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"ABSTRAKICS merekomendasikan latihan Kegel, sebagai terapi konservatif untuk mengatasi inkontinensia urin tekanan untuk dilakukan selama 12 minggu. Namun, beberapa penelitian menunjukkan bahwa latihan kegel selama 4, dan 8 minggu dapat memperbaiki gejala inkontinensia, kualitas hidup, dan meningkatkan kekuatan otot dasar panggul. Tujuan : Mengetahui gambaran perbaikan gejala subjektif dan objektif, peningkatan kekuatan otot dasar panggul, perbaikan derajat keparahan dan perbaikan kualitas hidup wanita penderita inkontinensia urin tekanan yang menjalani antara latihan Kegel yang 4, 8, dan 12 mingguMetode: 55 subjek terdiagnosis inkontinensia urin tekanan (berdasarkan nilai (QUID >4) dan tes pembalut positif 60 menit) diberikan latihan Kegel di Poliklinik Rehabilitasi Medik RSCM selama 12 minggu. Pengumpulan data, seperti kuesioner UDI-6; tes pembalut 60 menit; dan kuesioner IIQ-7 akan dicatat oleh subjek penelitian dalam buku kegiatan 4, 8, dan 12 minggu. Selain itu, evaluasi biofeedback(Myomed 932) dari kekuatan serat otot lambat dan serat otot cepat dilakukan setiap 2 minggu untuk menilai perbaikan. Hasil: Hasil penelitian menunjukkan bahwa adanya perbedaan bermakna antara skor UDI-6 dan IIQ-7 subjek sebelum latihan dan setelah latihan 4, 8, dan 12 minggu (uji Wilcoxon; p<0.05). Selain itu, adanya perbedaan yang signifikan pada kekuatan serat otot lambat dan serat cepat antara sebelum latihan dengan pasca latihan 8 minggu dan sebelum latihan dengan pasca 12 minggu. (dengan uji Wilcoxon; p <0.05).Kesimpulan : Latihan Kegel yang dilakukan dengan durasi minimal 8 minggu dapat memperbaiki gejala, kekuatan otot dasar pangul dan kualitas hidup wanita dengan inkontinensia urin tekanan.

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ABSTRACTKegel exercise is recommended by ICS, as a conservative therapy to improve stress urinary incontinence for 12 weeks. However, several studies have shown that Kegel exercise for 4 and 8 weeks can improve symptoms of incontinence, quality of life and increase pelvic floor muscle strength. Objective: To identify the improvement subjective and objective symptoms, increasing pelvic floor muscle strength, and improvement quality of life among women with stress urinary incontinence who performed kegel exercise 4, 8, and 12 weeks.Method: 55 subjects were diagnosed with stress urinary incontinence (based on (QUID score >4) and positive result of pad test 60 minutes) and were given the Kegel exercise at RSCM for 12 weeks. Datas such as UDI-6, pad test 60 minutes, and IIQ-7 will be documented by each subject in the book for 4, 8, and 12 weeks. In addition, Pelvic floor muscle (slow and fast fibers twitch) were assessed by biofeedback (myomed 932) every 2 weeks. Result: The results show that there is a significant difference between the UDI-6 and IIQ-7 scores before, after 4, 8, and 12 weeks Kegel exercise. (Wilcoxon testp < 0.05).In addition, there is a significant difference in the pelvic floor muscle strength (slow and fast fibers twitch) between before with after exercise for 8 weeks Kegel exercise and between before and after 12 weeks Kegel exercise. (Wilcoxon test; p <0.05).Conclusion: Performing Kegel exercise with a minimum duration of 8 weeks can improve symptoms, pelvic floor muscle strength and quality of life for women with stress urinary incontinence"

