Association Between Flamm Geiger Score And The Success Of Vaginal Delivery. Vaginal Birth After Cesarean (VBAC) is vaginal delivery on woman with history of cesarean delivery. A statement by Cragin (1916),  “Once a cesarean, always a cesarean”, has been a growing paradigm in the community which makes VBAC not a common practice. Flamm Geiger Scoring System is used to predict the likelihood of success in VBAC. The purpose of this research was to find out the association between Flamm Geiger score and the success of vaginal delivery. This research was an analytic observational study with cross sectional design. The population of this research were all patients that underwent delivery in dr. Mohammad Hoesin General Hospital Palembang from January to December  2014 and  the sample were all delivering patient with history of cesarean delivery.The data were taken from patient’s medical record and analyzed using Chi Square test or its alternative test (Fisher’s Exact Test). From 92 samples, there were 25 patients (27,2%) succeeded in undergoing VBAC and 67 patients (72,8%) delivered with repeated cesarean. There was an increasing probability for a successful VBAC ranging from 0% in samples with a score of 0-2 to 100% in samples with a score of 8-10. The result showed that there was an association between Flamm Geiger score and the success of vaginal delivery (p=0,000). There is association between Flamm Geiger score and the success of vaginal delivery in dr. Mohammad Hoesin General Hospital Palembang from January to December  2014.

Background. Vesicouterine fistula (VUF) is a rare pathological communication between the uterus or cervix and the bladder. Youssef's syndrome is an atypical presentation of a patient with a vesicouterine fistula, characterized by a triad of cyclic hematuria, amenorrhea, and absence of urinary incontinence. Because of this atypical presentation, the patient may go undiagnosed and patient management will be delayed. Case presentation. A 39-year-old woman complained of hematuria. The patient underwent a second caesarean section in 2008 and a few weeks after the procedure the patient complained of leakage of urine from her vagina. Six months later the patient complained hematuria on her menstrual cycle and amenorrhea, with absence of urinary incontinence. Ultrasound examination found adhesions between the uterus and vagina, and irregular bladder mucosa. Patient  underwent cystoscopy with endometriosis were suspected on vesicovaginal repair scars and a bladder biopsy was also performed with the results of no endometrial stroma and glands then followed by hysteroscopy. Hysteroscopy result showed a 20 mm diameter hole with irregular margins. Subsequently, the patient was treated with hysterorrhaphy laparotomy and fistula repair. Conclusion. One type of vesicouterine fistula is Youssef's syndrome, which is a complication following a lower segment caesarean section with undiagnosed bladder injury. The diagnosis can be confirmed by cystoscopy, intravenous pyelography, hysterosalpingogram, sonography, and other types of imaging tests. Management of patients with VUF can be conservative, medical, or surgical.

Objective: To find the effectiveness of uterine prolapse surgery in patients with bowel symptoms. Method: Clinical trial without comparison study of 32 consecutive women who underwent surgery for grade III and IV uterine prolapse with bowel symptoms. Bowel symptoms score was evaluated before and three months after surgery by using the Australian Pelvic Floor Questionnaire. Data was analyzed using SPSS version 20. Result: There were significant mean differences between bowel symptoms score three months after surgery for grade III and IV uterine prolapse and before surgery although there were patients with persistent symptoms. Bowel symptoms scores include constipation, flatus incontinence, fecal incontinence, fecal urgency, defecation frequency, defecation consistency, incomplete bowel emptying, laxative use, and frequency of defecation disorder score, with p

Objective: To know the effectiveness of pelvic organ prolapse surgery in decreasing depressive symptoms (based on PHQ9) and improving quality of life in women with pelvic organ prolapse. Methods: This experimental study without control is conducted at the Obstetrics and Gynecology Department of Dr. Mohammad Hoesin Hospital Palembang/Faculty of Medicine Sriwijaya University, from October 03 2012 until May 31, 2014. Data containing selfadministrated questionnaire about depressive symptoms (PHQ9) and quality of life (PFIQ and PFDI) were recorded. Questionnaire was performed before and six months after surgery. Sample included 26 women with pelvic organ prolapse seeking pelvic organ prolapse surgery, which qualified the inclusion criteria. Data were analyzed using Chi Square and Fisher Exact test. Data analysis was done using SPSS 18.0. Results: According to paired T test there is a significant difference between mean PHQ9 score before (6.69±3.80) and 6 months after surgery (1.96±1.75)(p=0.001). Total PFIQ score decreased from 17.15±9.39 to 2.88±4.01 with 14.27±5.38 reduction. PFDI score before surgery were 29.85±15.73 and decreased to 11.50±10.99, with a reduction of 18.35±4.74. Conclusion: There was significant reduction in depressive symptoms and improved quality of life in women with prolapse after surgery, compared to before surgery. [Indones J Obstet Gynecol 2015; 3-4: 196-199] Keywords: depression, quality of life, uterine prolapse

Objective: To investigate the association of bladder wall thickness (BWT) with severity of symptoms in overactive bladder patients in Obstetrics and Gynecology Department Dr. Mohammad Hoesin general hospital Palembang. Methods: An analytical observational study was conducted at Gynecology clinic Dr. Mohammad Hoesin General Hospital Palembang from November 2015 to August 2016. Data were analyzed with SPSS 16.0 for Windows. Bivariate analysis with the Chi square and association Rank-Spearman test was used to assess the association between BWT and visual analog scale (VAS). Results: Fourty subjects were included in the study. The mean BWT in the overactive bladder group was thicker compared to those without overactive bladder (5.8522  0.5783 vs 5.2176  0.67937). There was significant association between BWT and overactive bladder complaints. Abnormal group (5mm) had 12 times risk of overactive bladder compared to normal sample (5mm) (p = 0.029, RR = 12). Conclusion: Thus, the thickness of the urinary bladder wall measured with ultrasound examination (USG) can be used to assess the status and degree of urinary disorders in women with complaints of painful urinate and urinary disorders.  Keywords: bladder wall thickness, detrusor overactivity, overactive bladder, visual analog scale