Hasil Pencarian  ::  Simpan CSV :: Kembali

"ABSTRAK Latar belakang: Tesis ini bertujuan untuk mengetahui insidens retensio urin pasca rekonstruksi POP dan faktor-faktor yang berhubungan.Retensio urinmerupakan komplikasi akut tindakan rekonstruksi dan banyak dijumpai padaprosedur operasi, termasuk operasi POP (POP). Untuk menghindari morbiditaslebih lanjut, penelitian ini bertujuan untuk mengetahui insidens rertensio urinpasca rekonstruksi POP faktor-faktor risiko yang berhubungan.Metode: Penelitian ini adalah penelitian kohort prospektif yang dilaksanakan diRS Cipto Mangunkusumo dan RS Fatmawati dengan mengikutsertakan wanitayang hendak mengalami rekonstruksi POP dalam rentang waktu April 2013hingga April 2015. Kriteria inklusi dan eksklusi subjek meliputi wanita denganPOP derajat 2,3 dan 4 tanpa riwayat retensio urin sebelumnya, konsumsi obatobatanyangdapat 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 urinpada kandung kemih. Retensio urin didefinisikan dengan didapatkannya residuurin >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 operasiterhadap retensio urin. Jenis prosedur total vagina hysterectomy + kolporafianterior + kolpoperineorafi + sacrospinous fixation dan durasi operasi > 130menit berhubungan dengan retensio urin dengan RR 3,66 95% IK 2,91-4,60p<0,001 dan 1,66 95%IK 1,07-2,59 p=0,02, berturut-turutKesimpulan: Insidens retensio urin cukup tinggi pasca rekonstruksi POP. Jenistindakan rekonstruksi tertentu dan semakin lamanya durasi rekonstruksiberhubungan 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 associatedfactors.Post operative urinary retention (POUR) is considered as an acutecomplication after a surgey in many operative procedures, including pelvic organprolpase (POP) surgery. To avoid further morbidity, this study aimed to know theincidence of POUR after POP surgery and its risk factors. Methods: This is a prospective cohort study conducted in Cipto Mangunkusumohospital and Fatmawati Hospital from April 2013 to April 2015. Subjects werewomen who wanted to undergo POP surgery with two to four degree of POP.Subjects with history of urinary retention, drugs consumption that tend to causeurinary retention or bladder unjury were excluded. After the reconstruction,urinary catheter was placed for 24 hours. Then, after six hours, catheter wasremoved and residual urine was measured. Urinary retention was defined asresidual urine more than 100 ml. Results: Of 200 subjects recruited, 59 (29.5%) had POUR. There were noassociation between age, body mass index, degree of uterine POPe, degree ofcystocele, urinary tract infectionand POUR. Duration of surgery > 130 minute andTotal 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 theprocedure 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 associatedfactors.Post operative urinary retention (POUR) is considered as an acutecomplication after a surgey in many operative procedures, including pelvic organprolpase (POP) surgery. To avoid further morbidity, this study aimed to know theincidence of POUR after POP surgery and its risk factors. Methods: This is a prospective cohort study conducted in Cipto Mangunkusumohospital and Fatmawati Hospital from April 2013 to April 2015. Subjects werewomen who wanted to undergo POP surgery with two to four degree of POP.Subjects with history of urinary retention, drugs consumption that tend to causeurinary retention or bladder unjury were excluded. After the reconstruction,urinary catheter was placed for 24 hours. Then, after six hours, catheter wasremoved and residual urine was measured. Urinary retention was defined asresidual urine more than 100 ml. Results: Of 200 subjects recruited, 59 (29.5%) had POUR. There were noassociation between age, body mass index, degree of uterine POPe, degree ofcystocele, urinary tract infectionand POUR. Duration of surgery > 130 minute andTotal 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 theprocedure 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 associatedfactors.Post operative urinary retention (POUR) is considered as an acutecomplication after a surgey in many operative procedures, including pelvic organprolpase (POP) surgery. To avoid further morbidity, this study aimed to know theincidence of POUR after POP surgery and its risk factors. Methods: This is a prospective cohort study conducted in Cipto Mangunkusumohospital and Fatmawati Hospital from April 2013 to April 2015. Subjects werewomen who wanted to undergo POP surgery with two to four degree of POP.Subjects with history of urinary retention, drugs consumption that tend to causeurinary retention or bladder unjury were excluded. After the reconstruction,urinary catheter was placed for 24 hours. Then, after six hours, catheter wasremoved and residual urine was measured. Urinary retention was defined asresidual urine more than 100 ml. Results: Of 200 subjects recruited, 59 (29.5%) had POUR. There were noassociation between age, body mass index, degree of uterine POPe, degree ofcystocele, urinary tract infectionand POUR. Duration of surgery > 130 minute andTotal 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 theprocedure and duration of surgery were associated with POUR."

