Background: The incidence of sexual dysfunction increases in women with pelvic organ prolapse. In addition to physical factors, other important components that influence each other in sexual dysfunction are psychological aspects and genital self-image. Sociocultural factors also affect individual sexuality and sexual behavior. Until now, there are no data and the relationship between genital self-image and sexual dysfunction in pelvic organ prolapse is not known in Indonesia. Objective: This study aims to analyze the correlation of genital self-image with sexual dysfunction in women with pelvic organ prolapse. Methods: In this cross-sectional study, 113 consecutive women with pelvic organ prolapse were selected in urogynecology referral centers in Jakarta. Demographic data, physical examination, and guided interviews were filled in to complete the Female Sexual Function Index and Female Genital Self-Image Scale-7 questionnaires. Preliminary research has been carried out in the form of language translation and cultural validation of the Indonesian version of the Female Genital Self-Image Scale-7 questionnaires. Results: There is a significant correlation between genital self-image and sexual dysfunction, where the lower Female Genital Self-Image Scale-7 score significantly predicts the lower Female Sexual Function Index score ( p < 0.000; odds ratio: 14.17). Conclusion: Genital self-image is the main variable that affects sexual function in women with pelvic organ prolapse. It is necessary to evaluate and treat genital self-image because sexual function is an integrated component of quality of life.

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AbstrakPada kehamilan preeklampsia terjadi gangguan metabolisme karbohidrat dan lemak. Komponen sindrom metabolik berupa resistensi insulin, obesitas, dan dislipidemia memberikan kontribusi untuk terjadinya preeklampsia. Penelitian ini dilakukan dengan metode analitik observasional dengan desain kohort prospektif di Poliklinik Obgyn RSUP Dr. M. Djamil Padang, Puskesmas Koto Berapak, dan Bidan Praktek Swasta di Lintau pada bulan Juli 2013 sampai Mei 2014. Dari 60 sampel penelitian kehamilan trimester II dengan Roll over test positif. Setiap subjek diperiksa BMI, kadar gula darah puasa, LDL, HDL, trigliserida, dan insulin. Kemudian dibagi menjadi 2 kelompok, yaitu komponen metabolik positif dan negatif. Analisis statistik untuk menilai kemaknaan menggunakan unpaired t test dan chi square pada SPSS 18.0 for windows. Tidak terdapat hubungan yang bermakna antara komponen metabolik dengan kejadian preeklampsia (p>0.05). Hubungan yang tidak signifikan secara statistik ditemukan pada komponen metabolik lain seperti kadar HDL dan resistensi insulin (p>0.05). Pemeriksaan HOMA IR juga tidak memperlihatkan hubungan yang bermakna dengan kejadian preeklampsia. Namun analisis subgrup memperlihatkan rerata kadar insulin pasien preeklampsia lebih tinggi dibandingkan dengan kehamilan normal dan bermakna secara statistik (p<0.05). Penilaian BMI menunjukkan hubungan yang bermakna dengan kejadian preeklampsia (p<0.05) Kata Kunci : Preeklampsia, sindrom metabolik, gula darah puasa, LDL, HDL, trigliserida, HOMA IR, BMI. AbstractIn preeclampsia occurring carbohydrate and fat metabolism disorders. Components of the metabolic syndrome such as insulin resistance, obesity, and dyslipidemia contributes to the occurrence of preeclampsia. This was an observational analytic study with Kohort design and has been performed in Obgyn Department of M. Djamil Hospital Padang, primary health care in Koto Berapak, Private Practice Midwive in Lintau from July 2013 to May 2014. 60 samples of second trimester of pregnancy with positive Roll over test. Each subject was examined BMI, fasting blood glucose, LDL, HDL, triglycerides, and insulin level. Then divided into two groups, positive metabolic components group and negative metabolic components group. Statistical analysis to assess significance using the unpaired t test and chi square on SPSS 18.0 for windows. There was no significant association between metabolic components and preeclampsia (p>0.05). Other metabolic components such as HDL level and insulin resistance was not statistically significant with preeclampsia (p>0.05). HOMA IR examination also showed no significant association with the incidence of preeclampsia. However, subgroup analysis showed a mean insulin levels higher in preeclampsia patients compared with normal pregnancies (p<0.05). BMI showed a significant association with preeclampsia (p<0.05).

Objective: To report and discuss the causes and management of rectovaginal fistula in post repair chronic total perineal rupture.Method: A case report, a 29-year-old female patient who came to Fatmawati General Hospital with complaints of anal incontinence 9 days after repair chronic total perineal rupture. Rectovaginal examination revealed a rectovaginal fistula 2 mm in diameter at 1.5 cm proximal to the hymenal ring.Discussion: Rectovaginal fistula is one of the complications after repair of hronic total perineal rupture which disturbs the quality of life of women. The patient was diagnosed with a rectovaginal fistula in post repair chronic total perineal rupture. Conservative management with wound care and administration of honey to the patient showed improved postoperative outcome.Conclusion: Anatomical identification of the anal sphincter complex, surgical technique and postoperative care are important in preventing complications following repair of chronic total perineal rupture repair.Keywords : obstetrics sphincter anal injury,  postrepair chronic, rectovaginal fistulae .   Abstrak Tujuan : Untuk melaporkan dan mendiskusikan penyebab dan tatalaksana kasus fistula rektovagina pasca repair ruptur perineum total lama.Metode: Sebuah laporan kasus, pasien perempuan 29 tahun yang datang ke RSUP Fatmawati dengan keluhan inkontinensia anal 9 hari pascarepair ruptur perineum total lama. Pemeriksaan rectovaginal menunjukkan fistula rektovagina diameter 2 mm pada 1,5 cm proksimal hymenal ring.Diskusi : Fistula rektovagina merupakan salah satu komplikasi pascarepair ruptur perineum total yang mengganggu kualitas hidup perempuan. Pasien didiagnsos fistula rektovagina pascarepair ruptur perineum total lama. Manajemen konservatif dengan perawatan luka dan pemberian madu pada pasien menunjukkan perbaikan luaran paska operasi.Kesimpulan: Identifikasi anatomis kompleks sfingter ani, teknik operasi dan perawatan pascaoperasi penting dalam mencegah komplikasi pascarepair ruptur perineum total lama.Kata kunci: cedera sfingter ani obstetri, fistula rectovagina, repair ruptur perineum total lama