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All Journal Majalah Kedokteran Bandung Journal of the Medical Sciences (Berkala Ilmu Kedokteran) Jurnal Kesehatan Reproduksi Majalah Kesehatan FKUB Journal Of Holistic Nursing Science Indonesian Journal of Obstetrics and Gynecology (Majalah Obstetri dan Ginekologi Indonesia) Cermin Dunia Kedokteran
Nuring Pangastuti, Nuring
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Health Professions Immunology & microbiology Medicine & Pharmacology Neuroscience Nursing Public Health

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Komplikasi Bedah, Luaran Fungsi Seksual dan Menstruasi dari Prosedur Vaginoplasti Sigmoid pada Pasien dengan Agenesis Vagina Sinaga, Roy Jansen; Pangastuti, Nuring; Emilia, Ova
JURNAL KESEHATAN REPRODUKSI Vol 7, No 2 (2020)
Publisher : Fakultas Kedokteran, Kesehatan Masyarakat dan Keperawatan UGM

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.22146/jkr.52149

Abstract

Background:  Vaginal agenesis is one form of abnormality found in the uroginecology with a prevalence of 1: 4000 births. Various reconstruction techniques, both non-surgical and surgical, have been introduced, one of which is sigmoid vaginoplasty. Research on the complications and outcomes of sigmoid vaginoplasty procedure is still limited.Objective: To assess surgical complications, sexual and menstrual function outcomes of sigmoid vaginoplasty procedure.Method: This is a prospective study. A total 11 patients with a variety of genital tract malformations have been performed for sigmoid vaginoplasty during January 2017 to January 2019. Data are described descriptively-analytically. All patients were assessed for surgical complications, menstrual and sexual function after surgery.Results and Discussion: A total of 10 cases (90.9%) were diagnosed with vaginal agenesis and 1 case (9.1%) was diagnosed with Mayer-Rokitansky-Küster-Hauser (MRKH) syndrome. Durante surgery complications are severe bleeding and rectum injury, occurred in 2 cases (18.2%). Postoperative complication is surgical wound dehiscence, occurred in 2 cases (18.2%). All patients who have uterus (100%) showed good menstrual function outcomes. Of the 3 married patients, all patients (100%) showed good postoperative sexual function outcomes (FSFI score 27-30.4). Conclusion: The sigmoid vaginoplasty procedure is an effective procedure for patients with agenesis vaginal. This procedure has low surgical complications with good outcomes of menstrual and sexual function. Keywords: Sigmoid vaginoplasty; vaginal agenesis; menstrual function; sexual function.
Faktor-faktor yang Mendukung dan Menghambat Dilakukannya Versi Luar pada Kehamilan dengan Presentasi Bokong di Yogyakarta Pariartha, I Made; Siswishanto, Rukmono; Pangastuti, Nuring
JURNAL KESEHATAN REPRODUKSI Vol 7, No 2 (2020)
Publisher : Fakultas Kedokteran, Kesehatan Masyarakat dan Keperawatan UGM

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.22146/jkr.59811

Abstract

Background: Guidelines recommend that external cephalic version (ECV) should be offer to all women with fetus in breech presentation at term. Many literature show external cephalic version can lowering c-section rate caused by breech presentation.Objective: To explore the determinants (barriers and facilitators) affecting obstetricians and gynaecologists to do external cephalic version at Yogyakarta.Method: Explanatory mixed methods design with quantitative-qualitative model. Survey with validated questionnaire and in-depth interview with semi-structured question was done January 2019 until August 2019.Results and Discussion: 72 respondents (83.7%) was responded to questionnaire and in-depth interview was done to 12 respondents. Adherence to ECV guideline was varied: counselling (20.8%), advising for ECV (15.3%), and arranged for ECV to for (almost) all their clients (16.6%). Although 76.4% of respondents considered ECV to be an effective treatment for preventing caesarean childbirth, only 18.1% respondents agreed that every client with breech presentation should undergo ECV. Self-efficacy was the most important determinant influencing adherence. In-depth interview shows several determinants to performed or did not performed ECV: skill of clinicians, guideline for ECV, facility to emergency c-section, ECV characteristic, cost, other methods for breech presentation, perception about ECV in lowering c-section rate, perceived ECV risk and patient preferences.Conclusion: Most respondents agreed that ECV was effective intervention to reduce caesarean childbirth, but adherence to counselling, advising and arranging ECV for clients still very low. Several determinants influenced obstetrician and gynaecologists to perform or did not perform ECV.Keywords: External cephalic version; breech presentation; determinants.
Kualitas Kehidupan Seksual Perempuan Pasca Histerektomi Vaginal dan Kolporafi untuk Perbaikan Prolaps Organ Panggul Pangastuti, Nuring
Cermin Dunia Kedokteran Vol 46, No 4 (2019): Dermatologi
Publisher : PT. Kalbe Farma Tbk.

Show Abstract | Download Original | Original Source | Check in Google Scholar | Full PDF (481.296 KB) | DOI: 10.55175/cdk.v46i4.499

Abstract

Prolaps organ panggul yaitu keadaan turunnya organ panggul melalui vagina, merupakan salah satu disfungsi dasar panggul yang dapat berakibat nyeri senggama. Prosedur kolporafi anterior dan posterior dapat menurunkan gejala disfungsi seksual yang berhubungan dengan prolaps, serta memperbaiki kepuasan seksual, demikian pula prosedur pembedahan histerektomi vaginal. Dispareunia dapat terjadi pasca perbaikan dinding posterior vagina.Pelvic organ prolapse is when pelvic organs descend through the vagina, and can result in dyspareunia or sexual dysfunction. Anterior and posterior colporrhaphy and vaginal hysterectomy are the procedures to correct the condition. Dyspareunia can occur after repair of the posterior wall of the vagina.
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

Abstract

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

Abstract

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.
Co-Authors Akbar Novan Dwi Saputra Anis Widyasari Annisa Fitriani, Annisa Budi I Santoso, Budi I Budi Iman Santoso Denny Agustiningsih Dwi Cahyani Ratna Sari Hamamah, Jefi I Made Pariartha Ibnu Pranoto Iman, Santoso Budi Indraswari, Lathifa N Indraswari, Lathifa Nadhya Junizaf Junizaf Liligoly, Rivaldi D Muhammad Nurhadi Rahman Nurcahya Setyawan Ova Emilia Purwanta Purwanta Ramadona, Izwin Rukmono Siswishanto Shinta Prawitasari Sinaga, Roy Jansen Tyas Priyatini