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"Part of the Female Pelvic Surgery Video Atlas Series, this title enhances your surgical skills in the key area of gynecology, urogynecology, and urology."

"LATAR BELAKANG. Prolaps organ panggul menimbulkan keluhan kelemahan dasar panggul yang dapat mempengaruhi kualitas hidup seorang wanita. Prolaps organ urogenital dialami oleh 30-50 wanita yang berusia 20-59 tahun. Penanganan yang tepat dan dini untuk mengatasi gangguan tersebut menjadi salah satu upaya efektif. Untuk dapat melakukan penanganan dini maka diperlukan pengenalan awal terhadap penilaian prolaps organ panggul dengan keluhan minimal pada pasien. Sebelumnya studi yang dilakukan pada 296 wanita usia diatas 40 tahun, didapatkan penurunan vagina 0,5 cm di bawah himen dapat memprediksi secara akurat gejala penonjolan atau penurunan organ. Di Indonesia belum terdapat penelitian mengenai ambang batas prolaps organ panggul yang dapat memperkirakan munculnya keluhan kelemahan dasar panggul. Oleh karena itu, penelitian ini bertujuan untuk memperkirakan ambang batas timbulnya keluhan kelemahan dasar panggul, diketahuinya prevalensi kasus POP di RSCM dan diketahuinya sensitifitas dan spesifisitas kuesioner PFDI-20 dalam menilai keluhan POP. METODE. Penelitian ini merupakan suatu studi potong lintang. Data diambil dari pemeriksaan langsung POP-Q dan wawancara kuesioner PFDI-20 . Dilakukan di Poli ginekologi dan uroginekologi RSCM sejak bulan Juli 2017 hingga November 2017. HASIL. Pada penelitian ini disimpulkan bahwa dari 385 orang subyek penelitian didapat 13 mengalami prolaps organ panggul dengan proporsi masing-masing 11.2 mengalami prolaps uteri, 12.3 sistokel, dan 11.7 mengalami rektokel. Uji validitas dengan Pearson test dan reliabilitas dari kuesioner PFDI-20 menunjukan hasil valid dan reliabel. Penurunan sejauh 2.5 cm diatas himen yaitu prolapse derajat 1 sudah bisa menimbulkan keluhan penurunan organ panggul. Sedangkan untuk komponen keluhan pada kuesioner didapat PDFI-16 AUC 0.828 ndash; 0.860, IK 95 dan PFDI-19 AUC 0.831 - 0.854, IK 95 yaitu keluhan sulit menahan kemih dan sulit berkemih dianggap sebagai keluhan penurunan organ panggul yang lebih dini dirasakan oleh subyek penelitian. KESIMPULAN. Kuesioner PFDI-20 dapat digunakan sebagai skrining keluhan prolaps organ panggul. Ambang batas prolaps organ panggul yaitu jarak 2,5 cm diatas himen didalam vagina mulai menunjukkan adanya keluhan. Kata Kunci. Prolaps organ panggul, prolaps uteri, sistokel, rektokel.

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BACKGROUND. Prolaps of pelvic organs lead to complaints of pelvic floor weakness that may affect a woman 39;s quality of life. Urogenital organ prolapse is experienced by 30-50 of women aged 20-59 years. Proper treatment and early diagnosis of these disorders become one of effective efforts. To be able to perform early treatment is required early recognition of the assessment of pelvic organ prolapse with minimal complaints in patients. Previous studies conducted on 296 women over the age of 40 years, resulted a 0.5 cm vaginal protruded under the hymen can accurately predict symptoms of protrusion or prolapse of pelvic organ. In Indonesia there has been no research on pelvic organ prolapse thresholds that can estimate complaints of pelvic floor weakness. This study is aim to reveal of pelvic organ prolapse thresholds that can estimate complains of pelvic floor weakness, the prevalence of POP cases in RSCM and the sensitivity and specificity of PFDI-20 questionnare in assessing POP complaints. METHOD. This study is a cross sectional study. Data was taken from direct examination POP-Q and interview PFDI-20 questionnaire . Performed in the Gynecology and Urogynecology outpatient clinic at Cipto Mangunkusumo Hospital from July 2017 to November 2017 RESULTS. From 385 subjects, 13 had pelvic organ prolapse with proportion of 11.2 having uterine prolapse, 12.3 cystocele, and 11.7 had rectocele. Validity test with Pearson test and reliability of PFDI-20 questionnaire showed valid and reliable results. A decrease of 2.5 cm above the hymen ie 1st degree of prolapse can lead to early complaints of pelvic organ descent. As for the complaint component of the questionnaire revealed that PDFI-16 AUC 0.828 - 0.860, 95 IK and PFDI-19 AUC 0.831 - 0.854, 95 IK , that is difficult to resist urinary complaints and difficult in micturition, is considered an early complaint of pelvic organ felt by subjects. CONCLUSION. The PFDI-20 questionnaire can be used as a screening for pelvic organ prolapse complaints. The pelvic organ pelvic prolapse threshold of 2.5 cm above the hymen inside the vagina begins to show a complaint. Keywords. Pelvic organ prolapse, uterine prolapse, cystocele, rectocele"

