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"[ABSTRAKLatar Belakang : Inkontinensia urin sampai saat ini masih menjadi masalah bagimasyarakat dunia. Telah ada tiga penelitian yang membandingkan penurunanleher kandung kemih pada kelompok inkontinensia urin jenis stres dankontinensia. Namun penelitian mengenai perbandingan tersebut belum ada diIndonesia sementara hasil penelitian yang telah ada belum dapat digeneralisirpada populasi di Indonesia. Berdasarkan hal tersebut peneliti ingin mengetahuiapakah terdapat perbedaan rerata penurunan leher kandung kemih kelompokinkontinensia urin jenis stres dan kontinensia di Indonesia dengan perbedaan padatiga buah aspek, yaitu aspek penegakan diagnosis, kelompok pembanding, danpengukuran.Tujuan : Menganalisis perbedaan rerata mobilitas leher kandung kemih padainkontinensia urin jenis stres dan kontinensia.Metode : Penelitian ini merupakan penelitian observasional. Untuk menjawabpertanyaan penelitian utama dan tambahan digunakan desain deskriptif potonglintang. Populasi target dalam penelitian ini adalah semua perempuan yangmengalami inkontinensia urin jenis stres dan kontinensia di Indonesia. Populasiterjangkau penelitian ini adalah semua perempuan yang mengalami inkontinensiaurin jenis stres dan kontinensia masing-masing 37 orang yang berobat ke UnitRawat Jalan Poliklinik Ginekologi RSCM periode Februari 2014 sampai Januari2015.Hasil : Rerata jarak leher kandung kemih ke simfisis pubis saat istirahat, saatvalsava dan mobilitas leher kandung kemih pada inkontinensia urin jenis stresberturut-turut adalah 26,9 ( SB 3,2) mm, 5 ( -29 - 22) mm dan 24,3 (SB 7,9) mm.Rerata jarak leher kandung kemih ke simfisis pubis saat istirahat, saat valsava danmobilitas leher kandung kemih pada kontinensia berturut-turut adalah 26,9 (SB3,2) mm, 17,6 (SB 5,3) mm dan 10 (SD 4,1) mm. Rerata jarak leher kandungkemih ke simfisis pubis saat valsava pada inkontinensia urin jenis stres lebih kecildibandingkan kontinensia 6,3 (SB 7,1) mm VS 16,3 (SB 5,2) mm, p=0,0001.Rerata mobilitas leher kandung kemih pada inkontinensia urin jenis stres lebihbesar dibandingkan kontinensia 20,8 ( SB 7,0) mm VS 10,0 (SD 4,8) mm,p=0,0001.Kesimpulan : Rerata jarak leher kandung kemih ke simfisis pubis saat valsavapada inkontinensia urin jenis stres lebih kecil dibandingkan kontinensia. Reratamobilitas leher kandung kemih pada inkontinensia urin jenis stres lebih besardibandingkan kontinensia.

