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Malformasi Genital Perempuan: Kasus di RSUP Dr. Sardjito Yogyakarta Tahun 2019 Anis Widyasari; Muhammad Nurhadi Rahman; Akbar Novan Dwi Saputra; Nuring Pangastuti
JURNAL KESEHATAN REPRODUKSI Vol 9, No 2 (2022)
Publisher : Fakultas Kedokteran, Kesehatan Masyarakat dan Keperawatan UGM

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.22146/jkr.75774

BackgroundReproductive tract malformations are rare in general population but are commonly encountered in women with infertility and recurrent pregnancy loss. Their true prevalence in the general population is not absolutely known mainly owing to methodological bias. Common uterine anomalies are important owing to their impact on fertility, and certain Mullerian malformations are particularly important because they cause serious clinical symptoms and affect woman’s quality of life. Identification of symptoms and timely diagnosis are an important key to the management of these defects. Although MRI being gold standard in delineating uterine anatomy, recent advances in imaging technology, specifically 3-dimensional ultrasound, achieve accurate diagnosis. Surgical management depend on the type of anomaly and its complexity and also involves multiple specialties; thus, patients should be referred to centres with experience in the treatment of complex genital malformationsObjectiveDetermined the description of cases of female genital malformation at Dr. Sardjito Hospital in 2019.MethodThis is descriptive study. The subject in this study were all new patient with female genital malformation at Obgyn Polyclinic Dr. Sardjito Hospital January-December 2019. Obtained 30 cases of female genital malformation.ResultThere is 30 cases of genital malformation in 2019. They were 4-44 years with mode at group 16-20 years. They consist of vaginal and cervicovaginal agenesis 14 cases, Mayer-Rokitansky-Küster-Hauser (MRKH) Syndrom 6 cases, hematometra of hemiuterine 4 cases, Herlyn-Werner-Wunderlich (HWW) syndrome 3 cases, imperforate hymen, didelphys uterus and genital ambiguous each 1 case. Five cases of cervicovaginal agenesis have been done sigmoid vaginoplasty, all of them have good sexual function after procedure. One case MRKH syndrome has been done sigmoid vaginoplasty with good sexual function after that. Two cases HWW syndrome have been surgical treatment that are vaginal septectomy and vaginal septectomy with laparascopic cystectomy.ConclusionThe correct knowledge of embryology of the genitourinary is essential for the understanding, study, diagnosis and management of genital malformations, especially complex ones and those that lead to reproductive problems. Surgical techniques for correcting genital malformations depend on the type of anomaly and complexity.

Bahasa Inggris Akbar Novan Dwi Saputra; Dicky Moch Rizal; Nandia Septiyorini; Muhammad Nurhadi Rahman
Andalas Obstetrics And Gynecology Journal Vol. 8 No. 2 (2024)
Publisher : Universitas Andalas

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.25077/aoj.8.2.675-692.2024

Background : Platelet-rich plasma (PRP) is an autologous, self-blood product, an anticoagulated blood product generated by the centrifugation method of whole blood that primarily contains platelets at amounts up to 5 times those found in physiologic platelet concentrations. The use of PRP in pelvic floor reconstruction surgery is becoming much more common. Objective : To determine the efficacy of PRP on pelvic floor reconstruction surgery, we will synthesize the available research on the use of PRP for pelvic floor disorders.; Methods: This review was conducted on research articles in PubMed, Proquest, EBSCO, and ScienceDirect databases published between January 2010 – December 2023 regarding the use of PRP for pelvic floor reconstruction surgery. All primary research in humans, case reports and case series will be included to evaluate the outcome of PRP as an adjunct to conventional surgery in treating pelvic floor disorders; Results: A total of five articles were chosen for review. Every article makes use of PRP in pelvic floor reconstruction surgery. Conclusions: This review offers actual evidence of PRP's efficacy in pelvic floor reconstruction surgery. This is a new approach, and the findings of this study are expected to inform clinical practice and ongoing research focused on improving the outcome of pelvic floor disorders treatment. Trial registration number: osf.io/gyr72

Diagnosis approach, treatment, evaluation and fertility preservation in patient with Herlyn-Werner-Wunderlich syndrome: a case report Indraswari, Lathifa Nadhya; Pangastuti, Nuring; Dwi Saputra, Akbar Novan; Widyasari, Anis
Journal of the Medical Sciences (Berkala Ilmu Kedokteran) Vol 55, No 4 (2023)
Publisher : Universitas Gadjah Mada

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.19106/JMedSci005504202308

Herlyn-Werner-Wunderlich (HWW) syndrome is a very rare female congenital anomaly of urogenital tract. The definite etiology of HWW syndrome is still unknown. It may be caused by the abnormal development of Mullerian and Wolffian ducts. The characteristic triad of this syndrome includes didelphys uterus, obstructed hemivagina, and ipsilateral renal agenesis, recently known as Obstructed Hemivagina and Ipsilateral Renal Anomaly (OHVIRA) syndrome. A 17 y.o. presented with intermittent lower abdominal pain. Physical examination revealed in normal limit. From the ultrasonography examination, it was found uterus didelphys with left hemiuterus hematomethra, hematocolpos, with normal anatomy and function of the right kidney, but there was no left kidney. From pelvic magnetic resonance imaging (MRI) and laparoscopy showing a complete duplication of the uterus from the horn to the cervix with no connection between the two uterine cavities. Both ovaries were normal. The right fallopian tube was normal. The left tube was enlarged, attached to the uterus and the left ovary. No left kidney was found. From the previous surgery, there was a misdiagnosed with brown cyst. Physical examination such as rectal toucher often missed, regardless it can be used to determine some differential diagnosis. MRI is most accurate for providing details regarding the altered anatomy and for identifying associated hematocolpos, hematosalping or hematometra for HWW syndrome cases. The laparoscopy guiding diagnostic and operative management of the vaginal septectomy procedure was performed. In conclusion, misdiagnosis of HWW syndrome can be occurred on ultrasound examination. MRI is an examination that is considered appropriate to help confirm the diagnosis. Laparoscopy can be used with the aim of establishing a diagnosis or in surgical management, in this case, a septectomy is performed.