"This authoritative reference provides practical, easy-to-use guidance on the histopathologic diagnosis of gynecologic lesions. This visual resource clearly describes the cardinal clinical, gross, and microscopic features of each lesion, as well as the staging system for tumors at each site. Clinical correlations of surgical pathology, clinical data, and immunohistochemical data help in weighing all of the available evidence to form the most decisive diagnoses. "

"Latar Belakang: Prolaps organ panggul (POP) pada wanita menimbulkan morbiditas. Untuk mengurangi angka re-operasi dan meningkatkan kualitas hidup pasien dibutuhkan peningatan kualitas pelayanan secara terus menerus. Guideline yang saat ini secara luas dipakai dalam penatalaksanaan POP di Indonesia adalah Panduan Penatalaksanaan POP PB HUGI-POGI pada tahun 2013. Penelitian ini dilakukan bertujuan untuk mengetahui insidensi POP dan melakukan audit kesesuaian pada penatalaksanaan kasus POP di RSUPN Cipto Mangunkusumo tahun 2016-2018. Metode: Penelitian ini merupakan penelitian deskriptif dengan menggunakan desain penelitian cross-sectional menggunakan data sekunder. Sampel yang digunakan dalam penelitian ini adalah pasien POP yang didiagnosis dan mendapat tatalaksana di Polikinik Uroginekologi RSUPN Cipto Mangunkusumo pada bulan Januari 2016 sampai dengan Desember 2018, diikuti oleh wawancara pasien yang dipilih secara acak tentang follow up pasca operasi.Hasil: Terdapat 252 kasus prolaps organ pelvis di tahun 2016-2018 dengan prevalensi 15,96%. Proporsi kesesuaian anamnesis tatalaskana POP konservatif dan operatif adalah 88,1% dan 82,8%, pemeriksaan fisik 93,1% dan 97,3%, 100% pada informasi pemilihan tatakasana dan informed consent. Kepatuhan follow up 6 bulan dan 12 pasca operasi adalah masing-masing 40,4% dan 26,5%. Ketidakcocokan dalam anamnesis dan pemeriksaan fisik disebabkan oleh beberapa formulir penilaian yang harus diisi serta formulir penilaian uroginekologi yang tidak terlampir dengan catatan medis pasien.Kesimpulan: Panduan usulan pelayanan asesmen pasien POP dengan penulisan pada formulir asesmen uroginekologi yang telah diperbaharui dan mengintegrasikan ke dalam rekam medik menjadi usulan berdasarkan hasil audit.

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Background: Pelvic organ prolapse (POP) in women causes significant morbidity. In order to reduce the number of re-operations and improve the quality of life of patients, consistent quality of patient care is required. The Executive Board of the Urogynecology Association of the Indonesian Obstetrics & Gynecology Associations 2013 POP guideline is widely used in Indonesia, but compliance to the guidelines needed to be evaluated. This study aimed to investigate the incidence of POP and to audit POP management in Cipto Mangunkusumo General Hospital, Indonesia, in 2016-2018.

Method: This was a cross-sectional study on the medical records of POP patients who were diagnosed and treated at the Urogynecology Outpatient Clinic, Cipto Mangunkusumo General Hospital in January 2016 to December 2018, followed by randomly selected patient interview about follow-up discrepancy.