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ABSTRACTBackground : Stress urinary incontinence still be the world problem. Variousstudies compared decreasing bladder neck on stress urinary incontinence andcontinence have been done. Research with the same purpose has not been done inIndonesia. Based on that, need to study how the comparison decreasing ofbladder neck between stress urinary incontinence and continence groups inIndonesia with a difference in three aspects, such as diagnostic criteria,comparised group, and the observer.Aim : To analize difference bladder neck mobility on stress urinry incontinenceand continence.Methods : This study was an observational study. Main and additional researchquestions using a cross-sectional design . The target population in this study wereall women who undergo stress urinary incontinence and continence in Indonesia .The population of this study was affordable to all women who undergo stressurinary incontinence and continence were treated to the Outpatient Clinic ofGynecology Unit of Ciptomangunkusumo Hospital in the period Februari 2014 toJanuary 2015.Results : Mean of distance of bladder neck to the symphysis pubic at rest, valsavaand bladder neck mobility on stress urinary incontinence were 26,9 (SD 3,2) mm,5 (-29 - 22) mm and 24,3 (SD 7,9) mm. Mean of distance of bladder neck to thesymphysis pubic at rest, at valsalva and bladder neck mobility on continence were26,9 (SD 3,2) mm, 17,6 (SD 5,3) mm and 10,0 (SD 4,1) mm. There was nodifferences between the distance of bladder neck to the symphysis pubic at rest onstress urinary incontinence and continence 27,1 (SD 3,3) mm VS 26,3 (SD 3,5)mm, p=0,523. Mean of distance of bladder neck to the symphysis pubic atvalsava on stress urinary incontinenc was lower than continence 6,3 (SD 7,1) mmVS 16,3 (SD 5,2) mm, p=0,0001. Mean of bladder neck mobility on stress urinaryincontinence was greater than continence 20,8 ( SD 7,0) mm VS 10,0 (SD 4,8)mm, p=0,0001.Conclusion : Mean of distance of the bladder neck to the symphysis pubic atvalsava on stress urinary incontinenc was lower than continence. Mean ofbladder neck mobility on stress urinary incontinence was greater than continence, Background : Stress urinary incontinence still be the world problem. Variousstudies compared decreasing bladder neck on stress urinary incontinence andcontinence have been done. Research with the same purpose has not been done inIndonesia. Based on that, need to study how the comparison decreasing ofbladder neck between stress urinary incontinence and continence groups inIndonesia with a difference in three aspects, such as diagnostic criteria,comparised group, and the observer.Aim : To analize difference bladder neck mobility on stress urinry incontinenceand continence.Methods : This study was an observational study. Main and additional researchquestions using a cross-sectional design . The target population in this study wereall women who undergo stress urinary incontinence and continence in Indonesia .The population of this study was affordable to all women who undergo stressurinary incontinence and continence were treated to the Outpatient Clinic ofGynecology Unit of Ciptomangunkusumo Hospital in the period Februari 2014 toJanuary 2015.Results : Mean of distance of bladder neck to the symphysis pubic at rest, valsavaand bladder neck mobility on stress urinary incontinence were 26,9 (SD 3,2) mm,5 (-29 - 22) mm and 24,3 (SD 7,9) mm. Mean of distance of bladder neck to thesymphysis pubic at rest, at valsalva and bladder neck mobility on continence were26,9 (SD 3,2) mm, 17,6 (SD 5,3) mm and 10,0 (SD 4,1) mm. There was nodifferences between the distance of bladder neck to the symphysis pubic at rest onstress urinary incontinence and continence 27,1 (SD 3,3) mm VS 26,3 (SD 3,5)mm, p=0,523. Mean of distance of bladder neck to the symphysis pubic atvalsava on stress urinary incontinenc was lower than continence 6,3 (SD 7,1) mmVS 16,3 (SD 5,2) mm, p=0,0001. Mean of bladder neck mobility on stress urinaryincontinence was greater than continence 20,8 ( SD 7,0) mm VS 10,0 (SD 4,8)mm, p=0,0001.Conclusion : Mean of distance of the bladder neck to the symphysis pubic atvalsava on stress urinary incontinenc was lower than continence. Mean ofbladder neck mobility on stress urinary incontinence was greater than continence]"

"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: Meningkatnva populasi usia laniut. masalah kesehatan pada kelompok usia tersebut juga meningkat. Salah satu masalah kesehatan vane sering dijumpai adalah inkontinensia urin tine sires (IUS). Beberapa nenelitian telah dilakukan untuk melihat faktor- faktor risiko terjadinva IUS, tetapi hasilnva tidak konsisten.Tuiuan: Mengetahui hubungan antara usia, riwayat cara persalinan, jumlah persalinan lama menopause dan IMT dengan IUS pada perempuan usia laniut di RSCM Jakarta.Metodologi: Disain penelitian potong-lintang. Subyek pada perempuan >60 tahun yang memenuhi kriteria inklusi. Inkontinensia Urin tine Sires dinilai dari anamnesis, pemeriksaan fisik serta pemeriksaan kontraksi vagina dengan nerineometri.Hasil: Didapatkan hasil 35 kasus dan 47 kontrol. Subyek penelitian dengan usia >75 tahun didapatkan 8 (53.3%) IUS riwayat cara persalinan mengalami tindakan didapatkan 18 150.0%) IUS. jumlah persalinan lebih dari 2 kali didapatkan 30 (43,5%) IUS lama menopause lebih dari 7 tahun didapatkan 35 (45,5%) IUS, IMT ~ 26 didapatkan 14 (58.3%) IUS. Dilakukan analisis bivariat didapatkan hasil antara usia dan IUS dengan OR 1.69 (IK 95% 0.55 - 5.22).. antara riwavat cara persalinan dan IUS dengan OR 1,71 (TTY 95% 0.70 ? 4.14) antara iumlah persalinan dan MS dengan OR 1.23 (IK 95% 0.37 - 4.15). antara IMT > 26 dan IUS dengan OR 2.47 (IK 95% 0,93 - 6.52). Lama menopause tidak dapat dianalisis karena tidak didapatkan lama menopause < 7 tahun harus mengalami IUS. Seluruh variabel hasil analisis bivariat vane memiliki p mendekati 0.25 diikutsertakan dalam analisis multivariat. Setelah dilakukan analisis multivariat dengan regresi logistik didapatkan hanva IMT vane tampaknva berhubunsan denaan IUS (OR 2.9911K 95% 1.07-8.361)Simpulan: Indeks massa tubuh merunakan faktor risiko teriadinva IUS.

