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ABSTRAK
LATAR BELAKANG: perawatan kandung kemih dan pencegahan retensio urin postpartum sangatlah penting, apabila tidak dikenali secara baik, maka dapat berkembang menjadi kerusakan kandung kemih yang permanen akibat distensi yang berlebihan yang mengakibatkan denervasi. Hal ini akan menyebabkan terjadinya peningkatan resiko infeksi saluran kemih dan kerusakan saluran kencing bagian atas. Tatalaksana retensio urin saat ini adalah dengan melakukan kateterisasi. Penggunaan kateterisasi sangat bervariasi pada beberapa panduan praktek klinik. Selain kateterisasi, saat ini prostaglandin telah terbukti mampu menyebabkan terjadinya kontraksi otot polos kandung kemih sehingga diharapkan dapat menjadi stimulator kontraksi kandung kemih pada pasien retensi urin pasca persalinan pervaginam. TUJUAN: menentukan efektifitas prostaglandin E1 dan kateterisasi atau kateterisasi saja sebagai terapi pilihan dan kelayakan melalui telaah kritis suatu panduan praktek klinik dalam tatalaksana retensio urin postpartum METODE: Evidence Based Case Report ini melakukan pencarian melalui PubMed, TRIP Database, EBM Online, Clinical Evidence, Cochrane Library dan Google Scholar. Dengan menggunakan strategi pencarian ini, didapatkan 4 artikel pada PubMed, 101 artikel pada TRIP Database, 991 artikel pada EBM online, 687 artikel pada Clinical Evidence, 1 artikel pada Cochrane Library, dan 12600 artikel pada Google Scholar. Dari 21 artikel didapatkan 11 artikel yang berupa panduan praktek klinik dengan keseluruhan berupa naskah lengkap yang akan dilakukan telaah kritis dengan menggunakan AGREE II. HASIL: dari 11 panduan praktek klinik yang dilakukan telaah kritis, tidak ada satu panduan praktek klinik pun yang memperoleh penilaian pada setiap domain penilaian menurut AGREE II. Penilaian pada domain yang menjabarkan proses pengembangan panduan praktek klinik dengan pencarian evidence based, terapi alternatif, dan kebebasan editorial merupakan domain dengan penilaian terendah pada keseluruhan panduan praktek klinik. SIMPULAN: dari 11 panduan praktek klinik yang dilakukan telaah kritis, disimpulkan bahwa terapi untuk retensio urin postpartum yang digunakan saat ini adalah kateterisasi. Penggunaan terapi alternatif seperti prostaglandin tidak didapatkan pada keseluruhan panduan praktek klinik. Hanya saja keseluruhan panduan praktek klinik tidak didukung oleh evidence based yang sistematis sehingga kurang layak untuk dijadikan acuan untuk terapi. Dibutuhkan pencarian evidenced based secara sistematis terutama yang menggunakan desain randomized controlled trial RCT untuk dijadikan rujukan bagi terapi retensio urin postpartum.

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ABSTRACT
Bladder management and prevention of postpartum urinary retetntion are very important, and a failure in recognizing these conditions may lead to permanent bladder injury caused by overdistention which in turn lead to denervation. This may increase the risk of urinary tract infections and upper urinary tract damage. Current management of urinary retention is catherization. Besides catherization, prostaglandin have been proven to be effective in stimulating smooth muscle contraction of the bladder and is a promising alternative management in stimulating bladder contraction in vaginal postpartum urinary retention patients. GOALS to review several guidelines on postpartum urinary retention management METHOD The literature search for this Evidence Based Case Report conducted article from PubMed, TRIP Database, EBM Online, Clinical Evidence, Cochrane Library and Google Scholar were used for article searching. Using this strategy, we obtained 4 articles from PubMed, 101 articles from TRIP Database, 991 articles from EBM online, 687 articles from Clinical Evidence,1 article from Cochrane Library, and 12600 articles from Google Scholar. From 21 articles we found 11 with attached guidelines on its full text, and these articles will be critically reviewedusing AGREE II. RESULTS From 11 guidelines that have been critically reviewed, not one guideline had an appropriate score in each assessment domain according to AGREE II. Guideline development using evidence based materials, alternative management and editorial freedom were the lowest scored domains in general. CONCLUSION From the 11 guidelines that have been critically reviewed, we concluded that the current management of postpartum urinary retention is catherization. Alternative managements such as prostaglandin usage are not present in current guidelines. In general, current guidelines are not supported by systematic evidence based materials, rendering them less reliable to be used as the basis for management. A systematic evidence based search, especially randomized controlled trial RCT , is needed for references of postpartum urinary retention management.