"Latar Belakang : ICS merekomendasikan latihan Kegel, sebagai terapi konservatif untuk mengatasi inkontinensia urin tekanan untuk dilakukan selama 12 minggu. Namun, beberapa penelitian menunjukkan bahwa latihan kegel selama 4, dan 8 minggu dapat memperbaiki gejala inkontinensia, kualitas hidup, dan meningkatkan kekuatan otot dasar panggul. Tujuan : Mengetahui gambaran perbaikan gejala subjektif dan objektif, peningkatan kekuatan otot dasar panggul, perbaikan derajat keparahan dan perbaikan kualitas hidup wanita penderita inkontinensia urin tekanan yang menjalani antara latihan Kegel yang 4, 8, dan 12 mingguMetode:55 subjek terdiagnosis inkontinensia urin tekanan (berdasarkan nilai (QUID >4) dan tes pembalut positif 60 menit) diberikan latihan Kegel di Poliklinik Rehabilitasi Medik RSCM selama 12 minggu. Pengumpulan data, seperti kuesioner UDI-6; tes pembalut 60 menit; dan kuesioner IIQ-7 akan dicatat oleh subjek penelitian dalam buku kegiatan 4, 8, dan 12 minggu. Selain itu, evaluasi biofeedback(Myomed 932) dari kekuatan serat otot lambat dan serat otot cepat dilakukan setiap 2 minggu untuk menilai perbaikan. Hasil:Hasil penelitian menunjukkan bahwa adanya perbedaan bermakna antara skor UDI-6 dan IIQ-7 subjek sebelum latihan dan setelah latihan 4, 8, dan 12 minggu (uji Wilcoxon; p<0.05). Selain itu, adanya perbedaan yang signifikan pada kekuatan serat otot lambat dan serat cepat antara sebelum latihan dengan pasca latihan 8 minggu dan sebelum latihan dengan pasca 12 minggu. (dengan uji Wilcoxon; p <0.05).Kesimpulan :Latihan Kegel yang dilakukan dengan durasi minimal 8 minggu dapat memperbaiki gejala, kekuatan otot dasar pangul dan kualitas hidup wanita dengan inkontinensia urin tekanan.

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Introduction :

Kegel exercise is recommended by ICS, as a conservative therapy to improve stress urinary incontinence for 12 weeks. However, several studies have shown that Kegel exercise for 4 and 8 weeks can improve symptoms of incontinence, quality of life and increase pelvic floor muscle strength.

Objective:

To identify the improvement subjective and objective symptoms, increasing pelvic floor muscle strength, and improvement quality of life among women with stress urinary incontinence who performed kegel exercise 4, 8, and 12 weeks.

Method:

55 subjects were diagnosed with stress urinary incontinence (based on (QUID score >4) and positive result of pad test 60 minutes) and were given the Kegel exercise at RSCM for 12 weeks. Datas such as UDI-6, pad test 60 minutes, and IIQ-7 will be documented by each subject in the book for 4, 8, and 12 weeks. In addition, Pelvic floor muscle (slow and fast fibers twitch) were assessed by biofeedback (myomed 932) every 2 weeks.

Result:

The results show that there is a significant difference between the UDI-6 and IIQ-7 scores before, after 4, 8, and 12 weeks Kegel exercise. (Wilcoxon testp < 0.05).

In addition, there is a significant difference in the pelvic floor muscle strength (slow and fast fibers twitch) between before with after exercise for 8 weeks Kegel exercise and between before and after 12 weeks Kegel exercise. (Wilcoxon test; p <0.05).

Conclusion:

Performing Kegel exercise with a minimum duration of 8 weeks can improve symptoms, pelvic floor muscle strength and quality of life for women with stress urinary incontinence."

"Latar Belakang: Inkontinensia urin (IU) merupakan salah satu masalah kesehatan dengan prevalensi dan beban yang cukup tinggi di dunia. Inkotinensia urin tekanan (SIU) merupakan salah satu bentuk inkontinensia urin dengan prevalensi di Indonesia berkisar antara 14,57-52%. Latihan otot dasar panggul merupakan salah satu pencegahan dan tatalaksana yang direkomendasikan untuk inkontinensia urin. Namun, perbandingan antara efektivitas latihan yang dilakukan selama masa kehamilan dan pasca persalinan belum pernah dilakukan sebelumnya.Tujuan: Penelitian ini bertujuan untuk mengetahui efektivitas latihan otot dasar panggul pada masa kehamilan dan setelah persalinan sebagai pencegahan dan pengobatan terhadap terjadinya inkontinensia urin tekanan yang menetap pasca persalinan.Metode: Dilakukan penelitian dengan desain uji klinis acak terkontrol dan kerangka konsep etiologik. Populasi penelitian yaitu semua ibu hamil dengan gejala inkontinensia urin tekanan. Dalam kurun waktu penelitian didapatkan sampel sebanyak 70 ibu hamil dengan gejala inkontinensia urin tekanan pasca persalinan yang dibagi dalam kelompok tanpa intervensi, kelompok latihan otot dasar panggul sejak masa kehamilan, dan kelompok latihan otot dasar panggul pasca persalinan. Data dianalisis dengan metode analisis bivariat kategorik tidak berpasangan dua kelompok.Hasil: Dari hasil penelitian ini, didapatkan adanya hubungan yang bermakna pada ibu hamil yang diberikan latihan otot dasar panggul baik sejak masa kehamilan (p-value = 0.002) maupun pasca persalinan (p-value = 0.006) dengan penurunan proporsi kejadian inkontinensia urin tekanan menetap pasca persalinan. Namun, tidak didapatkan adanya perbedaan hasil yang bermakna secara statistik antara kelompok ibu hamil yang diberikan latihan otot dasar panggul sejak masa kehamilan dengan yang diberikan latihan pasca persalinan (p-value = 1.000).Kesimpulan: Pada penelitian ini tidak didapatkan adanya perbedaan yang bermakna antara latihan otot dasar panggul pada masa kehamilan dan setelah persalinan. Namun, latihan otot dasar panggul pada masa kehamilan dan setelah persalinan terbukti efektif dalam pencegahan dan pengobatan terhadap terjadinya inkontinensia urin tekanan yang menetap pasca persalinan dibandingkan dengan yang tidak melakukan.

