikan terhadap volume PVR pasca-perbaikan prolaps organ panggul.Analysis of Bladder Neck Movement Profile, Genital Hiatus Size, Points Aa and Ba on POP-Q with Urinary Retention in Post Pelvic Organ Prolapse Repair PatientsAbstract Introduction: Postoperative urinary retention is a common following surgical repair of pelvic organ prolapse (POP), with the incidence ranges between 2.5–24%. This study aimed to determine the relationship between bladder neck profile, genital hiatus, and Aa and Ba points in POP-Q on the incidence of urinary retention after repair of pelvic organ prolapse. Method: This analytical observational study was done with a cross-section design and included women underwent repair of pelvic organ prolapse at RSUP Dr. Hasan Sadikin Bandung in June–November 2023. Results: Bladder neck descent, retrovesical angle, urethral rotation, and genital hiatus were measured by ultrasonography. Points Aa and Ba were measured using POP-Q scoring, then post-void residual volume was measured. The patients had a mean age of 60±9 years. Most of the subjects were stage III POP. Conclusion: There were no significant differences between bladder neck descent, retrovesical angle, urethral rotation, urogenital hiatus, POP-Q scores points Aa and Ba and PVR volume (p>0.05). Point Ba on POP-Q was significantly correlated with PVR volume after pelvic organ prolapse repair.Key words: pelvic organ prolapse, post-void residual volume, urinary retention, rectovesical angle, urogenital hiatus
Characteristics of Endometrioma Recurrence Patients Maharani, Chintia Dewi; Bayuaji, Hartanto; Syam, Hanom Husni; Ritonga, Mulyanusa Amarullah; Mantilidewi, Kemala Isnainiasih; Rinaldi, Andi; Pratiwi, Yuni Susanti
Indonesian Journal of Obstetrics & Gynecology Science Volume 6 Nomor 3 November 2023
Publisher : Dep/SMF Obstetri & Ginekologi Fakultas Kedokteran Universitas Padjadjaran

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.24198/obgynia.v6i3.576

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Objective: To identify the characteristics of endometrioma recurrence cases. Method: This study was a descriptive retrospective, using secondary data taken from all medical records of Clinic Aster and Medical Records Installation in Dr. Hasan Sadikin General Hospital, Bandung, from 1st January 2018 – 31st December 2022. Data were presented in tables.Results: Of the 37 endometrioma recurrences, most of the patients are 20 to 35 in age. None of them has a parity history after the first surgical procedure. Both previous and recent cases are dominantly unilateral endometriomas. The history of postoperative medication is higher (54,1%). Obstetricians/Gynecologists appear to perform the most surgical procedure (67,6%). Mass is the main clinical manifestation of the recurrence. While menstrual and BMI profiles appear to be normal.Conclusions: The characteristic of the recurrence of endometrioma is related parity status after the first surgery, history of the previous medical treatment, and previous form of endometrioma are related to the current characteristic of endometrioma (age, lesion form, clinical manifestation, and recurrence interval).Karakteristik Pasien Endometrioma RekurenAbstrakTujuan: Mengetahui karakteristik dari pasien endometrioma rekuren.Metode: Penelitian ini merupakan penelitian deskripsi retrospektif dengan menggunakan data sekunder yang diambil dari seluruh rekam medis pasien kista endometriosis rekuren di Klinik Aster dan Instalasi Rekam Medis di Rumah Sakit Umum Pusat Dr. Hasan Sadikin Bandung dengan periode 1 Januari 2018 – 31 Desember 2022. Kemudian, data-data disajikan dalam bentuk tabel.                                                                                . Hasil: Dari 37 kasus e ndometrioma rekuren, sebagian besar pasien berusia 20 hingga 35 tahun. Seluruh pasien tidak mempunyai riwayat paritas setelah prosedur pembedahan sebelumnya. Baik kasus-kasus kista endometriosis sebelumnya maupun yang kambuh, keduanya dominan dalam bentuk unilateral. Riwayat pengobatan pasca operasi lebih tinggi (54,1%). Dokter Spesialis Obstetri/Ginekologi tampak melakukan tindakan pembedahan terbanyak (67,6%). Massa adalah manifestasi klinis utama dari kekambuhan. Selain itu, profil menstruasi dan BMI tampak normal.Kesimpulan: Karakteristik pada endometrioma rekuren berkaitan dengan status paritas setelah operasi pertama, riwayat pengobatan medis sebelumnya, dan bentuk endometrioma sebelumnya berhubungan dengan karakteristik endometrioma saat ini (usia, bentuk lesi, manifestasi klinis, dan rentang rekurensi)Kata kunci: karakteristik, rekuren, endometrioma
Diagnostic Approach to Vaginismus and How to Differentiate it from Dyspareunia Farhanah, Aninda Yasmin; Sukarsa, Mochamad Rizkar Arev; Armawan, Edwin; Achmad, Eppy Darmadi; Sasotya, R. M Sonny; Rinaldi, Andi; Ma’soem, Aria Prasetya; Praharsini, Raden Kania; Imantika, Efriyan; Nurtanio, Setiawan; Arwan, Berriandi
Indonesian Journal of Obstetrics & Gynecology Science Volume 8 Nomor 1 Maret 2025
Publisher : Dep/SMF Obstetri & Ginekologi Fakultas Kedokteran Universitas Padjadjaran

