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All Journal Indonesian Journal of Perinatology
Ongko, Eric Gradiyanto
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Health Professions Medicine & Pharmacology Nursing

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Retrograde Hysterectomy Approaches in Difficult Gynaecology Surgery I Gde Sastra Winata; Ongko, Eric Gradiyanto; I Nyoman Gede Budiana; I Nyoman Bayu Mahendra; Kade Yudi Saspriyana; Pande Kadek Aditya Prayudi; Arlando Martino Anapaku; Florencia
Indonesian Journal of Perinatology Vol. 6 No. 1 (2025): (Available online: 1 June 2025)
Publisher : The Indonesian Society of Perinatology, South Jakarta, Indonesia

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.51559/inajperinatol.v6i1.70

Abstract

Hysterectomy remains one of the most frequently performed gynecological surgeries worldwide. While extra-fascial hysterectomy is the standard abdominal approach, complex cases involving large fibroids, severe endometriosis, adhesions, or malignancy often require alternative techniques such as the Aldridge method or retrograde hysterectomy. These challenging situations are associated with distorted pelvic anatomy, fibrosis, and adhesions, increasing the risk of complications, including injury to adjacent organs. This article reviews strategies and operative steps in managing complex abdominal hysterectomies, with emphasis on retrograde hysterectomy as a valuable approach when the cervicovaginal junction cannot be clearly identified or when extensive adhesions are present. The surgical technique is described step by step, supported by imaging and intraoperative findings, and highlights methods such as hydrodissection and careful dissection around critical structures to minimize morbidity. Preoperative imaging, intraoperative decision-making, and technical modifications are emphasized as key factors for optimizing patient outcomes. Although this study provides a detailed description of techniques under challenging hysterectomies, its limitation lies in the reliance on schematic illustrations rather than comprehensive intraoperative photographic documentation.
Characteristics of cervical cancer screening using visual inspection with acetic acid and pap smear in the outpatient clinic at Prof. Dr I.G.N.G. Ngoerah Hospital Denpasar from January to December 2023 Aryana, Made Bagus Dwi; Surya, I Gede Ngurah Harry Wijaya; Winata, I Gde Sastra; Ongko, Eric Gradiyanto; Budiana, Nyoman Gede; Mahendra, I Nyoman Bayu; Saspriyana, Kade Yudi; Darmayasa, I Made; Prayudi, Pande Kadek Aditya
Indonesian Journal of Perinatology Vol. 6 No. 2 (2025): Available online : 1 December 2025
Publisher : The Indonesian Society of Perinatology, South Jakarta, Indonesia

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.51559/inajperinatol.v6i2.67

Abstract

Introduction: According to GLOBOCAN 2022, cervical cancer is the fourth leading cause of cancer-related morbidity and mortality among women worldwide, with 662,044 new cases and 348,709 deaths. In Southeast Asia, it ranks third in incidence and fourth in mortality. Indonesia contributes more than 50% of new cases (36,964) and deaths (20,708) in the region. Cervical cancer is largely preventable through early detection methods such as visual inspection with acetic acid (VIA) and Pap smear. However, differences in diagnostic accuracy between these screening methods highlight the need to identify patient characteristics appropriate for each modality. This study aimed to compare the characteristics of patients undergoing VIA and Pap smear screening at the outpatient clinic of Prof. Dr I.G.N.G. Ngoerah Hospital, Denpasar, from January to December 2023. Methods: This observational analytical study used secondary data obtained from outpatient clinic registers and medical records of female patients who underwent VIA or Pap smear screening during the study period. Data were analysed using univariate analysis. Results: Among 122 participants undergoing VIA, 24 (19.6%) had positive results. Pap smear examinations in 125 participants showed CIN I in 10 (8.0%), CIN II in 4 (3.2%), and CIN III in 5 (4.0%) participants. Vaginal discharge was reported in 7 VIA participants (5.7%) and 15 Pap smear participants (12.0%), while postcoital bleeding was reported in 2 participants (1.6%) in each group. Among VIA-positive cases, lesions were most commonly found in all four quadrants (45%). Conclusion: Patient characteristics in VIA and Pap smear screening at Prof. Dr I.G.N.G. Ngoerah Hospital varied considerably, with a higher proportion of positive results observed in VIA compared to Pap smear screening.
Co-Authors Arlando Martino Anapaku Aryana, Made Bagus Dwi Budiana, Nyoman Gede FLORENCIA I Gde Sastra Winata I Ketut Suwiyoga I Made Darmayasa I Nyoman Gede Budiana KADE YUDI SASPRIYANA Kade Yudi Saspriyana Nyoman Bayu Mahendra Pande Kadek Aditya Prayudi Prayudi, Pande Kadek Aditya Surya, I Gede Ngurah Harry Wijaya