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ABSTRAK
Latar belakang: Tesis ini bertujuan untuk mengetahui insidens retensio urin pasca rekonstruksi POP dan faktor-faktor yang berhubungan.Retensio urin merupakan komplikasi akut tindakan rekonstruksi dan banyak dijumpai pada prosedur operasi, termasuk operasi POP (POP). Untuk menghindari morbiditas lebih lanjut, penelitian ini bertujuan untuk mengetahui insidens rertensio urin pasca rekonstruksi POP faktor-faktor risiko yang berhubungan. Metode: Penelitian ini adalah penelitian kohort prospektif yang dilaksanakan di RS Cipto Mangunkusumo dan RS Fatmawati dengan mengikutsertakan wanita yang hendak mengalami rekonstruksi POP dalam rentang waktu April 2013 hingga April 2015. Kriteria inklusi dan eksklusi subjek meliputi wanita dengan POP derajat 2,3 dan 4 tanpa riwayat retensio urin sebelumnya, konsumsi obatobatan yang dapat menyebabkan retensio urin dan tanpa cedera kandung kemih. Pasca rekonstruksi, subjek dilakukan pemasangan kateter urin selama 24 jam. Kemudian, enam jam pasca pelesapan kateter, dilakukan pengukuran residu urin pada kandung kemih. Retensio urin didefinisikan dengan didapatkannya residu urin >100 ml. Hasil: Dari 200 subjek, ditemukan 59 subjek (29,5%) mengalami retensio urin. Tidak ada hubungan antara faktor risiko umur, Indeks Massa Tubuh (IMT), derajat POP, derajat sistokel, kejadian infeksi saluran kemih, dan durasi operasi terhadap retensio urin. Jenis prosedur total vagina hysterectomy + kolporafi anterior + kolpoperineorafi + sacrospinous fixation dan durasi operasi > 130 menit berhubungan dengan retensio urin dengan RR 3,66 95% IK 2,91-4,60 p<0,001 dan 1,66 95%IK 1,07-2,59 p=0,02, berturut-turut Kesimpulan: Insidens retensio urin cukup tinggi pasca rekonstruksi POP. Jenis tindakan rekonstruksi tertentu dan semakin lamanya durasi rekonstruksi berhubungan dengan kejadian retensio urin.ABSTRACT
Background: The objective of this study was to know the incidence of post operativeurinaryretention after pelvic organ prolapse surgery and associated factors.Post operative urinary retention (POUR) is considered as an acute complication after a surgey in many operative procedures, including pelvic organ prolpase (POP) surgery. To avoid further morbidity, this study aimed to know the incidence of POUR after POP surgery and its risk factors. Methods: This is a prospective cohort study conducted in Cipto Mangunkusumo hospital and Fatmawati Hospital from April 2013 to April 2015. Subjects were women who wanted to undergo POP surgery with two to four degree of POP. Subjects with history of urinary retention, drugs consumption that tend to cause urinary retention or bladder unjury were excluded. After the reconstruction, urinary catheter was placed for 24 hours. Then, after six hours, catheter was removed and residual urine was measured. Urinary retention was defined as residual urine more than 100 ml. Results: Of 200 subjects recruited, 59 (29.5%) had POUR. There were no association between age, body mass index, degree of uterine POPe, degree of cystocele, urinary tract infectionand POUR. Duration of surgery > 130 minute and Total vagina hysterectomy +anterior colporraphy + colpoperineorraphy + sacrospinous fixation procedure and duration of surgery > 130 minute were associated with POUR (RR 3.66, 2.91-4.60 95% CI, p<0.001 and 1.66 , 072.5995%CI, p=0.02; respectively) Conclusion: POUR incidence after POP surgery was quite high. Type of the procedure and duration of surgery were associated with POUR. ;Background: The objective of this study was to know the incidence of post operativeurinaryretention after pelvic organ prolapse surgery and associated factors.Post operative urinary retention (POUR) is considered as an