DIVISION OF UROGYNECOLOGY AND PELVIC RECONSTRUCTIVE SURGERY / DIAN UTAMI

MAY 26th – JUNE 2nd 2021

DATE OF
NO PATIENT ID DETAIL OF PATIENT TREATMENT RECOMMENDATION
ADMISSION
1. 27/05/2021 Mrs. S P8A0  Transvaginal  Vaginal hygiene
90 years old Menopause since >35 years ago hysterectomy  Surgical wound care
MR 117043  Anterior colporrhaphy  Heavy physical activities
Pre-Operative Diagnosis:  Posterior colporrhaphy should be avoided during this
St Khadijah I Uterine prolapse grade 4 + Cystocele grade 3 + Rectocele grade 3 + Rectal  Levatorplasty healing period.
Hospital prolapse

Post-Operative Diagnosis:
Uterine prolapse grade 4 + Cystocele grade 3 + Rectocele grade 3 + Rectal
prolapse

Pre-Operative Post-Operative POP-Q

Aa Ba C
+3 +7 +9

GH PB TVL
4 3 10

Ap Bp D
+3 +7 +8

2. 27/05/2021 Mrs. H P7A0  Transvaginal  Vaginal hygiene

68 years old Menopause since 20 years ago hysterectomy  Surgical wound care
MR 117299  Anterior colporrhaphy  Heavy physical activities
Pre-Operative Diagnosis:  Posterior colporrhaphy should be avoided during this
St Khadijah I Uterine prolapse grade 2 + Cystocele grade 3 + Rectocele grade 3 healing period.
Hospital

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 DIVISION OF UROGYNECOLOGY AND PELVIC RECONSTRUCTIVE SURGERY / DIAN UTAMI
MAY 26th – JUNE 2nd 2021

Post-Operative Diagnosis:
Uterine prolapse grade 2 + Cystocele grade 3 + Rectocele grade 3

Pre-Operative Post-Operative POP-Q

Aa Ba C
+2 +2 +1

GH PB TVL
4 3 10

Ap Bp D
+2 +2 -1

3. 28/05/2021 Mrs. Y P5A1  Transvaginal  Vaginal hygiene

70 years old Menopause since 20 years ago hysterectomy  Surgical wound care
MR 386574  Anterior colporrhaphy  Heavy physical activities
Pre-Operative Diagnosis:  Posterior colporrhaphy should be avoided during this
Grestelina Uterine prolapse grade 4 + Cystocele grade 4 + Rectocele grade 4 healing period.
Hospital
Post-Operative Diagnosis:
Uterine prolapse grade 4 + Cystocele grade 4 + Rectocele grade 4

Pre-Operative Post-Operative POP-Q

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 DIVISION OF UROGYNECOLOGY AND PELVIC RECONSTRUCTIVE SURGERY / DIAN UTAMI
MAY 26th – JUNE 2nd 2021

Aa Ba C
+3 +8 +8

GH PB TVL
3 2 9

Ap Bp D
+3 +7 +8

4. 31/05/2021 Mrs. M P3A0  Transvaginal  Vaginal hygiene

61 years old Menopause since 20 years ago hysterectomy  Surgical wound care
MR 934625  Anterior colporrhaphy  Heavy physical activities
Pre-Operative Diagnosis:  Posterior colporrhaphy should be avoided during this
Wahidin Uterine prolapse grade 4 + Cystocele grade 3 + Rectocele grade 3 healing period.
Sudirohusodo
Hospital Post-Operative Diagnosis:
Uterine prolapse grade 4 + Cystocele grade 3 + Rectocele grade 3

Pre-Operative Post-Operative POP-Q

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 DIVISION OF UROGYNECOLOGY AND PELVIC RECONSTRUCTIVE SURGERY / DIAN UTAMI
MAY 26th – JUNE 2nd 2021

Aa Ba C
+3 +7 +10

GH PB TVL
4 3 10

Ap Bp D
+3 +7 +8

5. 31/05/2021 Mrs. R P6A0  Le fort colpocleisis  Vaginal hygiene

67 years old Menopause since 20 years ago  Surgical wound care
MR 117349  Heavy physical activities
Pre-Operative Diagnosis: should be avoided during this
St Khadijah I Uterine prolapse grade 3 + Cystocele grade 2 + Rectocele grade 2 healing period.
Hospital
Post-Operative Diagnosis:
Uterine prolapse grade 3 + Cystocele grade 2 + Rectocele grade 2

Pre-Operative Post-Operative POP-Q

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 DIVISION OF UROGYNECOLOGY AND PELVIC RECONSTRUCTIVE SURGERY / DIAN UTAMI
MAY 26th – JUNE 2nd 2021

Aa Ba C
+3 +1 +7

GH PB TVL
4 3 10

Ap Bp D
+3 +1 +6

6. 01/06/2021 Mrs. H P5A0  Posterior colporrhaphy  Vaginal hygiene

45 years old  Surgical wound care
MR 117180 Pre-Operative Diagnosis:  Heavy physical activities
Uterine prolapse grade 1 + Rectocele grade 2 should be avoided during this
St Khadijah I healing period.
Hospital Post-Operative Diagnosis:
Uterine prolapse grade 1 + Rectocele grade 2