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.24198/obgynia.v8i1.689

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Introduction:Vaginismus is a recurrent or persistent spasm of the muscles of the outer third of the vagina that interferes with coitus. The diagnosis of vaginismus is challenging since it requires the exclusion of possible organic comorbidities. Vaginismus needs to be differentiated from dyspareunia. This article comprehensively discusses the approach to diagnosis and management of vaginismus and highlights its differences from dyspareunia.Methods: A literature search was conducted in PubMed®, ScienceDirect, and Google Scholar databases on February 7–8, 2024, using Boolean combinations of the specified keywords. No specific timeframe was used. Editorials, commentaries, and articles other than written in English and Indonesian were excluded.Results: The review found that vaginismus is characterized by involuntary pelvic floor muscle contractions and significant anxiety towards penetration, which is diagnosed mainly through patient history and physical examination. In contrast, dyspareunia encompasses a wider range of pain, which may be superficial or deep and can result from various physiological or psychological factors. Differentiating between the two conditions requires a detailed clinical interview, physical examination, and possibly additional tests to identify the specific cause.Conclusion: Treatment for vaginismus focuses on reducing fear and pelvic muscle spasms, while dyspareunia focuses on addressing the underlying cause and pain management.Pendekatan Diagnosis pada Vaginismus dan Cara Membedakannya dengan DispareuniaAbstrakPendahuluan: Vaginismus adalah spasme otot-otot sepertiga bagian luar vagina yang berulang atau terus-menerus dan mengganggu koitus. Diagnosis vaginismus menantang dan memerlukan eksklusi kemungkinan komorbiditas organik. Vaginismus perlu dibedakan dengan dispareunia. Artikel ini membahas pendekatan diagnosis dan penatalaksanaan vaginismus secara komprehensif dan menyoroti perbedaannya dengan dispareunia.Metode: Pencarian literatur dilakukan di basis data PubMed®, ScienceDirect, dan Google Scholar pada tanggal 7 – 8 Februari 2024 dengan menggunakan kombinasi Boolean dari kata kunci yang ditentukan. Tidak ada jangka waktu tertentu yang digunakan dalam pencarian artikel untuk tinjauan literatur ini. Editorial, komentar, dan artikel yang tidak berbahasa Inggris dan Indonesia tidak disertakan.Hasil: Tinjauan menunjukkan bahwa vaginismus ditandai oleh kontraksi involunter otot dasar panggul serta kecemasan signifikan terhadap penetrasi. Diagnosis utama didasarkan pada riwayat pasien dan pemeriksaan fisik. Sebaliknya, dispareunia mencakup spektrum nyeri, baik superfisial maupun dalam, yang dapat dipicu oleh berbagai faktor fisiologis atau psikologis. Untuk membedakan kedua kondisi tersebut, diperlukan wawancara klinis yang mendetail, pemeriksaan fisik, dan tes tambahan guna mengidentifikasi penyebab spesifik.Kesimpulan: Terapi untuk vaginismus berfokus pada pengurangan rasa takut dan spasme otot panggul, sedangkan dispareunia berfokus pada penanganan penyebab yang mendasari dan manajemen nyeri.Kata kunci: Diagnosis, dyspareunia, tatalaksana, vaginismus
Sexual Function in Cervical Cancer Patients Based on Female Sexual Function Index Questionnaire at Dr. Hasan Sadikin Central General Hospital From 2018 – 2023 Zakaria, Bangbang Ahmad Kholila Muhyiddin Abadi; Rinaldi, Andi; Zulvayanti, Zulvayanti
Indonesian Journal of Obstetrics & Gynecology Science Volume 8 Nomor 2 July 2025
Publisher : Dep/SMF Obstetri & Ginekologi Fakultas Kedokteran Universitas Padjadjaran