acute complication after a surgey in many operative procedures, including pelvic organ prolpase (POP) surgery. To avoid further morbidity, this study aimed to know the incidence of POUR after POP surgery and its risk factors. Methods: This is a prospective cohort study conducted in Cipto Mangunkusumo hospital and Fatmawati Hospital from April 2013 to April 2015. Subjects were women who wanted to undergo POP surgery with two to four degree of POP. Subjects with history of urinary retention, drugs consumption that tend to cause urinary retention or bladder unjury were excluded. After the reconstruction, urinary catheter was placed for 24 hours. Then, after six hours, catheter was removed and residual urine was measured. Urinary retention was defined as residual urine more than 100 ml. Results: Of 200 subjects recruited, 59 (29.5%) had POUR. There were no association between age, body mass index, degree of uterine POPe, degree of cystocele, urinary tract infectionand POUR. Duration of surgery > 130 minute and Total vagina hysterectomy +anterior colporraphy + colpoperineorraphy + sacrospinous fixation procedure and duration of surgery > 130 minute were associated with POUR (RR 3.66, 2.91-4.60 95% CI, p<0.001 and 1.66 , 072.5995%CI, p=0.02; respectively) Conclusion: POUR incidence after POP surgery was quite high. Type of the procedure and duration of surgery were associated with POUR. ;Background: The objective of this study was to know the incidence of post operativeurinaryretention after pelvic organ prolapse surgery and associated factors.Post operative urinary retention (POUR) is considered as an acute complication after a surgey in many operative procedures, including pelvic organ prolpase (POP) surgery. To avoid further morbidity, this study aimed to know the incidence of POUR after POP surgery and its risk factors. Methods: This is a prospective cohort study conducted in Cipto Mangunkusumo hospital and Fatmawati Hospital from April 2013 to April 2015. Subjects were women who wanted to undergo POP surgery with two to four degree of POP. Subjects with history of urinary retention, drugs consumption that tend to cause urinary retention or bladder unjury were excluded. After the reconstruction, urinary catheter was placed for 24 hours. Then, after six hours, catheter was removed and residual urine was measured. Urinary retention was defined as residual urine more than 100 ml. Results: Of 200 subjects recruited, 59 (29.5%) had POUR. There were no association between age, body mass index, degree of uterine POPe, degree of cystocele, urinary tract infectionand POUR. Duration of surgery > 130 minute and Total vagina hysterectomy +anterior colporraphy + colpoperineorraphy + sacrospinous fixation procedure and duration of surgery > 130 minute were associated with POUR (RR 3.66, 2.91-4.60 95% CI, p<0.001 and 1.66 , 072.5995%CI, p=0.02; respectively) Conclusion: POUR incidence after POP surgery was quite high. Type of the procedure and duration of surgery were associated with POUR.

Abstrak :
ABSTRAK
Tesis ini membahas insidens retensi urin pascahisterektomi total per vaginam, dan per abdominam, serta menilai perbandingan insidens retensi urin pada prosedur per vaginam dan per abdominam. Penelitian ini adalah penelitian analitik komparatif dengan desain kohort prospektif dan retrospektif. Hasil penelitian menunjukkan insidens retensi urin tidak meningkat pada histerektomi per vaginam. Dengan hasil ini diharapkan memperbaiki tatalaksana pascahisterektomi per vaginam yang lebih baik. Namun penelitian ini menyarankan bahwa dilakukan penelitian lebih lanjut dengan jumlah sampel yang lebih besar, menggunakan desain kohort prospektif, dan mengukur volume urin pascaberkemih (PVR) preoperatif.