Pre-Operative Post-Operative POP-Q

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 DIVISION OF UROGYNECOLOGY AND PELVIC RECONSTRUCTIVE SURGERY / DIAN UTAMI
MAY 26th – JUNE 2nd 2021

Aa Ba C
-3 -3 -8

GH PB TVL
4 3 10

Ap Bp D
+3 +4 -9

7. 27/05/2021 Mrs. H P5A0  Transabdominal total  Vaginal hygiene

74 years old Menopause since >30 years ago hysterectomy  Surgical wound care
MR 117135 History of purandares cervicopexy on 1996 due to uterine prolapse  Bilateral Salpingo-  Heavy physical activities
Using vaginal pessary on the last 5 years, complaining vaginal discharge for the Oophorectomy should be avoided during this
St Khadijah I last 2 months  Anterior colporrhaphy healing period.
Hospital
POP-Q

Aa Ba C
-1 -2 -1

GH PB TVL
4 3 9

Ap Bp D
-1 -2 -8

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 DIVISION OF UROGYNECOLOGY AND PELVIC RECONSTRUCTIVE SURGERY / DIAN UTAMI
MAY 26th – JUNE 2nd 2021

Pre-Operative Diagnosis:
Uterine prolapse grade 2 + Cystocele grade 1 + Rectocele grade 1 + Suspicion
adhesion of pelvic organ + Post purandare cervicopexy procedure

Post-Operative Diagnosis:
Uterine prolapse grade 2 + Cystocele grade 1 + Rectocele grade 1 + Uterine
adhesion with vesicouterine plica + Post purandare cervicopexy procedure

8. 27/05/2021 Mrs. R P1A1 Repair of perineal  Vaginal hygiene

26 years old History of vaginal birth 12 hours prior to admission, consulted to urogynecology laceration:
MR 219294 division due to grade IIIC of perineal laceration  SAI repaired with PGA
3.0 horizontal mattras
Ibnu Sina Pre-Operative Diagnosis:
suture
Hospital Grade IIIC of perineal laceration
 SAE repaired with PGA
2.0 overlapped suture
 Vaginal muscle repaired
Post-Operative Diagnosis:
Grade IIIC of perineal laceration with PGA 2.0 horizontal
continues suture
 Vaginal mucosa
repaired with PGA 3.0
continuous suture
Lactulose syrup/8 hours /orally
Cefadroxil 500 mg/12
hours/orally
Paracetamol 500 mg/8
hours/orally
  Inform the patient about the
 Avoid sexual intercourse for 6
weeks
 Avoid intra-rectal medication
 Educate to increase fiber
intake, drinking plenty of
water and using stool
softener for 2 weeks
 Perform pelvic floor and anal
sphincter exercise
 Evaluation sphincter healing
in 3-6-9-12 months after
delivery
risk of recurrence, risk of
developing anal incontinence
and mode of delivery for the
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 DIVISION OF UROGYNECOLOGY AND PELVIC RECONSTRUCTIVE SURGERY / DIAN UTAMI
MAY 26th – JUNE 2nd 2021

subsequent pregnancy

Pre-operative Post-operative

hymenal ring

bulbocavernosus muscle

transverse perineal muscle

external anal
sphincter

internal anal
sphincter

9. 02/06/2021 Ms.L Chief complaint : never had menstruation  Neovaginoplasty  Vaginal hygiene
24 years old Diagnosed with vaginal atresia on 2013 
MR 806652  Maintain urine catheter for
Physical examination 14 days
Wahidin  Secondary sex characteristic development is appropriate according to her age
Sudirohusodo  External genitalia appear normal
Hospital  Vaginal opening is absence
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DIVISION OF UROGYNECOLOGY AND PELVIC RECONSTRUCTIVE SURGERY / DIAN UTAMI
MAY 26th – JUNE 2nd 2021

Ultrasonography  Maintain vaginal mold for 10-

14 days

 Uterine agenesis
 Both adnexa within normal limit

Pre-Operative Diagnosis:
Primary amenorrhea due to vaginal agenesis ec. Mayer-Rokitansky-Kuster-Hauser
Syndrome

Post-Operative Diagnosis:
Mayer-Rokitansky-Kuster-Hauser Syndrome

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 DIVISION OF UROGYNECOLOGY AND PELVIC RECONSTRUCTIVE SURGERY / DIAN UTAMI
MAY 26th – JUNE 2nd 2021

Pre-operative.

Intra-operative

vaginal dimple

The dimple in the introital area is identified and hydrodissection performed. A transverse incision is made in the epithelium.
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DIVISION OF UROGYNECOLOGY AND PELVIC RECONSTRUCTIVE SURGERY / DIAN UTAMI
MAY 26th – JUNE 2nd 2021

Makassar, June 3rd 2021

Acknowledge By
Supervisor

Dr. dr. Trika Irianta, Sp.OG(K)

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