"Latar belakang: Gangguan saluran berkemih bawah gangguan berkemih meningkat seiring dengan bertambahnya usia oleh karena berbagai faktor. Dengan meningkatnya usia harapan hidup, populasi kelompok wanita menopause juga meningkat dan kualitas hidup terkait aktivitas fisik mereka sehari-hari dapat terganggu oleh karena gangguan berkemih. Tujuan: Untuk mengetahui prevalensi gangguan berkemih pada wanita menopause yang berkunjung ke poliklinik Departemen Ilmu Kesehatan Mata RSCM dan untuk melihat hubungan antara gangguan berkemih dengan kualitas hidup wanita menopause yang berkunjung ke poliklinik Departemen Ilmu Kesehatan Mata RSCM dengan menggunakan kuesioner Bristol Female Lower Urinary Tract Symptoms BF LUTS Questionnaire dan International Consultation on Incontinence Modular Questionnaire Female Lower Urinary Tract Symptoms ICIQ-LUTSQol . Metode: Studi potong lintang dilakukan pada wanita menopause pasien yang berkunjung ke Poliklinik Departemen Ilmu Kesehatan Mata Rumah Sakit Cipto Mangunkusumo pada bulan November-Desember 2017. Pasien yang setuju untuk berpartisipasi dalam studi ini ditanyakan beberapa pertanyaan sesuai dengan kuesioner Bristol Female Lower Urinary Tract Symptoms BF LUTS Quesionnaire dan kuesioner International Consultation on Incontinence Modular Questionnaire Female Lower Urinary Tract Symptoms ICIQ-LUTSQol . Hasil: Terdapat 259 pasien yang berpartisipasi pada studi ini, usia median 59 45-70 tahun. Dari 259 pasien didapatkan 36 pasien 13.6 tidak memiliki gangguan berkemih, 199 pasien 76.8 memiliki gangguan berkemih ringan dan 24 pasien 9.3 memiliki gangguan berkemih sedang. Prevalensi gangguan berkemih pada wanita menopause yang berkunjung ke poliklinik Departemen Ilmu Kesehatan Mata RSCM adalah 86.1 . Semakin berat gangguan berkemih skor BF LUTS yang semakin tinggi maka semakin buruk pula kualitas hidup wanita menopause semakin tinggi skor ICIQ LUTS Qol . Kesimpulan: Prevalensi gangguan berkemih pada wanita menopause yang berkunjung ke poliklinik Departemen Ilmu Kesehatan Mata RSCM adalah 86.1 . Semakin berat gangguan berkemih skor BF LUTS yang semakin tinggi maka semakin buruk pula kualitas hidup wanita menopause semakin tinggi skor ICIQ LUTS Qol .

---

Background: Lower urinary tract symptoms increase with age due to several factors. With the increase of life expectancy, the number of menopausal women also increase and their quality of life may be affected by lower urinary tract symptoms.Objective: To know the prevalence of lower urinary tract symptoms among menopausal women who visited Cipto Mangunkusumo Nationa Hospital rsquo;s Clinis Facility. To see the relationship between lower urinary tract symptoms and menopausal women whom visit Ciptomangunkusumo Hospital Policlinic using Bristol Female Lower Urinary Tract Symptoms BF LUTS Quesionnaire and International Consultation on Incontinence Modular Questionnaire Female Lower Urinary Tract Symptoms ICIQ-LUTSQol . Method: Cross-sectional study was conducted among menopausal women who visited Policlinic of the Ophtalmology Department of Cipto Mangunkusumo National Hospital from November ndash; December 2017. Patients who agreed to participate were asked several questions from both questionnaire Bristol Female Lower Urinary Tract Symptoms BF LUTS Questionnaire and International Consultation on Incontinence Modular Questionnaire Female Lower Urinary Tract Symptoms ICIQ-LUTSQol . Results: A total 259 patients were included in this study, median age was 59 45-70 years. Of the 259 patients, 36 patients 13.6 patient had no lower urinary tract symptoms, 199 patients 76.8 had mild lower urinary tract symptoms and 24 patients 9.3 had moderate lower urinary tract symptoms. Prevalence of lower urinary tract symptoms of menopausal women who visited is 86.1 . The more the lower urinary tract symptoms higher score of BF LUTS , the worse the quality of life ICIQ LUTS qol score . Conclusion: The prevalence of lower urinary tract symptoms in menopaussl women who visited Cipto Mangunkusumo National Hospital rsquo;s Clinic Facility was 86,1 . There is associations between quality of life and lower urinary tract symptoms on the three group p"