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Background: Urinary incontinence (UI) is one of the problematic health problems with high prevalence and monetary burden in the world. Stress urinary incontinence is one form of UI with a prevalence of 14.57 -52% in Indonesia. Pelvic floor muscle training (PFMT) is one of its recommended preventive and curative measures. Nevertheless, comparison between PFMT initiated during pregnancy period and postpartum period has never been studied before.

Objective: This study aims to determine the effectiveness of pelvic floor muscle exercises during pregnancy and after childbirth as prevention and treatment of the occurrence of persistent postpartum urinary incontinence.

Method: A randomized controlled trials with an etiological conceptual framework was done in this study. The study population were all pregnant women with symptoms of urinary incontinence. In the study period, a sample of 70 pregnant women with symptoms of postpartum urinary incontinence consisting of no-intervention group, pregnancy PFMT group, and postpartum PFMT group. The data were analyzed by two groups of unpaired categorical bivariate analysis methods.

Results: It was found that there was a significant association between pregnant women given pelvic floor muscle training (PFMT) both during pregnancy (p-value = 0.002) and postpartum (p-value = 0.006) with decline of persistent postpartum urinary incontinence proportion. However, there was no statistically significant difference of outcome found in the group of pregnant women given PFMT since pregnancy with those who were given after childbirth, p-value = 1,000.

Conclusion: In this study there was no significant difference of outcome between PFMT during pregnancy and after delivery. However, PFMT during pregnancy and after childbirth have been proven effective in the prevention and treatment of the occurrence of postpartum urinary incontinence compared with those who did not."

"Latar Belakang: Gangguan berkemih dalam kehamilan dapat mempengarui kualitas dari hidup seorang ibu hamil. Akan tetapi, Sampai saat ini belum didapatkan data mengenai hubungan paritas dan trimester kehamilan dengan kejadian gangguan berkemih di Indonesia.Tujuan: Menganalisis faktor-faktor yang berhubungan dengan berbagai gangguan kejadian berkemih yang terjadi selama kehamilan.Metode: Penelitian ini merupakan penelitian analitik observasional dengan metode potong lintang. Subjek pada penelitian ini adalah ibu hamil yang berkunjung ke Puskesmas Cempaka Putih dan Puskesmas Johar Baru menggunakan metode consecutive sampling pada Juli 2019 sampai Desember 2019. Data yang dikumpulkan melalui wawancara, pengisian daftar harian berkemih, kuesioner Questionnaire for Urinary Incontinence Diagnosis (QUID) dan penilaian indeks sandvik.Hasil: Didapatkan sebanyak 279 ibu hamil yang memenuhi kriteria inklusi dan eksklusi. Didapatkan multiparitas berhubungan dengan terjadinya inkontinensa tekanan pada wanita hamil (P= 0,045, OR 2,59, CI 95% 1,002-6,73), tetapi tidak bermakna pada variabel yang lain (primipara dan nulipara dengan inkontinensia tekana; multipara, primipara dan nullipara dengan inkontinensia desakan, gangguan frekuensi dan nokturia; trimester kehamilan dengan inkontinensia tekanan, desakan, gangguan frekuensi dan nokturia) (P>0,05). Prevalensi inkontinensia tekanan yang terjadi pada kehamilan sebesar 11,1%, dimana pada trimester I,II,III yakni 12,7%, 12,4%, 10,9%. Prevalensi inkontinensia desakan yang terjadi pada kehamilan sebesar 5,0%, dimana trimester I,II,III yakni 4,6%, 2,8%, 8%. Prevalensi gangguan frekuensi yang terjadi pada kehamilan sebesar 75,6%, dimana trimester I,II,III yakni 67,3%, 74,7%, dan 79,1%. Prevalensi nokturia yang terjadi pada kehamilan 86% ,dimana pada trimester I,II,III, yakni 81,6%, 83,5%,dan 89,2%. Indeks keparahan inkontinensia urin terbanyak dalam kehamilan adalah pada tingkat ringan (93,3%) dan sedang (6,7%).Kesimpulan: Adanya hubungan yang bermakna antara multiparitas dengan terjadinya inkontinensia tekanan pada wanita hamil. Dilakukan penelitian selanjutnya untuk menilai faktor-faktor lainnya yang berpengaruh terhadap gangguan berkemih pada ibu hamil dengan cakupan dan subjek yang lebih luas.