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Background: The increase of elderly nonulation leads to the increase of health problems among those who belongs to this population. Stress urinary incontinence (SUI) is one of many problems which is frequently found. Several studies have been carried out to detect risk factors for SUI. but the results were still inconsistent.Objective: To assess the relationship between age. types of delivery. Parity, menopausal period, and BM1 with SU1 in elderly women at Cipto Mangunkusumo Hospital, Jakarta.Method: A cross-sectional study of elderly women > 60 years who met the inclusion criteria. SUI was evaluated from interviews. physical examinations and vaginal contractions measured with a perineometer.Results: This study comprised 35 cases and 47 controls. SUI were detected in 8 (53.3%) of subjects who were > 75 years, in 18 (50.0%) of those who had intervention during delivery. in 30 (43,5%) of those who had parity > 2. in 35 (45.5%) of those who had had menopause > 7 years. and in 14 (58.3%) of those with BMI > 26. Bivariate analyses were performed and the results are OR 1,69 (95% CI 0.55-5.22) between age and SUL _ OR 1.71 (95% CI 0.70 - 4.14) between tunes of delivery and SUL OR L23 (95% CI 0,37 - 4.15) between parity > 2 and SU1. OR 2.47 (95% CI 0,93 - 6.521 between BM1 > 26 and Slll, Menopausal period could not be analyzed because no subjects who had less than 7 year - period of menopause was found to have SUI. Variables which had p close to 0.25 in bivariate analyses were measured in multivariate analyses with logistic regression. Those variables were types of delivery and BMI. As a result BMI was the only variable which was related to SUI (OR 2.99[95% CI 1,07-8,36 ).Conclusion: BM1 is a risk factor for SUI"

"Inkontinensia urin tekanan sering ditemukan padakehamilan dengan prevalensi tertinggi pada empat minggu terakhir kehamilan. Diketahui bahwa kelemahan otot dasar panggul merupakan salah satu penyebab inkontinensia urin tekanan. Penelitian ini bertujuan untuk mengetahui hubungan kekuatan otot dasar panggul dengan inkontinensia urin tekanan pada perempuan hamil trimester ketiga akhir, dan faktor-faktor yang mempengaruhinya. Penelitian ini menggunakan desain potong lintang dengan melibatkan perempuan hamil 36-40 minggu di poli Obstetri dan Ginekologi RSUK TebetJakarta. Data yang diperoleh berupa hasil anamnesis, Questionnaire for Urinary Incontinence Diagnosis QUID , pemeriksaan fisik, perineometer, dan tes batuk. Sampel berjumlah 142 orang dengan 54,2 diantaranya mengalami inkontinensia urin tekanan. Diketahui bahwa kekuatan otot dasar panggul dan taksiran berat janin memiliki perbedaan bermakna dengan inkontinensia urin tekanan p = 0,002, < 0,001, secara berurutan . Uji multivariat menunjukkan bahwa kekuatan otot dasar le; 25,5 cmH2O panggul dan TBJ ge; 3.100 gram paling mempengaruhi kejadian inkontinensia urin tekanan OR = 2,52, p= 0,021 dan OR = 3,34, p= 0,001, secara berurutan . Uji probabilitas menunjukkan bahwa apabila TBJ >3.100 gram dan kekuatan otot dasar panggul

