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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]"

"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. "

"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."

"ABSTRAKLatar belakang:Berdasarkan International Continence Society(ICS), inkontinensia urin merupakan keluhan dari kebocoran urin sebagai hasil dari abnormalitas fungsi saluran kemih bagian bawah atau sekunder dari penyakit tertentu yang dapat mengganggu kehidupan perempuan secara fisik, psikologis, dan sosial. Pada tahun 2003, prevalensi inkontinensia urin pada perempuan di seluruh dunia sebesar 17-50% dengan jenis yang paling sering adalah jenis tekanan (50%). Hipermobilitas leher kandung kemih merupakan salah satu dasar patologi dari inkontinensia tipe tekanan. Kondisi hipermobilitas leher kandung kemih dan uretra dapat membantu lebih memahami patofisiologi dari inkontinensia urin tipe tekanan yang terjadi. Penelitian ini ditujukan untuk menilai hubungan profil pergerakan leher kandung kemih dengan prolaps kompartemen anterior vagina pada pasien dengan inkontinensia urin jenis tekanan pada pasien dengan prolaps organ panggul.Metode:Studi ini memiliki desain potong lintang pada 112 subjek dengan riwayat POP yang memenuhi kriteria inklusi dan eksklusi. Data yang diambil pada penelitian ini adalah bladder neck descent(BND), retrovesical angle(RVA), Rotational urethra(RoU), funneling, titik Aa dan Ba pada POP-Q. Hasil:Data penelitian menunjukan inkontinensia tipe tekanan terjadi pada 50% subjek dengan POP. Pada analisis data didapatkan perbedaan yang signifikan antara funneling, sudut RVA dan sudut RoU dengan kejadian inkontinensia urin. Cutoff sudut RVA didapatkan bernilai 130.570dengan sensitivitas 64,3% dan spesifisitas 55.4%. Cutoff sudut RoU didapatkan bernilai 41.560dengan sensitivitas 76,8% dan spesifisitas 67,9%. Hasil yang didapatkan menunjukan hubungan yang bermakna pada analisis multivariat. Kesimpulan:Terdapat perbedaan yang bermakna antara sudut RVA, sudut RoU, dan riwayat funneling terhadap inkontinensia urin tipe tekanan pada perempuan dengan POP. Tidak terdapat perbedaan nilai penurunan Titik Aa, titik Ba, dan penurunan leher kandung kemih antara perempuan kontinensia dengan inkontinensia jenis tekanan. Sudut RVA, sudut RoU, dan riwayat funneling dapat digunakan untuk memprediksi terjadinya inkontinensia tipe tekanan pada subjek dengan POP.

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ABSTRACTBackground:Stress type urinary incontinence is a pressure induced urinary leakage caused by functional abnormality of lower urinary tract or other disease that cause physical, psychological, and social disturbance in female. The prevalence of urinary incontinence is 17-50% around the world with 50% of them are stress type urinary incontinence. Bladder neck mobility is one of the main pathology of stress type urinary incontinence. Observation of bladder neck mobility and urethra in stress type incontinence may increase the understanding of the urinary incontinence pathophysiology. This study is aimed to quantify the relation between bladder neck mobility profile and anterior compartment vaginal prolapse with stress-type urinary incontinence in patient with pelvic organ prolapse.Method:The study is a cross-sectional study with 112 subjects with history of pelvic organ prolapse and suits inclusion and exclusion criteria. Data obtained in this study are bladder neck descent (BND), retrovesical angle (RVA), rotational urethra (RoU), funneling, point Aa and Ba from POP-Q.Results:This study found stress-type urinary incontinence in 50% subjects with POP. In this study, significant difference found in funneling, RVA, and RoU between female with and without urinary incontinence. Cutoff of RVA obtained from this study are 130.570with 64.3% sensitivity and 55.4% specificity. Cutoff of RoU obtained from this study are 41.560with 76,8% sensitivity and 67,9% specificity. Cutoff result shows significant correlation with stress type urinary incontinence on multivariate analysis. Conclusion:There are significant difference in RVA, RoU, and funneling between female with and without stress type urinary incontinence. There are no significant difference in point Aa, point Ba, and bladder neck descent between female with and without urinary incontinence. Funneling, RVA, and RoU can predict incidence of stress type urinary incontinence in female with POP. "