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Background: Low urinary tract symptoms in pregnancy can affect the quality of life for a pregnant woman. However, until now there has been no data regarding the relationship between parity and trimester of pregnancy with the incidence of urinary disorders in Indonesia.

Objective: Analyzing the factors associated with various Low urinary tract symptoms has occur during pregnancy.

Methods: This research is an observational analytic study with cross sectional method. The subjects in this study were pregnant women who visited the Cempaka Putih Health Center and Johar Baru Health Center using the consecutive sampling method from July 2019 to December 2019. Data collected in the form of obstetric history through interviews, bladder dairy, Questionnaire for Urinary Incontinence Diagnosis (QUID) Indonesian version and index sandvik

Results:Obtained as many as 279 pregnant women who met the inclusion and exclusion criteria. Obtained multiparity associated with the occurrence of pressure incontinence in pregnant women (P = 0.045, OR 2.59, 95% CI 1.00-6.73), but not significant in other variables (primipara and nulipara with stress incontinence; multipara, primipara and nullipara with urge incontinence, frecuency and nocturia; trimester with stress incontinence, urge incontinence, frecuency and nocturia) (P> 0.05). The prevalence of stress incontinence that occurs in pregnancy is 11.1%, where in the I, II, III trimesters that is 12.7%, 12.4%, 10.9%. The prevalence of urge incontinence that occurs in pregnancy is 5.0%, where I, II, III trimesters are 4.6%, 2.8%, 8%. The prevalence of frequency that occur in pregnancy is 75.6%, where I, II, III trimesters are 67.3%, 74.7%, and 79.1%. The prevalence of nocturia that occurs in pregnancy is 86%, where in the I, II, III trimesters, ie 81.6%, 83.5%, and 89.2%. The highest severity index in urinary incontinence in pregnancy was mild (93.3%) and moderate (6.7%).

Conclusion: There is a significant relationship between multiparity with the occurrence of stress incontinence in pregnant women. It is recommended to have further research to study other factors that may influence low urinary tract symptoms on pregnant women with broader scope and subjects background"

"Latar Belakang: Inkontinensia urin (IU) menurut ICS didefinisikan sebagai keluarnya urin yang tidak dapat dikendalikan atau dikontrol, yang secara obyektif dapat diperlihatkan dan merupakan suatu masalah sosial dan higienis. Pada perempuan, gangguan fungsi berkemih ini sering kali didapatkan pasca-operasi koreksi kelainan Prolaps Organ Panggul (POP). Inkontinensia Urin Tekanan de novo (IUT de novo) adalah IU yang terjadi pada pasien POP pasca-operasi pervaginam yang tidak didapatkan sebelum operasi.Tujuan: Untuk mengetahui kejadian IUT de novo dan faktor risiko yang berhubungan pada pasien POP pasca-operasi pervaginam di Divisi Uroginekologi dan Rekonstruksi Departemen Obstetri dan Ginekologi RSCM Jakarta.Metode: Studi klinis potong lintang yang dilakukan pada 75 orang pasien POP pasca-operasi pervaginam di Divisi Uroginekologi dan Rekonstruksi Departemen Obstetri dan Ginekologi RSCM Jakarta pada bulan Januari 2016 sampai Juli 2017. Penilaian kejadian IUT de novo dan faktor risiko yang berperan dilakukan berdasarkan data Rekam Medik, lembar penilaian Kuesioner QUID (Questionnaire for Urinary Incontinence Diagnosis) versi Indonesia dan dikonfirmasi dengan pemeriksaan Cough Stress Test secara kualitatif dan tes pembalut pad test secara kuantitatif.Hasil: Dari 75 subyek penelitian didapatkan angka kejadian IUT de novo sebesar 8% (6/75). Uji analisis statistik menunjukkan hanya 2 faktor risiko yang berperan secara bermakna (p < 0,05) terhadap kejadian IUT de novo pada pasien POP pasca-operasi pervaginam di RSCM Jakarta, yaitu derajat POP yang berat dan penyakit Diabetes Mellitus dengan nilai OR 0,13 (95% CI 0,02-1,63) dan 23,75 (95%CI 2,29-590,2).Kesimpulan: Pada penelitian ini, angka kejadian IUT de novo pada pasien POP pasca-operasi pervagnam adalah 8% dengan faktor risiko yang berperan adalah derajat POP preoperatif yang berat dan penyakit Diabetes Mellitus.