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Stess urinary incontinence is the most frequent found during pregnancy with the highest prevalence in the last four weeks of pregnancy. It is known that weaken pelvic floor muscle is one of the causes of stress urinary incontinence. This study aims to know the relationship between the strength of pelvic floor muscle and stress urinary incontinence in late third trimester of pregnancy and its associated factors.A cross sectional study was conducted involving women with 36 until 40 weeks of pregnancy at Obstetric and Gynecology clinic of Tebet Subdistrict Hospital, Jakarta. Collected data included medical interview, Questionnaire for Urinary Incontinence Diagnosis QUID , physical examination, perineometer, and cough test. Among 142 samples, 54.2 had stress urinary incontinence. Discovered that pelvic floor muscle, and estimated fetal weight had significant differences with SUI p 0.002, 0.001, respectively . Multivariate analysis showed the strength of pelvic floor muscle le 25.5 cmH2O , and EFW ge 3,100 gram were the most influenced factors for SUI OR 2.52, p 0.021 dan OR 3.34, p 0.001, respectively . The likelihood of SUI was 75.39 if the strength of PFM was le 25.5 cmH2O,and EFW ge 3,100 gram. Weaken pelvic floor muscle, and EFW were the factors influencing SUI. "

"ABSTRAKInkontinensia urin sering ditemukan pada 50% wanita yang berusia dibawah 60. Yang terbanyak adalah inkontinensia urin jenis tekanan (IUT) sebesar 49%. Diketahui bahwa kelemahan otot dasar panggul merupakan salah satu penyebab inkontinensia urin jenis tekanan. Penelitian ini bertujuan untuk mengkaji hubungan antara kekuatan otot dan ketebalan otot levator ani dengan keluhan IU-T pada perempuan. Penelitian ini menggunakan desain Comparative Cross Sectional dengan melibatkan wanita yang berkunjung di poliklinik Obstetri dan Ginekologi RSUPN Dr. Cipto Mangunkusumo dengan kelompok studi adalah subyek dengan tes batuk positif sedangkan kelompok kontrol adalah subyek dengan tes batuk negative. Data yang diperoleh berupa hasil anamnesis, Questionnaire for Urinary Incontinence Diagnosis (QUID), pemeriksaan fisik (POPQ), tes batuk. perineometer, dan USG. Sampel berjumlah 82 orang. Hasil penelitian ini didapatkan tidak ada perbedaan bermakna antara ketebalan otot levator ani terhadap kejadian IUT dengan median ketebalan otot levator ani 0,63 cm (range 0,31-1,02 dan p=0,897). Sedangkan kekuatan otot levator ani terhadap IUT memiliki median 19,5 (range 4,6-88,6 dan p=0,001). Pada analisis multivariat didapatkan bukti bahwa secara murni IUT, prolap dan usia tidak mempunyai pengaruh bermakna terhadap kekuatan otot levator ani dengan nilai p masing-masing 0,243; 0,844; 0,903.

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ABSTRACTUrinary incontinence is often found in 50% of women under the age of 60. The most common is pressure type urinary incontinence (IUT) of 49%. It is known that pelvic floor muscle weakness is one of the causes of pressure type urinary incontinence. This study aims to examine the relationship between muscle strength and levator ani muscle thickness with IU-T complaints in women. This study uses a Comparative Cross Sectional design by involving women visiting the Obstetrics and Gynecology clinic of RSUPN Dr. Cipto Mangunkusumo with the study group were subjects with positive cough tests while the control group were subjects with negative cough tests. The data obtained in the form of history taking, Questionnaire for Urinary Incontinence Diagnosis (QUID), physical examination (POPQ), cough test. perineometer, and ultrasound. A sample of 82 people. The results of this study found no significant difference between the levator ani muscle thickness to the incidence of IUT with the median levator ani muscle thickness 0.63 cm (range 0.31-1.02 and p = 0.897). While levator ani muscle strength against IUT has a median of 19.5 (range 4.6-88.6 and p = 0.001). In multivariate analysis it was found that purely IUT, prolapse and age had no significant effect on the strength of levator ani muscles with a p value of 0.243 each; 0.844; .903."