Laporan Kasus: PROSEDUR VAGINOPLASTI SIGMOID PADA DUA KASUS SINDROM MAYER-ROKITANSKY-KÜSTER-HAUSER (MRKH) Pangastuti, Nuring; Fitriani, Annisa; Setyawan, Nurcahya; Widyasari, Anis; Saputra, Akbar Novan Dwi
Majalah Kesehatan Vol. 12 No. 1 (2025): Majalah Kesehatan
Publisher : Faculty of Medicine Universitas Brawijaya

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.21776/majalahkesehatan.2025.012.01.9

Sindrom Mayer-Rokitansky-Kuster-Hauser (MRKH) atau Mullerian agenesis atau Mullerian aplasia adalah kelainan bawaan yang jarang terjadi pada saluran genetik seorang perempuan dengan agenesis parsial atau kompleks dari uterus, hipoplasia vagina, atau agenesis vagina, tetapi memiliki ovarium dan genitalia eksterna yang normal. Sindrom MRKH terbagi menjadi 3 jenis, dengan manifestasi masing-masing yang bisa berbeda meskipun tergolong jenis MRKH yang sama. Dilaporkan dua kasus sindrom MRKH tipe I dengan keluhan utama amenorea primer. Kasus pertama adalah perempuan berusia 27 tahun menjelang menikah, sedangkan kasus kedua adalah perempuan menikah berusia 26 tahun yang aktif secara seksual namun memiliki keluhan suami tidak bisa melakukan penetrasi pada aktivitas seksual. Kedua kasus dengan keluhan amenore primer. Hasil pemeriksaan fisik dan hormonal dalam batas normal, sedangkan pemeriksaan ultrasonografi transabdominal, Colon in Loop (CIL) dan Magnetic Resonance Imaging (MRI) mendukung diagnosis sindrom MRKH tipe I. Vaginoplasti sigmoid dilakukan untuk tujuan pembuatan neovagina untuk aktivitas seksual, pada kasus pertama menggunakan teknik iso peristaltik dan pada kasus kedua teknik anti/kontra peristaltik. Pasca operasi, neovagina terbentuk dengan baik tanpa tanda-tanda infeksi pada kedua kasus, meski harus diberikan transfusi darah berupa 500 ml packed red cell serta dilakukan manajemen konservatif terhadap dehisensi luka operasi abdomen pada kasus kedua. Dijumpai stenosis ringan pada kedua kasus, yang dapat diatasi dengan prosedur dilatasi vagina menggunakan dilator Hegar mulai pada 3 pekan pasca operasi. Kesimpulannya, sindrom MRKH merupakan kasus yang jarang terjadi sehingga memerlukan penanganan yang cermat terkait prosedur pembentukan neovagina untuk tujuan penetrasi pada aktivitas seksual. Meskipun memerlukan keahlian khusus dan operasi dilakukan berkolaborasi dengan ahli bedah digestif, pada kedua kasus yang dilaporkan operasi berlangsung dengan baik, tidak terdapat komplikasi yang signifikan, serta menghasilkan kondisi pasca operasi yang memuaskan.

Bahasa Inggris Saputra, Akbar Novan Dwi; Rizal, Dicky Moch; Septiyorini, Nandia; Rahman, Muhammad Nurhadi
Andalas Obstetrics And Gynecology Journal Vol. 8 No. 2 (2024)
Publisher : Fakultas Kedokteran Universitas Andalas

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.25077/aoj.8.2.675-692.2024

Background : Platelet-rich plasma (PRP) is an autologous, self-blood product, an anticoagulated blood product generated by the centrifugation method of whole blood that primarily contains platelets at amounts up to 5 times those found in physiologic platelet concentrations. The use of PRP in pelvic floor reconstruction surgery is becoming much more common. Objective : To determine the efficacy of PRP on pelvic floor reconstruction surgery, we will synthesize the available research on the use of PRP for pelvic floor disorders.; Methods: This review was conducted on research articles in PubMed, Proquest, EBSCO, and ScienceDirect databases published between January 2010 – December 2023 regarding the use of PRP for pelvic floor reconstruction surgery. All primary research in humans, case reports and case series will be included to evaluate the outcome of PRP as an adjunct to conventional surgery in treating pelvic floor disorders; Results: A total of five articles were chosen for review. Every article makes use of PRP in pelvic floor reconstruction surgery. Conclusions: This review offers actual evidence of PRP's efficacy in pelvic floor reconstruction surgery. This is a new approach, and the findings of this study are expected to inform clinical practice and ongoing research focused on improving the outcome of pelvic floor disorders treatment. Trial registration number: osf.io/gyr72

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