"ABSTRAKPenelitian ini bertujuan untuk memberikan gambaran evaluasi anatomis serta fungsional pasien pasca neovagina dengan graft membran amnion. Penelitian ini dilakukan dengan desain potong lintang deskriptif. Didapatkan 11 subyek dengan nilai minimum dan maksimum panjang vagina yaitu 7 dan 8 cm. Nilai minimum dan maksimum diameter vagina yaitu 3.5 dan 4.0 cm. Seluruh subyek mempunyai epitelisasi lengkap dan hasil histopatologi sesuai dengan epitel vagina serta tidak didapatkannya komplikasi. Total skor FSFI menunjukkan nilai minimum dan maksimum skor 27.2 dan 31.7, menunjukkan tidak didapatkan disfungsi seksual.

---

ABSTRACTThis study aims to provide an overview of anatomical and functional evaluation of patients post neovagina with amniotic membrane graft. This study was conducted with a descriptive cross-sectional design. Obtained 11 subjects with a minimum and maximum length of the vagina are 7 and 8 cm. The minimum and maximum diameter of the vagina are 3.5 and 4 cm. All subject had complete epithelialization, vaginal epithelium as histopathological result and no complications. Total FSFI score showed the minimum and a maximum score of 27.2 and 31.7, shows no sexual dysfunction."

"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.

---

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: Prolaps organ panggul (POP) merupakan masalah ginekologi dengan insidensi POP 2,04 per 1000 wanita per tahun. Di RSCM, sistokel grade 3 dan 4 terjadi pada 71% wanita dengan POP. Keberhasilan kolporafi anterior sebagai tatalaksana sistokel ditandai dengan rekurensi pasca tindakan, yaitu paling tinggi sebesar 65%. Sehingga perlu dilakukan pengkajian faktor risiko rekurensi tersebut. Tujuan: Untuk mengetahui faktor risiko rekurensi sistokel pasca kolporafi anterior Metode: Penelitian ini menggunakan desain kohort retrospektif dengan mengambil data sekunder dari rekam medis pasien yang dilakukan tindakan kolporafi anterior, saat preoperatif dan saat pasien kontrol minimal 6 bulan pasca tindakan. Tindakan diambil dari RSCM dan RSF tahun 2012 sampai Juli 2019. Total sampel yang memenuhi kriteria inklusi dan eksklusi adalah 91 orang. Selanjutnya dilakukan analisis dengan uji MannWhitney untuk variabel numerik dan uji Fischer untuk kategorik. Beberapa variabel yang dianggap bermakna dilakukan uji multivariat dengan metode regresi logistik.Hasil: Rekurensi anatomis didapatkan sebesar 24,2% dan rekurensi simptomatik 12,1%. Faktor usia, indeks massa tubuh, status menopause, paritas dan berat lahir terbesar, serta tindakan histerektomi, tidak bermakna terhadap rekurensi sistokel. Total panjang GH dan PB didapatkan bermakna pada uji univariat dengan p = 0,008 namun tidak bermakna pada uji regresi logistik. Sistokel derajat berat didapatkan hasil bermakna dengan p=0,023 dan RR 6,12. Tindakan gantung tidak menunjukkan hasil bermakna, namun bila dipisahkan menjadi antara jenis tindakan, USLS menurunkan kejadian rekurensi sistokel dengan RR 0,25 (p=0,025). Kesimpulan: Tindakan kolporafi anterior dengan native tissue didapatkan cukup baik dalam menatalaksana sistokel. Adanya data rekurensi dan faktor risiko ini dapat menjadi dasar pemilihan tindakan, dan sebagai informasi yang bermanfaat untuk diinformasikan pada pasien sebelum tindakan.