"ABSTRAK Inkontinensia urin tekanan sering ditemukan padakehamilan dengan prevalensi tertinggi pada empat minggu terakhir kehamilan. Diketahui bahwa kelemahan otot dasar panggul merupakan salah satu penyebab inkontinensia urin tekanan. Penelitian ini bertujuan untuk mengetahui hubungan kekuatan otot dasar panggul dengan inkontinensia urin tekanan pada perempuan hamil trimester ketiga akhir, dan faktor-faktor yang mempengaruhinya. Penelitian ini menggunakan desain potong lintang dengan melibatkan perempuan hamil 36-40 minggu di poli Obstetri dan Ginekologi RSUK TebetJakarta. Data yang diperoleh berupa hasil anamnesis, Questionnaire for Urinary Incontinence Diagnosis QUID , pemeriksaan fisik, perineometer, dan tes batuk. Sampel berjumlah 142 orang dengan 54,2 diantaranya mengalami inkontinensia urin tekanan. Diketahui bahwa kekuatan otot dasar panggul dan taksiran berat janin memiliki perbedaan bermakna dengan inkontinensia urin tekanan p = 0,002, < 0,001, secara berurutan . Uji multivariat menunjukkan bahwa kekuatan otot dasar le; 25,5 cmH2O panggul dan TBJ ge; 3.100 gram paling mempengaruhi kejadian inkontinensia urin tekanan OR = 2,52, p= 0,021 dan OR = 3,34, p= 0,001, secara berurutan . Uji probabilitas menunjukkan bahwa apabila TBJ >3.100 gram dan kekuatan otot dasar panggul ABSTRACT Stess urinary incontinence is the most frequent found during pregnancy with the highest prevalence in the last four weeks of pregnancy. It is known that weaken pelvic floor muscle is one of the causes of stress urinary incontinence. This study aims to know the relationship between the strength of pelvic floor muscle and stress urinary incontinence in late third trimester of pregnancy and its associated factors.A cross-sectional study was conducted involving women with 36 until 40 weeks of pregnancy at Obstetric and Gynecology clinic of Tebet Subdistrict Hospital, Jakarta. Collected data included medical interview, Questionnaire for Urinary Incontinence Diagnosis QUID , physical examination, perineometer, and cough test. Among 142 samples, 54.2 had stress urinary incontinence. Discovered that pelvic floor muscle, and estimated fetal weight had significant differences with SUI p = 0.002, < 0.001, respectively . Multivariate analysis showed the strength of pelvic floor muscle le; 25.5 cmH2O , and EFW ge; 3,100 gram were the most influenced factors for SUI OR = 2.52, p = 0.021 dan OR = 3.34, p = 0.001, respectively . The likelihood of SUI was 75.39 if the strength of PFM was le; 25.5 cmH2O,and EFW ge; 3,100 gram. Weaken pelvic floor muscle, and EFW were the factors influencing SUI."