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ABSTRAK
The focus of this study is to establish the incidence of postoperative urinary retention after performing vaginal hysterectomy, and abdominal hysterectomy, also to compare postoperative urinary retention between vaginal and abdominal hysterectomy. This research is comparative analytic interpretive, using design of prospective and retrospective cohort study. The study result is postoperative urinary retention did not increase by vaginal hysterectomy. Knowing this will improve management of postoperative hysterectomy cases. The researcher suggests for the next research will be using prospective cohort, with large amount of samples, and evaluate post-void residual volume (PVR) preoperatively.

Abstrak :
Latar belakang: Prolaps organ panggul (POP) merupakan suatu permasalahan utama kesehatan dengan risiko seumur hidup pada perempuan yang menjalani paling sedikitnya satu kali intervensi pembedahan prolaps. Retensio urin pasca operasi rekonstruksi prolaps organ panggul disebabkan oleh beberapa faktor mulai dari pemeriksaan hingga penanganan pasca operasi yang berkontribusi terhadap terjadinya retensio urin. Penelitian di RSCM tentang penggunaan kateter 24 jam pada pasien pasca operasi prolapse organ panggul terhadap insiden retensio urin adalah sebesar 29,5%. Penelitian ini akan melakukan perbandingan penggunaan kateter 24 jam yang dibandingkan kateter 48 jam terhadap insiden retensio urin yang nantinya akan menjadi standar baku terbaru di RSCM dan RSUD Arifin Achmad Pekanbaru. Tujuan: Untuk mengetahui mana di antara kateter 24 jam dan 48 jam yang lebih baik untuk mengurangi angka kejadian retensio urin pascaoperasi prolaps organ panggul. Metode: Penelitian diagnosa, uji klinis acak, pengambilan sampel berturut-turut. Perbandingan antara kateter 24 jam dan 48 jam setelah operasi prolaps organ panggul Hasil: Total 54 subjek dalam penelitian ini, 3 subjek (11,1%) di antara 27 subjek dengan kateter 24 jam mengalami retensio urin. 1 subjek (3,7%) di antara 27 subjek dengan kateter 48 jam mengalami retensio urin. Kesimpulan: Penggunaan kateter 48 jam pascaoperasi prolaps organ panggul lebih baik daripada kateter 24 jam dalam mengurangi angka kejadian retensio urin. ......Background: Pelvic organ prolapse (POP) is a major health problem with a lifetime risk in women who undergo at least one prolapse surgical intervention. Postoperative retention of urine pelvic organ prolapse reconstruction is caused by a number of factors ranging from examinations to postoperative clients that contribute to the occurrence of urinary retention. Research at the RSCM about 24- hour catheter use in postoperative pelvic organ prolapse patients for the incidence of urinary retention was 29.5%. This study will compare the use of a 24-hour catheter compared to a 48-hour catheter against the incidence of urinary retention which will later become the latest standard in RSCM and RSUD Arifin Achmad Pekanbaru. Objective: To know which one among 24-hour and 48-hour catheter is better to decrease incidence of urinary retention after pelvic organ prolapse surgery. Methode: Diagnosis research, randomized clinical trial, consecutive sampling. Comparison between 24-hour and 48-hour catheter after pelvic organ prolapse surgery Result: Total 54 subjects in this research, 3 subjects (11.1%) among 27 subjects with 24-hour catheter experienced urinary retention. 1 subject (3.7%) among 27 subjects with 48-hour catheter experienced urinary retention. Conclussion: The application of 48-hour catheter after pelvic organ prolapse surgery is beter than 24-hour catheter to decrease the incidence of urinary retention.