Characteristic of patients with pelvic organ prolapse in obstetric and gynecologic outpatient clinic in Sanglah Hospital, Bali, Indonesia from January 2014 to December 2015

Kusuma, I Gede Yogi Suwistha; Putra, I Gede Mega; Megadhana, I Wayan; Sanjaya, I Nyoman Hariyasa; Manuaba, Ibg

doi:10.15562/bmj.v6i1.390

Cited by 9 publications

(6 citation statements)

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“…10 These fi ndings were similar to another study at the Sanglah Hospital in Denpasar which found that the majority of cases of uterine prolapse were more than 60 years old. 11 This study found that all respondents had menopause for more than 5 years. Menopause plays a role in the pathogenesis of uterine prolapse.…”

Section: Discussionmentioning

confidence: 70%

Uterine Prolapse in Postmenopausal Women in the Coastal Areas

Saimin¹,

Hafizah²,

Indriyani³

et al. 2020

Indones J Obstet Gynecol

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Objective: To assess the characteristics of postmenopausal women in the coastal areas that experience uterine prolapse.Methods: This was a retrospective descriptive study conducted at Alpha Gynecology Clinic in Kendari. Samplesare cases of uterine prolapse from coastal areas that visited in January to December 2017. Samples were taken by consecutive sampling. The diagnosis of uterine prolapse is based on the Pelvic Organ Prolapse Quantification system. Data is presented with tables and narration.Results: There were 21 respondents who experienced uterine prolapse. Most respondents were aged 61-70 years (42.8%), work as housewives (71.4%), parity more than 4 (85.7%), and duration of menopause >5 years (100.0%). The most common complaint at the fi rst time was a feeling of a lump in the vagina (81.0%), in the third degree of uterine prolapse (57.1%), and accompanied by comorbidities (66.7%). Conclusions: Uterine prolapse in postmenopausal women in the coastal areas was found in housewives, aged 61-70 years, grande-multiparous, and duration of menopause >5 years. The main complaint was felt a lump in the vagina, in the third degree and accompanied by comorbidities. Counselling, information and education regarding symptoms and management of uterine prolapse need to be done.Keywords: coastal areas, postmenopausal women, uterine prolapse.AbstrakTujuan: Mengetahui karakteristik perempuan postmenopause di daerah pesisir yang mengalami prolapsus uteri.Metode: Penelitian ini bersifat deskriptif retrospektif yang dilakukan di Klinik Ginekologi Alfa di Kendari. Sampel adalah kasus prolapse uteri yang berasal dari daerah pesisir yang berkunjung pada bulan Januari sampai Desember 2017. Sampel diambil secara consecutive sampling. Diagnosis prolapsus uteri berdasarkan sistem Pelvic Organ Prolapse Quantification. Data disajikan dalam bentuk tabel dan narasinya.Hasil: Hasil penelitian menunjukkan terdapat 21 responden yang mengalami prolapsus uteri. Responden terbanyak berusia 61-70 tahun (42,8%), pekerjaan sebagai ibu rumah tangga (71,4%), paritas lebih dari 4 (85,7%), dengan lama menopause lebih dari 5 tahun (100,0%). Keluhan yang paling sering dialami pada saat pertama datang adalah terasa ada yang mengganjal di jalan lahir (81,0%), dengan diagnosis prolapsus uteri derajat 3 (57,1%), dan disertai penyakit penyerta (66,7%).Kesimpulan: Prolapsus uteri pada perempuan postmenopause di daerah pesisir ditemukan pada ibu rumah tangga, usia 61-70 tahun, grande multipara, menopause >5 tahun. Keluhan utama terasa ada yang mengganjal di jalan lahir disertai penyakit penyerta, dengan diagnosis prolapse uteri derajat 3. Perlu dilakukan penyuluhan, konseling dan edukasi mengenai gejala dan penatalaksanaan prolapsus uteri.Kata kunci: daerah pesisir, prolaps uteri, perempuan postmenopause.

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Section: Discussionmentioning

confidence: 70%

Uterine Prolapse in Postmenopausal Women in the Coastal Areas

Saimin¹,

Hafizah²,

Indriyani³

et al. 2020

Indones J Obstet Gynecol

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“…9 Study from Bali, Indonesia also conclude that severe stage POP is most likely to be found in women with high parity, older age (≥60 years old), and who went through menopause already. 10 Saimin et al 11 found that menopaused women had higher POP prevalence compared to pre-menopausal women. Menopause is associated with older age and decreased of estrogen levels.…”

Section: Discussionmentioning

confidence: 98%

Comparison of levator hiatal area and anteroposterior length between pelvic organ prolapse subject with and without bulging symptoms