"ABSTRAKLatar belakang:Berdasarkan International Continence Society(ICS), inkontinensia urin merupakan keluhan dari kebocoran urin sebagai hasil dari abnormalitas fungsi saluran kemih bagian bawah atau sekunder dari penyakit tertentu yang dapat mengganggu kehidupan perempuan secara fisik, psikologis, dan sosial. Pada tahun 2003, prevalensi inkontinensia urin pada perempuan di seluruh dunia sebesar 17-50% dengan jenis yang paling sering adalah jenis tekanan (50%). Hipermobilitas leher kandung kemih merupakan salah satu dasar patologi dari inkontinensia tipe tekanan. Kondisi hipermobilitas leher kandung kemih dan uretra dapat membantu lebih memahami patofisiologi dari inkontinensia urin tipe tekanan yang terjadi. Penelitian ini ditujukan untuk menilai hubungan profil pergerakan leher kandung kemih dengan prolaps kompartemen anterior vagina pada pasien dengan inkontinensia urin jenis tekanan pada pasien dengan prolaps organ panggul.Metode:Studi ini memiliki desain potong lintang pada 112 subjek dengan riwayat POP yang memenuhi kriteria inklusi dan eksklusi. Data yang diambil pada penelitian ini adalah bladder neck descent(BND), retrovesical angle(RVA), Rotational urethra(RoU), funneling, titik Aa dan Ba pada POP-Q. Hasil:Data penelitian menunjukan inkontinensia tipe tekanan terjadi pada 50% subjek dengan POP. Pada analisis data didapatkan perbedaan yang signifikan antara funneling, sudut RVA dan sudut RoU dengan kejadian inkontinensia urin. Cutoff sudut RVA didapatkan bernilai 130.570dengan sensitivitas 64,3% dan spesifisitas 55.4%. Cutoff sudut RoU didapatkan bernilai 41.560dengan sensitivitas 76,8% dan spesifisitas 67,9%. Hasil yang didapatkan menunjukan hubungan yang bermakna pada analisis multivariat. Kesimpulan:Terdapat perbedaan yang bermakna antara sudut RVA, sudut RoU, dan riwayat funneling terhadap inkontinensia urin tipe tekanan pada perempuan dengan POP. Tidak terdapat perbedaan nilai penurunan Titik Aa, titik Ba, dan penurunan leher kandung kemih antara perempuan kontinensia dengan inkontinensia jenis tekanan. Sudut RVA, sudut RoU, dan riwayat funneling dapat digunakan untuk memprediksi terjadinya inkontinensia tipe tekanan pada subjek dengan POP.

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ABSTRACTBackground:Stress type urinary incontinence is a pressure induced urinary leakage caused by functional abnormality of lower urinary tract or other disease that cause physical, psychological, and social disturbance in female. The prevalence of urinary incontinence is 17-50% around the world with 50% of them are stress type urinary incontinence. Bladder neck mobility is one of the main pathology of stress type urinary incontinence. Observation of bladder neck mobility and urethra in stress type incontinence may increase the understanding of the urinary incontinence pathophysiology. This study is aimed to quantify the relation between bladder neck mobility profile and anterior compartment vaginal prolapse with stress-type urinary incontinence in patient with pelvic organ prolapse.Method:The study is a cross-sectional study with 112 subjects with history of pelvic organ prolapse and suits inclusion and exclusion criteria. Data obtained in this study are bladder neck descent (BND), retrovesical angle (RVA), rotational urethra (RoU), funneling, point Aa and Ba from POP-Q.Results:This study found stress-type urinary incontinence in 50% subjects with POP. In this study, significant difference found in funneling, RVA, and RoU between female with and without urinary incontinence. Cutoff of RVA obtained from this study are 130.570with 64.3% sensitivity and 55.4% specificity. Cutoff of RoU obtained from this study are 41.560with 76,8% sensitivity and 67,9% specificity. Cutoff result shows significant correlation with stress type urinary incontinence on multivariate analysis. Conclusion:There are significant difference in RVA, RoU, and funneling between female with and without stress type urinary incontinence. There are no significant difference in point Aa, point Ba, and bladder neck descent between female with and without urinary incontinence. Funneling, RVA, and RoU can predict incidence of stress type urinary incontinence in female with POP. "