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Background: Stress Urinary Incontinence remains a main women's health problem due to its devastating impacts to the quality of life. Some patients with pelvic organ prolapse (POP) may suffer from stress urinary incontinence (SUI) named de novo SUI after pelvic floor reconstruction2. The epidemiology study of de novo SUI in Indonesia is not known yet. In the world, a few studies have reported a wide range (2-43%) in incidence of de novo SUI following surgical repair of POP in previously continent patients. This study aimed to investigate the occurrence of de novo SUI and determined related risk factors after vaginal surgery on POP patients in Ciptomangunkusumo Hospital Jakarta. Methods: This is a cross-sectional study of 108 patients who underwent pelvic floor vaginal surgery due to pelvic organ prolapse (POP) at the Department of Obstetry and Gynecology, Urogynecology and Recontruction Division in Indonesian University-Ciptomangunkusumo Hospital from January 2016 to December 2017. According to the inclusion and exclusion criteria, 75 patients were enrolled in the study with consecutive sampling technique. The occurrence of de novo SUI was determined 6-12 months postoperatively by using Indonesian version of Questionnaire for Urinary Incontinence Diagnosis (QUID), and objectively by positive Cough Stress Test (CST) during gynecological examination after negative Preoperative Prolapse Reduction Stress Test (PPRST). The clinical characteristic of positively de novo SUI patients identified were age, parity, Body Mass Index, menopause periode before surgery, degree of Pelvic Organ Prolapse based on POP-Q system, type of vaginal surgery and clinical result of Diabetes Mellitus. Thes significant risk factors that contribute for the occurrence of de novo SUI determined by multivariate statistical analysis (95% CI and 𝛼 0.05).Results: The occurrence of de novo SUI was 8% or 6 from 75 patiens 6-7 month postoperative for pelvic floor reconstruction due to POP. Average of age, parity, BMI, menopause periode before surgery, respectively were 56.17 ± 4.67, 3.17 ± 1.07, 28.58 ± 5.18, and 12,8 ± 7,0. There were 50,0% (3/6) patients with severe degree of POP and 50% (3/6) with mild degree of POP with most of them 66,7% (4/6) had underwent non colpocleisis procedure for POP reconstruction. All of the patient but one were positively Diabetes Mellitus according to clinical hystory and laboratory finding, and most of them about 83,3% (5/6) were in menopause state. There were two significant risk facors that contribute to the occurrence of de novo SUI which are severe degree of preoperative POP (p 0.038; OR 0.13 95% CI 0,02-0,63) and Diabetes Mellitus (p 0.02; OR 23.75 95% CI 2.29-590.2).Conclusion: The occurrence of de novo SUI after vaginal surgery of Pelvic Organ Prolapse patients in Ciptomangunkusumo Hospital Jakarta was 8%. Most of them were average of age < 60 years old, parity < 4, non- obese women, in menopausal periode, and diabetic patient. The determinant significant risk factors contribute to the occurrenceof de novo SUI were evere degree of preoperative POP and Diabetes Mellitus."