Results: There were 252 cases of POP in 2016-2018, with a prevalence of 15.96%. Proportion of conformities in POP management with conservative and operative management was 88.1% and 82.8% in history taking, 93.1% and 97.3% in physical examination, both 100% in examinations and informed consent. Compliance of 6 months and 12 months follow up in operative management was 40.4% and 26.5%, respectively. Mismatches in history taking and physical examination were due to multiple assessment forms that have to be completed as well as unintegrated urogynecology assessment form with patients medical record.

Conclusion: Our audit suggests that urogynecology assessment form should be integrated into patients medical records is needed to improve patient care. A patient book should be provided to improve follow-up rates."

"The book State of the art Vaginal Surgery would be of immense value to postgraduate students and practicing gynecologists to keep themselves abreast of the latest advances in various surgical techniques performed vaginally. It is a multiauthor book and has chapters written by authors of national and international fame covering extensively various vaginal techniques. It has been divided into 9 sections covering surgical anatomy, instrumentation, operation theater set-up, and risk management. In a systematic manner, all the vaginal surgeries including hysterectomies, fistula repair and stress ur"

"Latar Belakang: Prolaps Organ Panggul (POP) dikelompokkan menjadi prolaps dinding anterior, posterior dan puncak vagina. 40% wanita dengan POP dinding anterior vagina memiliki elongasio serviks yang akan mempengaruhi tatalaksana pembedahan POP. Terdapat beberapa alat untuk mengukur panjang serviks, diantaranya Pelvic Organ Prolapse Quantifications System (POP-Q), dengan mengukur perbedaan titik C dan D. Sampai saat ini belum terdapat penelitian yang menguji sensitivitas, spesifisitas dan akurasi pemeriksaan POP-Q dalam mengukur panjang serviks untuk mendiagnosis elongasio serviks pada pasien POP. Tujuan: Diketahuinya nilai sensitivitas, spesifisitas dan akurasi POP-Q untuk menilai panjang serviks sebagai diagnosis elongasio serviks pada pasien POP dengan baku emas pengukuran anatomi serviks dari hasil histerektomi. Metode: Uji diagnosis, potong lintang, consecutive sampling. Data diambil dari pemeriksaan POP-Q dan pengukuran anatomi serviks dari hasil histerektomi. Hasil: 66 subjek, 1.5% POP derajat 2, 45.5% POP derajat 3 dan 53.0 % POP derajat 4. Rerata (± sb) usia dan indeks massa tubuh (IMT) berturut-turut 59.88 tahun (± 9.347) dan 24.41 (± 3.67) kg/m2. Median (min-maks) PS POPQ dan PS Anatomi berturut-turut 4 cm (1-12) dan 5 cm (3-10). Sensitivitas, Spesifisitas dan Akurasi POP-Q berturut-turut 79%, 58% dan 68%. Kesimpulan: Pemeriksaan POPQ memiliki spesifitas yang baik (79%) tetapi dengan sensitivitas yang kurang baik (58%) dan akurasi 68% untuk diagnosis elongasio serviks pada prolaps organ panggul.

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Background: Pelvic Organ Prolapse (POP) categorized as anterior, posterior and apical prolapse. 40% women with anterior POP have cervical elongation. Cervical elongation will make difference in surgical POP treatment. There are several tool for measure cervical length, one of them is Pelvic Organ Prolapse Quantifications System (POP-Q), by measure difference in point C and D. Until now, there is no research to measure sensitivity, specificity and accuracy of POP-Q to measure cervical length for cervical elongation diagnose in POP patients. Objective: To know sensitivity, specificity and accuracy of POP-Q to measure cervical length for cervical elongation diagnose in POP patients with gold standard was anatomical cervical length from hysterectomy result. Methode: Diagnosis research, cross sectional, consecutive sampling. POP-Q was taken before operation and anatomi cervical length was from hysterectomy result. Result: 66 subject, 1.5% 2nd degree POP, 45.5% 3rd degree POP, and 53.0 % 4th degree POP. Mean (± sd) age and body mass index consecutively 59.88 years (± 9.347) and 24.41 (± 3.67) kg/m2. Median (min-max) cervical length POP-Q and anatomy consecutively 4 cm (1-12) and 5 cm (3-10). Sensitivity, Spesifisity dan Accuracy POP-Q consecutively 79%, 58% dan 68%. Conclussion: POPQ has good specificity (79%) but with less sensitivity (58%) with accuracy 68% to diagnose cervical elongation in POP."