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.24198/obgynia.v8i2.899

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Objective: To describe the sexual function of cervical cancer patients undergoing radiation therapy at RSHS using the Female Sexual Function Index (FSFI) questionnaire.Methods: This cross-sectional study involved cervical cancer patients who received radiation therapy at RSHS between January 2018 and December 2023. Data were collected using the FSFI questionnaire and were analyzed descriptively.Results: Among 100 patients aged 15 to 70 years, the participants experienced overlapping symptoms. The most frequently reported dysfunctions were vaginal dryness (90.63%), orgasm disorders (79.17%), dyspareunia (64.58%), and decreased libido (58%). Comorbidities included hypertension, diabetes mellitus, and urinary tract infections.Conclusion: Most cervical cancer patients receiving radiation therapy experience sexual dysfunction, as identified using the FSFI questionnaire. Limited clinical discussion, psychosocial stress, and socioeconomic constraints contribute to this issue. Integrating sexual health assessment and support into survivorship care is essential to improving overall patient well-being.Fungsi Seksual pada Pasien Kanker Serviks Berdasarkan Kuesioner Female Sexual Function Index di Rumah Sakit Umum Pusat Dr. Hasan Sadikin Bandung Tahun 2018 – 2023Abstrak Tujuan: Penelitian ini bertujuan untuk mengetahui gambaran fungsi seksual pasien kanker serviks yang menjalani terapi radiasi di RSHS menggunakan kuesioner Female Sexual Function Index (FSFI).Metode: Penelitian ini menggunakan metode potong lintang dan dilakukan pada pasien kanker serviks yang sedang menjalani terapi radiasi di RSHS antara Januari 2018 hingga Desember 2023. Data dikumpulkan menggunakan kuesioner FSFI dan dianalisis secara deskriptif.Hasil: Dari 100 pasien berusia 15 – 70 tahun, para pasien mengalami gejala yang saling tumpang tindih. Disfungsi seksual yang paling sering dilaporkan adalah vagina kering (90,63%), gangguan orgasme (79,17%), dispareunia (64,58%), dan penurunan libido (58%). Komorbiditas yang ditemukan meliputi hipertensi, diabetes melitus, dan infeksi saluran kemih.Kesimpulan: Sebagian besar pasien kanker serviks yang menjalani terapi radiasi mengalami disfungsi seksual, sebagaimana diidentifikasi melalui kuesioner FSFI. Kurangnya diskusi klinis, stres psikososial, dan keterbatasan sosial ekonomi turut berkontribusi terhadap masalah ini. Integrasi penilaian dan dukungan kesehatan seksual dalam perawatan pascaterapi sangat penting untuk meningkatkan kesejahteraan pasien secara menyeluruh.Kata kunci: fungsi seksual; kanker serviks; komplikasi radioterapi
Colorectal Anal Distress Inventory 8 (CRADI-8) Scores in PFDI-20 In Women With OASIS Before and After Repair Mulyana, Rifqi Rahman; Sukarsa, M. Rizkar Arev; Rinaldi, Andi
Indonesian Journal of Obstetrics & Gynecology Science Volume 8 Nomor 2 July 2025
Publisher : Dep/SMF Obstetri & Ginekologi Fakultas Kedokteran Universitas Padjadjaran

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.24198/obgynia.v8i2.780

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Objectives: This research aims to assess and compare CRADI-8 scores in women with grade 3-4 OASIS before and after surgical repair. Methods: This cross-sectional study analyzed 37 OASIS patients at Hasan Sadikin Hospital, Bandung (January 2021-December 2023). CRADI-8 scores were measured pre- and post-surgery, with scores categorized by grade (0-4). The McNemar test was used for statistical analysis (p
The Success Rate for Diagnosing Congenital Anomalies During Prenatal Firmansyah, Silva Elifa; Pribadi, Adhi; Pramatirta, Akhmad Yogi; Rachmawati, Anita; Rinaldi, Andi
Indonesian Journal of Obstetrics & Gynecology Science Volume 7 Nomor 3 November 2024
Publisher : Dep/SMF Obstetri & Ginekologi Fakultas Kedokteran Universitas Padjadjaran