"Inkontinensia urin tekanan (IUT) merupakan kondisi bocornya urin saat tekananintrabdominal meningkat. Tatalaksana konservatif seperti latihan kegel (LK) yangmerupakan pilihan pertama dalam penanganan kasus IUT. Namun, terdapathambatan seperti kepatuhan yang buruk serta ketidakmampuan pasienmengontraksikan otot panggul, ketika menjalani program LK sehingga mengalamikegagalan dan berlanjut pada tindakan operasi. Penelitian ini bertujuan menyusunbuku panduan LK untuk membantu kepatuhan pasien dalam melakukan LK danmenganalisis luaran subjektif, klinis, kepatuhan, serta kekuatan kontraksi otot dasarpanggul pada pasien yang berlatih LK selama 12 minggu. Penelitian ini memilikidesain eksplorasi sequential mixed-method research yang terdiri atas penelitiankualitatif dan penelitian kuantitatif. Penelitian kualitatif bertujuan menyusun bukupanduan LK baku menggunakan tahapan analyze, design, development,implementation, and evaluation (ADDIE) dan penelitian kuantitatifmengujicobakan buku panduan LK tersebut dalam praktik klinis dan dievaluasiefektivitasnya dalam menangani IUT. Penelitian berlangsung sejak Agustus 2020sampai September 2022, di berbagai rumah sakit seperti RS dr.CiptoMangunkusumo, RS Fatmawati, RSCM Kintani, RS Buah Hati Ciputat danPamulang, RS Prikasih, dan RS YPK Mandiri. Luaran yang dievaluasi padapenelitian kuantitatif adalah gejala subjektif yang diukur berdasarkan kuesionerIIQ-7 dan UDI-6, gejala klinis yang diukur berdasarkan 1-hour pad test, kekuatanotot dasar panggul dengan perineometer, dan kepatuhan pasien. Buku panduan LKberhasil disusun menggunakan metode ADDIE dan diujicobakan pada tahappenelitian kuantitatif. Subjek penelitian adalah 178 pasien IUT dari berbagai rumahsakit dan 148 berhasil mengikuti penelitian hingga selesai. Setelah 12 minggu LKterdapat perbaikan gejala subjektif, gejala klinis, dan kekuatan otot panggul yangbermakna. Tidak ada perbedaan gejala subjektif yang bermakna antara kelompokintervensi dan kontrol. Terdapat perbedaan gejala klinis, kekuatan otot dasarpanggul, dan kepatuhan yang bermakna pada kelompok intervensi dan kontrol.Buku panduan LK yang berhasil disusun menggunakan metode ADDIE berhasilmeningkatkan gejala subjektif, klinis, kekuatan otot panggul, dan kepatuhan pasienIUT dalam melakukan LK. Jika dibandingkan kontrol, pasien yang menggunakanbuku panduan LK memiliki perbaikan gejala klinis, peningkatan kekuatan ototpanggul, dan peningkatan kepatuhan yang bermakna.

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Stress Urinary Incontinence (SUI) is a condition in which urine leaks when intraabdominal pressure increases. Worldwide, many women have suffered from SUI. Conservative management, one of which is Pelvic Floor Muscle Training (PFMT), is the first choice in handling IUT cases. However, various obstacles, such as poor compliance and the inability of women to contract the pelvic muscles, are often encountered by women undergoing the PFMT program. They would be likely to fail and undergo surgery. This study aimed to create a PFMT Guidebook and evaluate the effectiveness in improving subjective, clinical, compliance, and pelvic floor muscle contraction of SUI women after twelve weeks. This study was an exploratory sequential mixed-method research design consisting of qualitative and quantitative research. This qualitative study aims to compile a standardized PFMT guidebook using the ADDIE stage and quantitative research to test the PFMT guidebook in clinical practice and evaluate its effectiveness in dealing with SUI. This process took place from August 2020 untill September 2022 in various hospital centers such as CiptoMangunkusumo Hospital, Fatmawati Hospital, Kintani RSCM, Buah Hati Pamulang and Ciputat Hospitals, Prikasih Hospital, and YPK Mandiri Hospital. The outcomes evaluated in this quantitative study were subjective symptoms measured by the IIQ-7 and UDI-6 questionnaires, clinical symptoms measured by the 1-hour pad test, pelvic floor muscle strength using a perineometer, and patient compliance. ADDIE method helped us to create a PFMT guidebook. There were 178 SUI women from various hospitals recruited. 148 of them successfully followed this study to completion. After 12 weeks of PFMT, compared to the control group, there was no difference in clinical symptoms. There were significant differences in clinical symptoms, pelvic floor muscle strength, and adherence between the intervention and study groups. The PFMT guidebook created using the ADDIE method improved subjective, clinical symptoms, pelvic muscle strength, and SUI patient compliance in performing PFMT. Compared with controls, patients who used the PFMT manual significantly improved clinical symptoms, increased pelvic muscle strength, and increased compliance."