"ABSTRAKTujuan: untuk mengetahui prevalensi inkontinensia urin, sebaran tipe inkontinensia urin dan faktor-faktor risiko yang berhubungan pada wanita yang berusia diatas 50 tahun.Metode: penelitian ini merupakan penelitian deskriptif dengan desain potong lintang. Sebanyak 278 wanita berusia diatas 50 tahun yang tinggal di panti werdha, telah dilakukan wawancara secara terpimpin menggunakan kuesioner Questionnaire for Urinary Incontinence Diagnosis (QUID) yang telah diterjemahkan dan divalidasi. Hasil prevalensi inkontinensia urin disajikan dalam bentuk proporsi/persentase, sedangkan hubungan antara faktor risiko dengan kejadian inkontinensia urin dianalisa dengan uji chi square atau uji Fisher bila syarat uji chi square tidak terpenuhi, dan juga dilakukan uji multivariat.Hasil: dari 278 subyek penelitian, didapatkan sebanyak 95 orang (34,2%) menderita inkontinensia urin. Dengan sebaran tipenya adalah sebagai berikut: inkontinensia urin tipe campuran 67 orang (70,5%), inkontinensia urin tipe tekanan 17 orang (17,9%) dan inkontinensia urin tipe desakan 11 orang (11,6%). Indeks massa tubuh (IMT) berlebih dan obesitas tidak memiliki hubungan dengan kejadian inkontinensia urin (p> 0,05), mungkin pada penelitian ini jumlah subyek dengan IMT berlebih dan obesitas jumlahnya terlalu kecil. Sedangkan faktor-faktor risiko yang berhubungan dengan inkontinensia urin adalah: usia diatas 60 tahun (OR 7,79, p= 0,021), menopause >10 tahun (OR 5,08, p=0,004), dan multipara (OR 1,82, p=0,019). Pada saat dilakukan uji multivariat, faktor risiko usia diatas 60 tahun didapatkan menjadi tidak berhubungan dengan kejadian inkontinensia urin (p> 0,05). Hal ini disimpulkan bahwa faktor usia diatas 60 tahun bukan merupakan faktor tunggal akan terjadinya inkontinensia urin melainkan multifaktor.Kesimpulan: penelitian ini mendapatkan angka prevalensi inkontinensia urin pada wanita yang tinggal di panti werdha adalah sebesar 34,2%. Sedangkan sebaran tipe inkontinensia urin adalah: inkontinensia urin tipe campuran 67 orang (70,5%), inkontinensia urin tipe tekanan 17 orang (17,9%) dan inkontinensia urin tipe desakan 11 orang (11,6%). Faktor-faktor risiko inkontinensia urin adalah: menopause >10 tahun dan multipara.

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ABSTRACTAim: to identify the prevalence of urinary incontinence, the distribution of the type of urinary incontinence and and related risk factors in women older than 50 years.Method: this is a descriptive study with cross sectional design. Two hundred and seventy eight women older than 50 years old living in nursing house were interviewed using the Questionnaire for Urinary Incontinence Diagnosis (QUID) that has been translated and validated previously. The prevalence result will be presented in the form of percentage; while the relationship between risk factors and the incidence or urinary incontinence will be analyzed using chi square test or Fisher’s exact test if the requirement for chi square test is not met, and multivariate analysis.Result: Of 278 research subjects, we obtain 95 subjects (34,2%) suffering from urinary incontinence. And the distribution of the type is as follow: 67 subjects (70,5%) with mixed urinary incontinence, 17 (17,9%) with stress urinary incontinence and 11 subjects (11,6%) with urge incontinence. Overweight and obesity body mass index (BMI) are not related with the prevalence of urinary incontinence (p> 0,05), probably in this research the number of subjects with overweight and obesity is too small. While factors related to urinary incontinence are age older than 60 years (OR 7,79, p = 0,021), menopause ≥10 years (OR 5,08, p=0,004) and multiparity (OR 1,82, p = 0,019). When multivariate analysis was done, the risk factor age older than 60 years becomes not related to urinary incontinence (p>0,05). Thus it can be inferred that age older than 60 years is not a singular factor of urinary incontinence but rather a multifactor.Conclusion: This study shows that the prevalence of urinary incontinence in women living in nursing home is 34,2%; while the distribution of the urinary incontinence is: 67 subjects (70,5%) with mixed urinary incontinence, 17 subjects with stress urinary incontinence (17,9%) and 11 subjects (11,6%) with urge urinary incontinence. Risk factors for urinary incontinence are: menopause ≥10 years and multiparity."