---

Background: Pelvic Organ Prolapse (POP) is one of gynecological problem with incidence 2,04 every 1000 women every year. In RSCM, cystocele grade 3 and 4 occured in 71% women with POP. Anterior colporraphy as surgical management of cystocele is evaluated by the recurrence of cystocele after surgery, that reached 65% in the previous study. To decrease this number, we need to evaluate the risk factor of the recurrence.

Objective: To determine the risk factors of cystocele recurrence after anterior colporraphy

Method: This is a retrospective cohort study, using documented data from medical record. Data of patients underwent anterior colporraphy were taken, preoperative and after at least 6 months after surgery. Data were collected in RSCM and RSF from 2012- July 2019. Total sample met the inclusion and exclusion criteria was 91. We analyzed these data using Mann-whitney and Fischer test. Finally, we performed multivariate analysis using logistic regression method.

Result: We found the anatomical recurrence was 24,2% and symptomatic recurrence 12,1%. Age, body mass index, menopausal status, parity, largest birth weight, and hysterectomy was not significantly related to cystocele recurrence. total length of GH and PB found statistically significant by univariate analysis with p =0,008, but not significant by logistic regression test. Preoperative diagnosis of cystocele found statistically significant with p=0,023 and RR 6,12. Apical suspension found not statistically significant, but when we analyzed the types separately, USLS reduce the risk for cystocele recurrence with RR 0,25 (p=0,025).

Conclusion: Colporraphy anterior found to be reliable for cystocele management. Understanding the risk factors for recurrence could help us to decide the best option for management and additional important information to be delivered to the patient before surgery.

"

"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.

---

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."

"Latar belakaog : Prevalensi penderita prolaps organ panggul (POP) terus bertambah, seiring dengan angka harapan hidup yang meningkat. Berbagai studi telah dilakukan untuk melihat terapi pasien POP. Pesarium merupakan pitihan utama terapi POP, tetapi sampai saat ini sangat sedikit literatur yang membahas evaluasi penggunaan jangka panjangnya. Tujuan : Mengetahui perbaikan kualitas hidup pasien POP yang diterapi dengan pesarium, dibandingkan sebelum pemasangan dengan bulan ketiga dan keenam pasca pemasangan. Metode : Pasien POP yang bersedia ikut penelitian akan diberikan kuesionar dengan cara anamnesis terpimpin. Kuesioner yang digunakan adalah Pelvic Floor Distress 111Ventoryshort form 20 (PFDI-20) dan Pelvic Floor Impact Questionnaire-shortform 7 (PFIQ-7) yang sudah diterjemahkan. Setelah pemasangan berhasil, akan dilakukan follow up pada bulan ketiga dan keenam pasca pemasangan, serta dilakukan penilaian efek samping penggunaan pesarium, yaitu keluhan saluran kemih bagian bawah, vaginitis, dan erosi vagina. Basil : Terdapat 51 SP ikut serta dalam penelitian, dengan 45 SP meneruskan penggunaan pesarium setelah menyelesaikan penelitian dan 6 SP melanjutkan terapi operasi. Penilaian kualitas hidup mendapatkan hasil bermakna pada bulan ketiga dan keenam dibandingkan dengan awal penelitian, baik dengan kuesioner PFDI-20 maupun PFIQ-7. Kesimpulan : Terdapat perbaikan kualitas hidup pasien POP setelah penggunaan pesarium selama 6 bulan.

---

Background: Prevalence of womens with pelvic organ prolapse have increased by day, correspond to higher life expectancy. There are many study that observe the best treatment for pelvic organ prolapse. Pessary is one of them, but until now only few literature tells about the effect of this treatment for improving quality of live. Objective: To understand the improvement of quality of life in women with pelvic organ prolapse, before and after six months pessary treatment. Methods: Womens presenting for pessary insertion completed both Pelvic Floor Distress Inventory-short form 20 (PFDI-20) and Pelvic Floor Impact Questionnaire-short form 7 (PFIQ-7). After successful pessary insertion, subjects were reviewed after 3 and 6 months treatment. Result: There were 51 subjects enrolled in this study, with 45 subjects continued the used of pessary after fmished the study and 6 subjects were changed into surgery. There were statistically and clinically significant improvements of quality of life, after 3 and 6 months treatment with pessary, both using PFDI-20 and PFIQ-7 questionnaire. Conclusion: The use of pessary for 6 months reduces symptoms and improves the quality of life in women with pelvic organ prolapse."