"ABSTRAK Tingkat Kesesuaian Dan Penerimaan Subjek Terhadap Uji Pembalut 20 Menit Dibandingkan 60 Menit Sebagai Metode Pengukuran Derajat Keparahan Inkontinensia Urin Tipe TekananKadek Fajar Marta, Fernandi MoegniDivisi uroginekologi dan rekonstruksi, Fakultas Kedokteran, Universitas Indonesia AbstrakMengingat prevalensi yang tinggi dan efek negatif dari SUI maka perlu dilakukan penanganan yang tepat. Pemilihan terapi sangat tergantung dari penilaian derajat keparahan SUI yang diderita. Diperlukan suatu metode akurat yang secara objektif dapat mengukur derajat keparahan SUI sehingga terapi dapat diberikan secara tepat. Penelitian ini menggunakan desain eksperimen silang sehingga hanya memerlukan satu kelompok sampel yang akan menjadi pembanding bagi dirinya sendiri. Pasien SUI yang terdiagnosis di Poliklinik Uroginekologi Cipto Mangunkusumo, General Hospital, Jakarta, Indonesia dan memenuhi kriteria inklusi, mendapatkan dua kali uji pembalut yaitu uji pembalut 20 menit kemudian uji pembalut 60 menit atau sebaliknya dengan selisih jangka waktu satu minggu dan akan diwawancarai menggunakan kuisioner pada setiap uji pembalut selesai dikerjakan. Kuisioner ini dibuat oleh peneliti dan sebelum digunakan ke subjek penelitian, dilakukan uji coba pada 5 orang pasien perempuan yang didiagnosis SUI. Hasil Kappa R = 0,84 yang menunjukkan uji pembalut 20 menit memiliki uji kesesuaian yang baik dengan uji pembalut 60 menit. Pada tingkat kepuasan didapatkan 25 responden 83,3 mengatakan puas pada uji pembalut 20 menit, bahkan 5 responden 16,7 mengatakan sangat puas. Sedangkan pada uji pembalut 60 menit, 3 responden 10 mengatakan kurang puas dan sisanya mengatakan puas. Terdapat kesesuaian yang baik antara pemeriksaan uji pembalut 20 menit dan 60 menit dalam menilai derajat keparahan inkontinensia urin. Pada pemeriksaan uji pembalut selama 20 menit didapatkan persentase subjek yang menyatakan puas dan sangat puas lebih tinggi dibandingkan dengan uji pembalut selama 60 menit. Kata kunci: Uji pembalut 20 menit, uji pembalut 60 menit, tingkat kesesuaian dan penerimaan subjek ......ABSTRACT Level of agreement and Acceptance of 20 Minute versus 60 Minutes Sanitary Pad Test as a Method of Measuring Severity Degree of Stress Urinary IncontinenceKadek Fajar Marta, Fernandi MoegniUrogynecology Reconstruction Surgery Division, Faculty of Medicine, Universitas Indonesia AbstractLevel of agreement and Acceptance of 20 Minute versus 60 Minutes Sanitary Pad Test as a Method of Measuring Severity Degree of Stress Urinary IncontinenceGiven the high prevalence and negative effects of SUI is necessary to do the appropriate treatment. Selection of therapy depends on the assessment of the severity of SUI. An accurate method is needed which can objectively measure the severity of SUI so that therapy can be administered appropriatelyThis study used cross-experimental design so that it only requires one sample group that will be compared to itself. The subject are SUI patients in Urogynecology Polyclinic Cipto Mangunkusumo, General Hospital, Jakarta, Indonesia and met the inclusion criteria. Two times sanitary pad test was obtained, the first test was 20 minutes pad test and then followed with 60 minutes pad test or vice versa within one-week period. Subjects will be interviewed using questionnaire at the end of each pad test. The questionnaire was prepared by the researcher and a trial was performed on 5 patients prior the use to the subject of the study.Results Kappa R = 0.84 indicating that a 20-minute sanitary pad test had a good level of agreement to 60-minute. On the level of satisfaction, 25 respondents 83,3 stated that they were satisfied with 20 minute pad test and 5 respondents 16,7 stated that they were very satisfied. On the other hand, 3 respondents 10 stated that they were less satisfied with the 60-minute sanitary pad test, and the others was satisfied.There is a good agreement between the 20 minute and 60 minute sanitary pad test in assessing the severity of urinary incontinence. Compared to 60 minutes sanitary pad test, 20 minutes pad test obtained higher percentage of subject rsquo;s satisfaction. Keywords: 20 Minutes Sanitary Pad Test, 60 Minutes Sanitary Pad Test, Stress Urinary Incontinence"

