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All Journal Narra J Journal of International Surgery and Clinical Medicine
Rusnaidi Rusnaidi
Division of Reproductive Endocrinology and Infertility, Department of Obstetrics and Gynecology, Faculty of Medicine, Universitas Syiah Kuala, Banda Aceh, Indonesia
Biochemistry, Genetics & Molecular Biology Health Professions Immunology & microbiology Medicine & Pharmacology Public Health

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Proximal Transverse Vaginal Septum In Women With Primary Infertility : A Rare Case Report Rauzatul Jannah; Yusra Septivera; Rusnaidi Rusnaidi; Sarah Nainggolan
Journal of International Surgery and Clinical Medicine Vol. 6 No. 1 (2026): Available online : 1 June 2026
Publisher : Surgical Residency Program Syiah Kuala University

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.51559/jiscm.v6i1.78

Abstract

Introduction: A transverse vaginal septum (TVS) represents an uncommon congenital malformation of female genital structures resulting from incomplete canalization where the urogenital sinus meets the distal portion of Müllerian ducts. This condition occurs in approximately 1 per 2,100 to 1 per 72,000 female live births. TVS manifests as either obstructive or non-obstructive variants and frequently correlates with infertility and painful intercourse. Surgical intervention is necessary to reestablish normal vaginal structure and enhance fertility potential. Case description: This report details a 28-year-old female presenting with inability to conceive following 18 months of consistent unprotected marital relations. Her complaints included painful sexual activity, reduced menstrual flow, and menstrual cramping. Physical examination identified a dense transverse membrane in the proximal vaginal third, measuring roughly 2 cm in thickness, positioned 5 cm beyond the introitus, containing a tiny opening that obscured cervical observation. Sonographic evaluation demonstrated unremarkable uterine and adnexal structures. Hysterosalpingography could not be completed due to septal blockage. Surgical management included vaginal septal excision combined with diagnostic laparoscopy and chromopertubation, demonstrating normal reproductive organs with open fallopian tubes and endometrial implants on the uterine surface that underwent ablation. Patient recovery proceeded without complications. Conclusion: A transverse vaginal septum constitutes a rare congenital malformation potentially presenting with fertility difficulties and dyspareunia during reproductive years. Surgical removal with vaginal restoration represents the preferred therapeutic approach to reestablish normal anatomy and maximize reproductive potential. Continued postoperative surveillance is crucial for detecting complications and assessing fertility outcomes.
Multi-stakeholder perspectives on cervical cancer screening implementation in Indonesia: A qualitative study of cervical screening barriers in Banda Aceh Febrina Yolanda; Tgk. Puspa Dewi; Sarah I. Nainggolan; Munawar Munawar; Munizar Munizar; Rijal Bulqini; Rachmad Suhanda; Rusnaidi Rusnaidi
Narra J Vol. 6 No. 1 (2026): April 2026
Publisher : Narra Sains Indonesia

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.52225/narra.v6i1.3022

Abstract

Indonesia is committed to the WHO's cervical cancer elimination strategy through the National Action Plan (RAN) 2023–2030, targeting 75% screening coverage by 2030. However, current rates remain critically low at 7.02%. This study explores multi-stakeholder perspectives to identify implementation barriers and facilitators for policy enhancement. A qualitative descriptive case study was conducted in Banda Aceh (July-August 2025) involving 25 stakeholders: City Health Office Head, 11 puskesmas heads, 11 VIA coordinators and 2 community organization representatives. Thematic analysis using NVivo v.16 identified key implementation factors. Five major themes emerged: (1) Knowledge gaps—screening perceived necessary only when symptomatic despite available information; (2) Access paradox—excellent geographic access and flexibility undermined by limited examination rooms, insufficient midwives, and psychosocial barriers (shame, fear, lack of spousal support); (3) Financial sustainability—free services threatened by complex BPJS claims and low reimbursement affecting logistics; (4) Service quality variation—dependent on cross-sector collaboration and staff competency, with uneven training and limited cryotherapy (only 2 centers); and (5) Communication challenges—inconsistent digital media use necessitates face-to-face counseling and cadres, though reach remains limited. Implementation faces psychological barriers, capacity limitations, and uneven digital adoption despite strong infrastructure. Priority policy recommendations include: (1) HPV DNA self-sampling to overcome privacy barriers; (2) simplified BPJS claims with adequate reimbursement; (3) systematic competency-building and cryotherapy expansion; and (4) culturally-adapted education integrating local language and religious leaders. These evidence-based enhancements could accelerate Indonesia's RAN 2030 elimination targets.
Co-Authors Febrina Yolanda Munawar Munawar Munizar Munizar Rachmad Suhanda Rauzatul Jannah Rijal Bulqini Sarah I. Nainggolan Sarah Nainggolan Tgk. Puspa Dewi Yusra Septivera