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Nuring Pangastuti
Departemen Obgin, FKKMK UGM
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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

Abstract

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.
Evaluasi KIPPas (Kartu Instrumen Prediktor Pangastuti) Jogja sebagai Instrumen Prediktor Disfungsi Dasar Panggul Pasca Persalinan Vaginal Fauzan Achmad Maliki; Nuring Pangastuti; Rukmono Siswishanto
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.77584

Abstract

Background: Postpartum pelvic floor dysfunction is pelvic floor disorder, which can be in the form of pelvic organ prolapse, urinary problem, defecation problem or sexual dysfunction. The incidence of postpartum pelvic floor dysfunction occurs in 46% of postpartum women. Until now, there is no standard instrument used to estimate the incidence of postpartum pelvic floor dysfunction. In previous studies, an instrument was obtained, namely KIPPas Jogja, to estimate the incidence of pelvic floor dysfunction after delivery, but it was still not sufficient for the number of research samples needed.Objective: To evaluate the Pangastuti Jogja Predictor Instrument Card (KIPPas Jogja) as a predictor of pelvic floor dysfunction in the form of pelvic organ prolapse after vaginal delivery.Method: This study was a prospective cohort study. Subjects who gave vaginal delivery were examined according to the KIPPas Jogja instrument and then evaluated for the diagnosis of pelvic floor dysfunction in the form of pelvic organ prolapse with POPQ examination and complaints of pelvic floor dysfunction using the PFDI and FSFI instruments at 3 months postpartum.Results and Discussion: From 133 research subjects, the results of the KIPPas Jogja assessment are high risk in 42.9% of subjects and low risk in 57.1% of subjects. The incidence of pelvic floor dysfunction in the form of pelvic organ prolapse was found in 69.17% subjects. Complaints of pelvic floor dysfunction were present in 20.31% subjects and complaints of sexual dysfunction in 11.3% subjects. The sensitivity of KIPPas Jogja is 80% and specificity is 95% with a positive predictive value of 97% and a negative predictive value of 68% to detect pelvic dysfunction in the form of pelvic organ prolapse. Meanwhile, to predict complaints of pelvic floor dysfunction, measured with PFDI-20, the sensitivity was 93% and specificity was 52%, and the positive predictive value was 33% and the negative predictive value was 96%. To predict sexual dysfunction, KIPPas obtained sensitivity of 64%, specificity of 42% with a positive predictive value of 10% and a negative predictive value of 92%.Conclusion: KIPPas Jogja can be used as a predictor of postpartum pelvic floor dysfunction. Keywords: postpartum pelvic floor dysfunction, KIPPas Jogja, POPQ, PFDI-20, FSFI
Hubungan Kejadian Disfungsi Dasar Panggul dan Kualitas Hidup Perempuan Usia Menopause di Daerah Istimewa Yogyakarta Ratih Kumalasari; Nuring Pangastuti; Ova Emilia
JURNAL KESEHATAN REPRODUKSI Vol 9, No 3 (2022): In Process
Publisher : Fakultas Kedokteran, Kesehatan Masyarakat dan Keperawatan UGM

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.22146/jkr.75089

Abstract

Latar Belakang: Disfungsi dasar panggul paling banyak terjadi pada perempuan usia lanjut, dengan insidensi sekitar 39,8%. Hal ini erat hubungannya dengan kejadian menopause. Menopause akan menyebabkan penurunan hormon estrogen, yang berkontribusi terhadap kelemahan dan atrofi otot dasar panggul. Jarangnya perempuan dengan disfungsi dasar penggul memeriksakan dirinya, mengakibatkan tidak adanya data yang tepat mengenai angka kejadian disfungsi dasar panggul pada perempuan menopause. Keadaan disfungsi dasar panggul pada perempuan menopause akan berpengaruh terhadap kualitas hidupnya, terutama dalam hal fisik, seksual, dan psikososial. Berdasarkan hal tersebut, penilaian kualitas hidup perempuan dengan disfungsi dasar panggul dilakukan dengan instrumen MENQOL yang dapat menilai kualitas hidup perempuan menopause secara umum.Tujuan: Untuk mengetahui hubungan kejadian disfungsi dasar panggul dengan kualitas hidup perempuan usia menopause di Daerah Istimewa Yogyakarta.Metode: Penelitian ini merupakan penelitian analitik cross sectional yang dilakukan di beberapa daerah di DIY. Subjek dilakukan penilaian disfungsi dasar panggul berupa prolaps organ panggul dengan pemeriksaan POPQ, sedangkan kualitas hidup perempuan menopause dinilai berdasarkan instrumen MENQOL.Hasil: Dari 192 subjek, didapatkan 140 subjek (72,92%) mengalami prolaps organ panggul, dengan kejadian sistokel 69,79%, rektokel 67,71%, dan prolaps uteri 46,35%. Gambaran kualitas hidup perempuan usia menopause menunjukkan variasi dalam tingkat keluhan dari subjek. Terdapat perbedaan yang bermakna dari median skor pada domain fisik MENQOL antara kelompok disfungsi dasar panggul dan tidak (p=0,000). Usia, paritas, riwayat obstetri, penyakit kronis, dan lamanya menopause, memiliki hubungan yang bermakna secara signifikan terhadap kejadian disfungsi dasar panggul (p < 0,05). Kualitas hidup perempuan usia menopause juga dipengaruhi oleh faktor usia, pekerjaan, riwayat penyakit kronis, dan lamanya menopause (p < 0,05).Kesimpulan: Kualitas hidup berdasarkan domain fisik MENQOL lebih rendah pada  perempuan usia menopause dengan disfungsi dasar panggul (p<0,05).
Co-Authors Akbar Novan Dwi Saputra Anis Widyasari Fauzan Achmad Maliki Muhammad Nurhadi Rahman Ova Emilia Ratih Kumalasari Rukmono Siswishanto