"Latar Belakang: Inkontinensia urin tipe tekanan (IUT) merupakan gangguan uroginekologi yang relatif sering ditemukan pada ibu hamil. Perubahan anatomis, hormonal dan jaringan yang dialami oleh perempuan hamil membuatnya rentan untuk mengalami IUT. IUT secara signifikan dapat mengganggu kualitas hidup ibu hamil. Studi tentang prevalensi IUT telah dilakukan di Indonesia tetapi sampai saat ini belum ada penelitian yang menilai prevalensinya pada perempuan primigravida trimester ketiga akhir yang cenderung lebih rentan mengalami kondisi SUI persisten postpartum. Selain itu, penelitian tentang parameter ultrasonografi (USG) pada pasien IUT pada ibu hamil belum dilakukan di Indonesia. Studi tersebut penting untuk mengetahui prevalensi IUT pada perempuan primigravida akhir trimester ketiga serta hubungan kondisi IUT dengan parameter USG untuk mobilitas leher kandung kemih.Tujuan: Tujuan dari penelitian ini adalah untuk mengetahui prevalensi IUT pada perempuan primigravida trimester ketiga akhir di Jakarta, Indonesia selama periode 1 November 2016 sampai 31 Juli 2019. Penelitian ini juga mengidentifikasi pasien karakteristik yang secara signifikan berkorelasi dengan IUT. Selanjutnya, penelitian ini menguji korelasi antara parameter USG yang terdiri dari penurunan leher kandung kemih (BND), sudut retrovesikal (RVA), sudut rotasi uretra (RoU), dan funneling dengan IUT pada pasien tersebut.Metode: Penelitian ini merupakan bagian dari penelitian besar mengenai penggunaan USG dasar panggul pada perempuan dengan berbagai jenis disfungsi dasar panggul di DKI Jakarta. Sebagian data merupakan data sekunder dari penelitian besar sementara sebagian lainnya dikumpulkan oleh peneliti. Penelitian ini menggunakan metode cross-sectional untuk menemukan prevalensi IUT pada perempuan primigravida trimester ketiga akhir di DKI Jakarta. Kemudian, penelitian cross-sectional komparatif dilakukan untuk pengukuran parameter USG berupa BND, RVA, RoU dan funneling. Diagnosis IUT dilakukan melalui anamnesis, pemeriksaan fisik, serta Kuesioner Diagnosis Inkontinensia Urin (QUID) dan tes batuk stres. Sebanyak 30 subjek yang terdiagnosis IUT dan 30 subjek tanpa IUT yang memenuhi kriteria penelitian dipilih dan dikumpulkan datanya dengan formulir dan database penelitian. Data awalnya dikumpulkan dalam perangkat lunak Microsoft Excel dan kemudian diperiksa dan diberi kode untuk dianalisis dalam SPSS versi 25 untuk Mac. Data kategoris disajikan sebagai frekuensi (persentase) sedangkan data numerik kontinu disajikan sebagai mean + standar deviasi untuk data yang terdistribusi normal serta median (rentang) untuk data yang tidak berdistribusi normal. Signifikansi statistik dinyatakan sebagai 0,05. Analisis kurva karakteristik receiver-operator digunakan untuk mendapatkan nilai cut-off BND, RVA, dan RoU yang secara signifikan berhubungan dengan IUT antara sensitivitas dan spesifisitasnya. Analisis bivariat dilakukan untuk membandingkan faktor risiko IUT yang signifikan secara statistik. Pearson chi-square atau uji eksak Fisher digunakan untuk analisis bivariat kategoris sementara uji T tidak berpasangan atau Mann Whitney digunakan untuk analisis perbedaan rerata. Analisis multivariat menggunakan regresi logistik kemudian dilakukan untuk mengidentifikasi faktor risiko independen IUT dan untuk mendapatkan rasio odds yang disesuaikan dari prediktor.

Hasil: dari 209 perempuan primigravida trimester ketiga akhir, inkontinensia urin tipe tekanan diamati pada 57 pasien, sehingga prevalensinya sebesar 27,3%. Faktor risiko IUT yang teridentifikasi adalah indeks massa tubuh (IMT) lebih dari 23 kg/m2 (P=0,037), RVA lebih dari 155,020 (P=0,002), serta adanya funneling pada USG translabial. Nilai rerata BND (1,78 + 0,64 cm) dan rerata RVA (158,04 + 14,460) secara signifikan lebih tinggi dibandingkan kelompok non-IUT, dengan P=0,044 dan P=0,001. Sedangkan nilai rerata RoU tidak berbeda bermakna dengan non-IUT. Nilai cut-off untuk BND, RVA, dan RoU yang digunakan untuk mengkategorikan pasien berisiko tinggi masing-masing adalah 1,77 cm, 155,020, dan 27,830. Pada analisis multivariat, hanya IMT (P=0,05, aOR 3,73) dan funneling positif (P=0,03, aOR 4,3) yang terbukti sebagai faktor risiko independen IUT. Prevalensi IUT di antara primigravida trimester ketiga akhir lebih rendah dibandingkan penelitian lain. Faktor risiko IUT yang diidentifikasi dengan data ini sesuai dengan penelitian sebelumnya baik di Indonesia maupun di luar negeri.