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.24198/obgynia.v7i3.722

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Introduction: This study aimed to determine the success of prenatal diagnosis in cases of congenital abnormalities at RSHS Bandung.Methods: This study was descriptive and cross-sectional. We collected data from all neonatal patients with congenital abnormalities who received prenatal care at RSHS Bandung between January 1, 2021, and December 31, 2023. Data processing used Microsoft Excel 16.66.1 and IBM SPSS Statistics.Result: The results show that 59 patients, or 93.6%, had appropriate abnormalities diagnosed, while only 4 patients, or 6.3%, had inappropriate abnormalities.Conclusion: Prenatal diagnosis of congenital abnormalities showed a fairly high concordance value, namely 93.6%.Tingkat Keberhasilan Penegakan Diagnosis Kelainan Kongenital pada saat PrenatalAbstrakTujuan: Tujuan penelitian ini untuk mengetahui keberhasilan diagnosis prenatal pada kasus kelainan kongenital di RSHS Bandung.Metode: Penelitian ini bersifat deskriptif cross-sectional. Data diperoleh dari seluruh pasien neonatal yang disertai kelainan kongenital pada saat prenatal di RSHS Bandung 1 Januari 2021 – 31 Desember 2023. Pengolahan data menggunakan Microsoft Excel 16.66.1 dan IBM SPSS Statistics.Hasil: Hasil yang didapatkan yaitu akurasi pasien terdiagnosis sesuai ada kelainan sebanyak 59 atau sebesar 93.6% dan terdiagnosis tidak sesuai ada kelainan sebanyak 4 atau sebesar 6.3%. Kesimpulan: Penegakan diagnosis kelainan kongenital pada saat prenatal menunjukkan nilai kesesuaian yang cukup tinggi, yaitu sebesar 93,6%.Kata kunci: Prenatal, kelanan kongenital,
Amniotic Membrane Graft and Hysteroscopic Adhesiolysis as Treatment for Asherman Syndrome Case Rusly, Dewi Karlina; Ritonga, Mulyanusa Amarullah; Rachmawati, Anita; Rinaldi, Andi; Djuwantono, Tono
Indonesian Journal of Obstetrics & Gynecology Science Volume 7 Nomor 3 November 2024
Publisher : Dep/SMF Obstetri & Ginekologi Fakultas Kedokteran Universitas Padjadjaran

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.24198/obgynia.v7i3.603

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Introduction: Secondary amenorrhea which caused by intrauterine adhesions is called Asherman’s syndrome. This occurs when the uterine cavity becomes partially or completely blocked, which can damage the basal layer of the endometrium and cause the formation of adhesive cicatricial tissue. The prevalence or incidence of Asherman Syndrome ranges from 2.84-5.5% in women. Case Report: A woman 33 years old had a history of amenorrhea for 2 years and three times curettage due to miscariage. Ultrasound findings showed 1.35 cm long cicatrix in the uterine cavity, and probe had only entered 3 cm. The patient underwent hysteroscopy adhesiolysis and grafting of intrauterine amniotic membrane. The intrauterine catheter was monitored for 1 month. Postoperatively the patient also received estradiol valerate therapy 3 x 2 mg for three months. Management of Asherman syndrome with hysteroscopy adhesiolysis with direct observation accompanied by grafting of amniotic membrane using intrauterine catheter tube is one of the techniques to overcome recurrent intrauterine adhesion. Conclusion:  Secondary amenorrhea in Asherman syndrome is better treated operatively with direct observation of the hysteroscopy and adhesiolysis. The using of amniotic membrane graft and supportive therapy are very helpful for the success of endometrial growth and preventing recurrent adhesions, increase the menstrual volume and chances of pregnancy.Pencangkokan Selaput Ketuban dan Histeroskopi Adhesiolisis sebagai Penatalaksanaan untuk Kasus Sindrom AshermanAbstrakPendahuluan: Amenorea sekunder yang disebabkan oleh perlengketan intrauterin disebut sindrom Asherman dengan prevalensi berkisar antara 2,84 - 5,5%.Laporan Kasus: Seorang wanita berusia 33 tahun mempunyai riwayat amenore 2 tahun dan kuretase sebanyak 3 kali akibat abortus. Temuan USG menunjukkan cicatrix sepanjang 1,35 cm di rongga rahim, sondage hanya masuk 3cm. Pasien menjalani histeroskopi adhesiolisis dan pemasangan cangkok selaput ketuban intrauterin. Kateter intrauterin dipantau selama 1 bulan. Pascaoperasi pasien juga mendapat terapi estradiol valerat 3 x 2mg selama tiga bulan. Penatalaksanaan sindrom Asherman dengan histeroskopi adhesiolisis dengan observasi langsung disertai pemasangan cangkok selaput ketuban menggunakan selang kateter intrauterin merupakan salah satu teknik yang efekstif untuk mengatasi adhesiolisis intrauterin berulang.Kesimpulan: Amenore sekunder pada sindrom Asherman lebih baik ditangani secara operatif dengan observasi langsung berupa histeroskopi dan adhesiolisis. Pemasangan cangkok selaput ketuban dan terapi suportif sangat membantu keberhasilan pertumbuhan endometrium dan mencegah perlengketan berulang, meningkatkan volume darah saat menstruasi dan peluang terjadinya pembuahan.Kata kunci: Adhesi intrauterin, Histeroskopi, Pencangkokan selaput ketuban, Rekonstruksi endometrium, Sindrom Asherman.
Diagnosis and Management of Utero-Sigmoid Fistula Cases: Case Report Arwan, Berriandi; Rinaldi, Andi; Sasotya, R. M. Sonny; Achmad, Eppy Dharmadi; Sukarsa, Moch. Rizkar Arev
Indonesian Journal of Obstetrics & Gynecology Science Volume 7 Nomor 3 November 2024
Publisher : Dep/SMF Obstetri & Ginekologi Fakultas Kedokteran Universitas Padjadjaran