"ABSTRAKLATAR 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.

---

ABSTRACTBladder 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."

"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.

---

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: Kehamilan dan persalinan merupakan faktor risiko utama terjadinya disfungsi dasar panggul. Manifestasi utama pada kelainan tersebut adalah gejala saluran kemih bagian bawah dan inkontinensia urin. Studi mengenai prevalensi dan faktor risiko kondisi-kondisi tersebut sangat penting untuk diagnosis dini dan tata laksana yang komprehensif. Namun, hingga saat ini belum terdapat studi mengenai prevalensi dan faktor-faktor risiko tersebut secara komprehensif pada ibu hamil di Indonesia.Tujuan: Mengetahui prevalensi inkontinensia urin dan gejala saluran kemih bagian bawah serta faktor-faktor yang memengaruhi.Metode: Penelitian ini merupakan penelitian analitik observasional dengan metode potong lintang (cross sectional). Subjek dari penelitian ini adalah ibu hamil yang datang untuk pemeriksaan rutin di Puskesmas Kecamatan Jakarta pada April 2021-Maret 2022. Pasien dengan riwayat inkontinensia, kehamilan ganda, diabetes tidak terkontrol, gangguan neurologis, atau riwayat operasi sebelumnya dieksklusi dari penelitian. Faktor risiko yang dinilai adalah usia ibu, usia kehamilan, paritas, indeks massa tubuh, dan riwayat obstetrik sebelumnya.Hasil: Didapatkan sebanyak 236 subjek yang diikutsertakan dalam penelitian. Didapatkan inkontinensia urin tekanan 8,5%, inkontinensia urin desakan 14%, dan inkontinensia urin campuran 1,6%. Didapatkan keluhan berkemih berupa frekuensi (59,3%), nokturia (87,3%), urgensi (33,1%), hesitansi (8,9%), dan straining (0,8%). Hanya terdapat 5,1% subjek yang tidak memiliki keluhan berkemih sama sekali. Faktor risiko yang berpengaruh dengan keluhan berkemih dan inkontinensia urin adalah usia ibu dan trimester kehamilan.Kesimpulan: Didapatkan prevalensi inkontinensia urin dan gejala saluran kemih bagian bawah yang tinggi pada ibu hamil di Indonesia. Faktor risiko terjadinya gangguan saluran kemih dan inkontinensia urin pada ibu hamil adalah usia ibu dan trimester kehamilan.

---

Background: Pregnancy and childbirth are the main risk factors for pelvic floor dysfunction. The main manifestations of this disorder are lower urinary tract symptoms and urinary incontinence. Studies on the prevalence and risk factors of these conditions are essential for early diagnosis and comprehensive management. However, until now there has been no comprehensive study of the prevalence and risk factors for pregnant women in Indonesia.

Objective: To determine the prevalence of urinary incontinence and lower urinary tract symptoms and the factors that influencing.

Methods: This research was an observational analytic study with cross sectional method. The subjects of this study were pregnant women who came for routine check-ups at the Jakarta Publics Health Center in April 2021-March 2022. Patients with a history of incontinence, multiple pregnancy, uncontrolled diabetes, neurological disorders, or a history of previous surgery were excluded from the study. The risk factors assessed were maternal age, gestational age, parity, body mass index, and previous obstetric history.

Results: There were 236 subjects who were included in the study. We found stress urinary incontinence 8.5%, urgency urinary incontinence 14%, and mixed urinary incontinence 1.6%. There were urinary complaints in the form of frequency (59.3%), nocturia (87.3%), urgency (33.1%), hesitancy (8.9%), and straining (0.8%). There were only 5.1% of subjects who did not have urinary complaints at all. The risk factors that influence lower urinary tract symptoms and urinary incontinence are maternal age and trimester of pregnancy.

Conclusions: We found a high prevalence of urinary incontinence and lower urinary tract symptoms in pregnant women in Indonesia. Risk factors for urinary tract disorders and urinary incontinence in pregnant women are maternal age and trimester of pregnancy."