Introduction: Uterine prolapse is a gynecological problem that women often experience with a prevalence of 50% and is predicted that the next 30 years will increase by 45% as life expectancy increases. Increased degrees of uterine prolapse have an impact on the deterioration of women's quality of life. The uterine prolapse is influenced by several mutually supportive factors. The purpose of this study was to analyze the relationship between these factors to the degree of uterine prolapse.Methods: This research is an observational analytic research with cross sectional approach. The number of samples were 65 patients with uterine prolapse at Policlinic Gynecology RSUD Dr. Soetomo Surabaya from 2015-2017. Sampling was done by consecutive sampling. To find out the significant level, the collected data will be tested with Fisher Exact Test statistic at significance level α = 0,05.Results: The result showed that there was significant difference between degree of uterine prolapse with age factor (p = 0,016) and obesity (p = 0,041). As for the parity factor (p = 0.508) there was no significant difference between the parity factor and the degree of uterine prolapse.Discussion: Age is a major factor affecting the degree of uterine prolapse, weakening of pelvic floor tissue and muscle in elderly women is the main cause. While on the obesity factor, there is no data to support that obesity is related to the degree of uterine prolapse because the trend indicates that the majority of patients are not obese. In contrast the parity factor, although according to the statistical test there is no difference to the degree of uterine prolapse, the trend shows that parity leads to increased incidence of uterine prolapse itself.Conclusion: Age is a factor that affects the degree of uterine prolapse.

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Patient: Female, 23-year-old Final Diagnosis: Giant fibroepithelial polyps of the vulva in women with uterine myoma and primary infertility Symptoms: Irregular bleeding and mass on the vulva Medication:— Clinical Procedure: — Specialty: Obstetrics and Gynecolog Objective: Rare disease Background: Reproductive health is closely related to long-term quality of life and maternal well-being in obstetrics. The overall incidence of fibro-epithelial polyps in the general population is about 46%, but a location on the vulva is quite rare, and is very rare when the size is more than 5 cm. Case Report: A 23-year-old woman reported irregular bleeding and a mass on the vulva. After anamnesis, physical examination, biopsy, and radiology imaging, the patient was diagnosed with uterine myoma, primary infertility, and a large solid and benign mass on the vulva. The mass found on the vulva was apparently unrelated to intra-abdominal organs and urogynecology. After performing an excision accompanied by a laparoscopic myomectomy, the histopathological results showed that the mass on the vulva was a 16×11×6 cm fibroepithelial polyp weighing 700 g. After 7 months of therapy, the submucosal uterine myoma recurred. Submucosal uterine myomas were found rooted into the vaginal canal, so the surgeon performed an extirpation operation. Eight months later, the patient succeeded in having a pregnancy that ended in delivery by cesarean section. Conclusions: Giant fibroepithelial polyps are very rare. Management is by excision accompanied by a laparoscopic myomectomy. They affect reproductive health and require appropriate management and diagnosis.

Background: Cervical cancer is one of the deadliest diseases for women’s lives. It is estimated that almost every hour, one died because of cervical cancer and 70% of new cases are found in an advanced stage. Many factors could cause cervical cancer, one of the risk factors is the age of the early coitarche. This study aims to determine the association between the age of coitarche and cervical cancer.Methods: This study was an analysis of observational study with a case-control design. There were two groups in this study; the case group of outpatients who were diagnosed with cervical cancer and the control group of outpatients who had normal cervical cytology by Papanicolaou screening. The 39 respondents of both the control and case groups, calculated using the Lemeshow’s formula for consecutive sampling, were interviewed for their details concerning reproductive and sexual histories, socio-economic status, hygiene, and education. The independent variable in this study was the age of coitarche; the dependent variable was cervical cancer. The data were analyzed descriptively and using the bivariate analysis (Chi-square) with α=0.05.Results: It is identified that 39 respondents for each group (case and control) have almost the same percentage of the age of coitarche in One-Stop Oncology Polyclinic (POSA’s outpatient); early coitarche of 43.6% and late coitarche of 56.4%. The age of early coitarche in Obstetrics and Gynecology’s outpatients, as a control group, is rare (4 of 39 respondents; 10.3%) and most of them did their sexual debut at the age of >18 years (89.7%). The chi-square test showed there was a correlation between the age of coitarche and cervical cancer (P=.002; OR=6.76; 95% CI 2.01–22.75).Conclusions: Early coitarche has a potential effect on cervical cancer.

Recurrent Pelvic organ prolapse is a condition that affects the quality of life for women. Uterine prolapse percentage reached 35-50 % of women and the incidence increases with age and parity. In young women in reproductive age, uterine prolapse incidence is low, only 2 % nulliparous women experience POP. This case report aims to study the causes of uterine prolapse stage III-IV at young age after second reconstructive surgery. A 38 years old woman came to gynecology outpatient clinic dr Soetomo hospital, her chief complaint was uterine dropped after second reconstructive surgery. She had the first surgery at the age of 22, with reduction of round ligament (Baldy-Webster suspension), and had the second reconstruction surgery at the age of 31 years. A Purandare procedure was done few weeks afterwards, when she had cough and the pelvic organ going downward again. The third operation is scheduled, few weeks afterward, it was decided to do purandare procedure because of her age and nulliparity. However, due to severe adhesion and during surgery right tuboovarial abcess is found, SVH-SOD, adhesiolisis and Purandare procedure to suspend cervix stomp. Histopathologic result shows decreased collagen levels IA2. As a conclusion, the cause of twice uterine prolapse in these patients is the decrease of collagen, intraabdominal pressure and infection from tuboovarial abscess.