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.24198/obgynia.v7i3.698

Abstract

Introduction: Intrauterine devices (IUDs) are a common form of contraception due to their affordability and effectiveness. But they can also result in migration into the myometrium, which can cause utero-sigmoid fistulas. Utero-sigmoid fistulas is a rare but dangerous side effect of intrauterine device migration, which can make diagnosis and device retrieval challenging. Here, we present a case report that highlights the diagnosis and the management of utero-sigmoid fistula.Case Presentation: A 63-year-old woman came to the hospital due to feces appearing from her vagina. Later, it was confirmed from vaginal touch examination. On US examination, the IUD was found to have migrated to the deeper part of the uterus and a defect was confirmed as a fistula between the sigmoid colon and the uterus by contrast-enhanced abdominal MSCT. The patient then underwent a joint surgery consisting of wedge reesection of the uterus + fistula repair by the digestive surgery team, and hysterotomy + bilateral salpingectomy by the obgyn team. The procedure was success, and the fistula was closed, however the IUD was not retrieved during surgery. The patient had no early post-operative problem.Conclusion: The management of utero-sigmoid fistulas varies greatly and is not standardized. The diagnosis can be confirmed by hysteroscopy or surgical exploration, although non-invasive imaging techniques like MRI can aid in the process. Even though utero-sigmoid fistulas are uncommon, physicians need to be aware of this possible IUD complications.Diagnosis dan Tatalaksana Kasus Fistula Utero-Sigmoid: Laporan KasusAbstrakPendahuluan: Alat Kontrasepsi Dalam Rahim (AKDR) merupakan bentuk kontrasepsi yang umum digunakan karena harganya terjangkau dan efektif. Namun, AKDR dapat bermigrasi ke dalam miometrium yang dapat menyebabkan pembentukan fistula utero-sigmoid. Fistula utero-sigmoid adalah efek samping yang jarang terjadi tetapi berbahaya akibat migrasi AKDR. Migrasi AKDR dapat menjadi tantangan untuk diagnosis penyebab fistula utero-sigmoid dan penyulit saat prosedur pengambilan AKDR. Laporan kasus ini akan membahas mengenai diagnosis dan penanganan fistula utero-sigmoid.Presentasi Kasus: Seorang wanita berusia 63 tahun datang ke rumah sakit mengeluhkan feses yang keluar dari vaginanya. Kemudian, hal itu dikonfirmasi saat pemeriksaan vagina. Pada pemeriksaan USG ditemukan IUD yang berpindah ke bagian uterus yang lebih dalam dan suatu defek yang terkonfirmasi sebagai fistula antara kolon sigmoid dan uters melalui MSCT abdomen dengan kontras. Kemudian pasien menjalani operasi bersama yang terdiri dari wedge reesection pada rahim + repair fistula oleh tim bedah digestif, dan histerotomi + salpingektomi bilateral oleh tim obgyn. Prosedur berjalan dengan baik dan fistula berhasil ditutup, namun AKDR tidak diambil pada saat operasi. Tidak didapati komplikasi akut pascaoperasi.Kesimpulan: manajemen fistula utero-sigmoid sangat bervariasi dan belum terstandardisasi. Diagnosis dapat dikonfirmasi melalui histereskopi atau eksplorasi pembedahan, namun teknik pencitraan non-invasif seperti MRI dapat membantu proses diagnosis. Meskipun fistula utero-sigmoid jarang terjadi, klinisi tetap harus waspada akan komplikasi ini akibat dari IUDKata kunci: AKDR, Diagnosis, Fistula utero-sigmoid, manajemen,