Kesimpulan: Prevalensi IUT di antara primigravida trimester ketiga akhir adalah 27,3% dan diperoleh mean serta nilai batas untuk parameter USG BND, RVA dan RoU untuk pasien tersebut. Hanya funneling positif serta IMT yang terbukti menjadi faktor risiko independen IUT.

......Background: Stress urinary incontinence is a relatively common urogynecological disorder in a pregnant women. The gross anatomical as well as hormonal and tissue changes encountered by pregnant women posed themselves prone to acquire SUI. SUI can significantly disrupts pregnant women’s quality of life. Studies about the prevalence of SUI have been conducted in Indonesia but up to now, there is no study assessing its prevalence on late third trimester primigravid women which are likely more prone to have persistent condition after the delivery. Besides, study about the ultrasound parameters in SUI patients among pregnant women has not been conducted in Indonesia.

Purpose: The aim of this study is to find the prevalence of SUI among late third trimester primigravid women in Jakarta, Indonesia during the period of November, 2016 until July, 2019. This study also attempts to identify the patients’ characteristics that significantly correlate with SUI. Furthermore, this study examines the correlation between ultrasound parameters comprising of bladder neck descent (BND), retrovesical angle (RVA), rotational of urethra (RoU), and funneling with SUI in such patients.

Method: This study is part of a study about the utilization of pelvic ultrasonography for patients with various pelvic floor dysfunction in the Greater Jakarta region. Some parts of the data were secondary data obtained from the main studies while the rest were collected by the author herself. This study employs a descriptive-observational cross-sectional method for the investigation of SUI prevalence in the late third trimester primigravid women from the cohort. Furthermore, a comparative cross-sectional study was conducted involving a total of 60 subjects which were equally divided into two groups, the SUI group and non-SUI group. The diagnosis of SUI was conducted through history taking, physical examination, as well as Questionnaire for Urinary Incontinence Diagnosis (QUID) and stess cough test. The subjects of each group were consecutively selected from the cohort and their anthropological, clinical, as well as recent BND, RVA, RoU and funneling data from ultrasound records were collected. Data were initially collected in a Microsoft Excel software and then were checked and coded to be analyzed in SPSS version 25 for Mac. Categorical data were presented as number (percentage) while continuous numeric data were presented as mean + standard deviation for normally distributed data as well as median (range) for data with no normal distribution. Statistical significance was stated as 0,05. A receiver-operator characteristics curve analysis was employed to obtain the cut-off value of BND, RVA, and RoU which were significantly associated with SUI among with their sensitivity and specifity. Bivariate analysis was conducted to compare the statistically significant risk factors of SUI. Pearson chi-square or Fisher exact test were used for categorical bivariate analysis while unpaired T-test or Mann Whitney were used for mean difference analysis.  Multivariate analysis using logistic regression were then conducted to identify the independent predictors of SUI and to obtain the adjusted odds ratio of the predictors.

Results: from 209 late third trimester primigravid women, stress urinary incontinence was observed in 57 patients, giving the prevalence of 27,3%. The identified risk factors of SUI were a body mass index more than 23 kg/m² (P=0,037), RVA of more than 155,02 degrees (P=0,002), as well as the presence of funneling in the translabial ultrasound. The mean value of BND (1,78 + 0,64 cm) as well as mean RVA (158,04 +14,46 degrees) were significantly higher than that of control group, with P=0,044 and P=0,001 respectively. Meanwhile, mean RoU value were not significantly different with control. The cut-off value for BND, RVA, and RoU which were used to categorize patient as high-risk were 1,77 cm, 155,02 degrees, as well as 27,83 degrees respectively. In the multivariate analysis, only BMI (P=0,05, aOR 3,73) and positive funneling (P=0,03, aOR 4,3) which were shown to be independent predictors of SUI. The prevalence of SUI among late third trimester primigravid were lower than that of other studies. The risk factors of SUI identified with this data were in accordance with the other previous studies from Indonesia as well as overseas.

Conclusion: The prevalence of SUI among the cohort of late third trimester primigravid was 27.3 percent and the mean as well as cut-off values for ultrasound parameter of BND, RVA and RoU for such patients were obtained. Only positive funneling as well as BMI were shown to be the independent risk factors of SUI."