Moegni

Natanael

Priyatini

et al. 2022

UIJ

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Pelvic Organ Prolapse (POP) is defined as the descent of the pelvic viscera (uterus, bladder, urethra, and rectum) from its normal position. There are different stages of POP starting from early asymptomatic until late obvious symptomatic stages. Levator Anal Muscle (LAM) which plays an important part in POP pathogenesis, showed that there was difference in Levator Hiatal (LH) area and anteroposterior length on every grade of POP. It is important to determine early diagnose of asymptomatic POP clinically by anteroposterior length measurement, and determined its relation with LH area measurement using Ultrasound (US) imaging. To compare LH area and anteroposterior length between POP subject with and without bulging symptom. A cross-sectional study was conducted among women diagnosed as POP with and without bulging symptom in a Urogynecology Clinic between November 2019 to March 2021. Patients were examined using the POP-Q system and 3D/4D imaging of the LH area using Voluson type systems. Data were analyzed to compare LH area and anteroposterior length between groups. A total of 109 subjects were included in this study. There was a significance difference in LH area (28.9+5.59 cm2 vs 19.6+4.63 cm2, p < 0.05 during valsalva maneuver, 15.2+4.08 cm2 vs 12.5+3.15 cm2, p <0.05 during contraction) and anteroposterior length (8.6+1.06 cm, vs 6.8+1.13 cm, p<0.05) between groups with and without bulge symptom. LH area and anteroposterior length cut-off to differentiate between subject with and without bulging symptom was respectively 25,1 cm2 [sensitivity 84,6%, specificity 92,9%, AUC 0,925 (0,864-0,986)] and 7,75 cm [sensitivity 87,2%, specificity 77,1%, AUC 0,859 (0,787-0,932)]. In patient without bulging symptom there was a significant difference of anteroposterior length between prolapse stage 1, 2, and 3. Post hoc analysis with Tukey test showed a significant difference of anteroposterior length only between grade 0 and 2, and grade 1 and 2. There was a significant difference in LH area and anteroposterior length between groups with and without bulging symptom. LH area cut-off at 25,1 cm2, anteroposterior length cut-off at 7.75 cm showed good sensitivity and specificity to differentiate between 2 groups.

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“…Another study showed that the prevalence of POP in developing countries was around 19.7%. In an observational descriptive study at the Department of Obstetrics and Gynecology at the Faculty of Medicine, Udayana University/ Prof I. G. N. G Ngoerah Hospital Denpasar in 2014-2015, it was found that 11.38% of the total gynecologic cases were controlled by the obstetrics clinic [1]- [3].…”

Section: Introductionmentioning

confidence: 99%

Low HOXA13 Expression in the Sacrouterine Ligament as A Risk Factor for Grade III-IV Uterine Prolapse

Tjiptohardjo¹,

Megadhana²,

Putra³

et al. 2023

EJMED

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Introduction: Uterine prolapse grade III and IV or advance stage uterine prolapse manifest in symptoms that reduces the quality of life of women. Sacrouterine ligaments are the main support of the uterus in preventing advanced stage uterine prolapse. Remodeling process occurs in the extracellular matrix and there are many genes that are involved in the process. One of the gene that is involved is the HOXA13 that upregulates the components of extracellular matrix. This study focuses on the expression of HOXA13 in the sacrouterine ligament as a risk factor in occurring advanced stage uterine prolapse. Methods: We designed an unmatched case-control study to include 44 cases of women that was performed hysterectomy in Prof I. G. N. G Ngoerah Hospital. 22 cases are with advanced stage uterine prolapse and the 22 controls are with non-uterine prolapse. Sacrouterine ligaments samples were collected, and immunohistochemistry was performed. Chi-square test was done to find the odds ratio of the low expression of HOXA13 with advanced stage uterine prolapse. Results: We found 16 (72%) women in this case group had a low HOXA13 expression, while only 5 (22%) women in the control group had a low expression of the gene. Low expression of HOXA13 in sacrouterine ligament has 9 times risk of having advanced stage uterine prolapse (OR = 9.067; 95% CI = 2,3-36.65; p =0,001) compared with the high expression. Conclusion: Low expression of HOXA13 increases the risk of advanced stage uterine prolapse and subsequently may become a possible predictor for uterine prolapse.

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Characteristic of patients with pelvic organ prolapse in obstetric and gynecologic outpatient clinic in Sanglah Hospital, Bali, Indonesia from January 2014 to December 2015

Cited by 9 publications

References 0 publications

Uterine Prolapse in Postmenopausal Women in the Coastal Areas

Uterine Prolapse in Postmenopausal Women in the Coastal Areas

Comparison of levator hiatal area and anteroposterior length between pelvic organ prolapse subject with and without bulging symptoms

Low HOXA13 Expression in the Sacrouterine Ligament as A Risk Factor for Grade III-IV Uterine Prolapse

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