"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."

"ABSTRAKNama : Imam Ahmadi FaridNPM : 1406667463Program Studi/Divisi : Obstetri ndash; Ginekologi / Uroginekologi Rekonstruksi Judul: Prevalensi, karakteristik dan Faktor Risiko Terkait Pada Pasien Inkontinensia Urin Dalam Poliklinik Ginekologi Menggunakan Kuesioner Untuk Diagnosis Inkontinensia Urin QUID Versi Bahasa Indonesia Latar belakang: Inkontinensia urin tetap menjadi masalah kesehatan utama wanita karena dampaknya yang menghancurkan terhadap kualitas hidup. Namun, studi epidemiologi tentang inkontinensia urin UI di Indonesia sangat terbatas. Bisa jadi karena keluhan pasien yang kurang dilaporkan. Kami bertujuan untuk menentukan prevalensi, karakteristik dan faktor risiko UI di antara pasien ginekologi. Metode: Pasien mengunjungi klinik rawat jalan ginekologi di Cipto Mangunkusumo, Rumah Sakit Umum, Jakarta, Indonesia yang ditawarkan untuk berpartisipasi dalam penelitian ini. Subyek yang memenuhi syarat melakukan wawancara untuk mengisi kuesioner QUID versi Bahasa Indonesia. Faktor terkait untuk stres inkontinensia urin SUI , mendesak inkontinensia urin UUI , dan kontinum urin campuran MUI diidentifikasi setelah analisis bivariat dan multivariat. Hasil: Prevalensi SUI, UUI, dan MUI masing-masing 4,3 , 3,0 , dan 2,7 di antara 400 subjek yang memenuhi syarat. Usia di atas 61 tahun, usia antara 51 hingga 60 tahun, tingkat pendidikan rendah, kelebihan berat badan, multiparitas, persalinan pervaginam dan keadaan menopause meningkatkan risiko untuk semua jenis UI. Pada analisis multivariat, usia yang lebih tua adalah faktor risiko paling signifikan untuk memiliki UI p = 0,000, OR 5,4 95 CI: 2,13-13,87 . Kesimpulan: Usia di atas 61 tahun, usia antara 51 hingga 60 tahun, tingkat pendidikan rendah, kelebihan berat badan, multiparitas, persalinan pervaginam dan menopause adalah faktor risiko untuk SUI, UUI, dan MUI. Umur adalah faktor terkait yang paling signifikan. Kata kunci: QUID Questionnaire, faktor risiko, inkontinensia urin.

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ABSTRACT

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Abstract Nama Imam Ahmadi FaridNPM 1406667463Program Studi Divisi Obstetri ndash Ginekologi Uroginekologi Rekonstruksi Title Prevalence, characteristics and Related Risk Factors In Urinary Incontinence Patients In Gynecology Polyclinics Using Questionnaire For Urinary Incontinence Diagnosis QUID Indonesian Version Background Urinary Incontinence remains a main women rsquo s health problem due to its devastating impacts to the quality of life. However, the epidemiology study of urinary incontinence UI in Indonesia is very limited. It could be due to the under reported complaints of the patients. We aim to determine the prevalence, characteristics and risk factors of UI among gynecological patients. Methods Patients visited gynecological outpatient clinic at Cipto Mangunkusumo, General Hospital, Jakarta, Indonesia were offered to be participated in this study. Eligible subjects underwent interview to fulfill Indonesian version of QUID questionnaires. The associated factors for stress urinary incontinence SUI , urge urinary incontinence UUI , and mixed urinary continence MUI were identified after bivariate and multivariate analysis. Results The prevalence of SUI, UUI, and MUI were respectively 4.3 , 3.0 , and 2.7 among 400 eligible subjects. Age over 61 years old, age between 51 to 60 years old, low education level, overweight, multiparity, vaginal delivery and menopausal state were increased the risk for any types of UI. On multivariate analysis, older age was the most significant risk factor for having UI p 0.000, OR 5.4 95 CI 2,13 13,87 . Conclusion Age over 61 years old, age between 51 to 60 years old, low education level, overweight, multiparity, vaginal delivery and menopausal state were the risk factor for SUI, UUI, and MUI. Age was the most significant associated factor. Keywords QUID Questionnaire, risk factors, urinary incontinence "

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

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