Raymond Surya
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A Preliminary Study: The Effectiveness of CO2 Laser Therapy for Stress Urinary Incontinence: Sebuah Studi Awal: Efektivitas Terapi Laser CO2 sebagai Terapi Inkontinensia Urin Tipe Tekanan Fernandi Moegni; Nadir Chan; Budi I. Santoso; Raymond Surya; Leonardo Tanamas
Indonesian Journal of Obstetrics and Gynecology Volume 8 No. 4 October 2020
Publisher : Indonesian Socety of Obstetrics and Gynecology

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.32771/inajog.v8i4.763

Abstract

Objective: To evaluate the role of fractioned CO2 laser intravaginal as a non-invasive treatment for relieving stress urinary incontinence (SUI) symptoms.Methods: This was a prospective, quasi-experimental study in patients with SUI. The patients were treated through three different sessions in a month apart by the fractioned CO2 laser Femilift©, produced by Alma Lasers. The patients fi lled and completed questionnaires about continence assessment, quality of life, and sexuality before and after therapy based on PISQ-12 and ICIQ-UI questionnaire. Perineometry was performed to prove the outcome.Results: Twenty women were enrolled. At 4 weeks following the third treatment, there was a signifi cant improvement for continence assessment (7.70 ± 4.38 to 4.50 ± 2.88; p < 0.001), quality of life and sexuality (28.13 ± 7.06 to 33.13 ±7.80; p < 0.001), and vaginal perineometer results (37.20 ± 17.24 to 48.80 ± 16.72; p = 0.009).Conclusions: Fractioned CO2 intravaginal laser has a role in improving SUI symptoms.Keywords: fractioned CO2 laser, stress urinary incontinence, vaginal rejuvenation. AbstrakTujuan: Untuk mengetahui efektivitas terapi laser CO2 terfraksi intravaginal sebagai terapi non-invasif untuk mengurangi gejala inkontinensia urine (IU) tipe tekanan.Metode: Penelitian ini merupakan studi prospektif, quasieksperimental pada pasien dengan inkontinensia urin (IU) tipe tekanan yang mengikuti terapi laser CO2 terfraksi intravaginal tiga sesi berbeda, dengan jarak satu bulan menggunakan laser CO2 terfraksi Femilift© dari Alma Lasers. Subjek mengisi kuesioner mengenai penilaian kontinensia, kualitas hidup dan kehidupan seksual sebelum dan sesudah terapi (kuesioner PISQ-12 dan ICIQ-UI). Selain kuesioner, pemeriksaan perineometri juga dilakukan pada beberapa subjek penelitian untuk membuktikan efektivitas terapi.Hasil: Dua puluh subjek ikut dalam penelitian ini. Penilaian pada minggu keempat setelah sesi terapi ketiga, menunjukkan peningkatan yang signifi kan pada penilaian kontinensia (7.70 ± 4.38 ke 4.50 ± 2.88; p < 0.001), pada kualitas hidup dan kehidupan seksual (28.13 ± 7.06 ke 33.13 ±7.80; p < 0.001), dan pada hasil perineometri (37.20 ± 17.24 ke 48.80 ± 16.72; p = 0.009).Kesimpulan: Terapi laser CO2 terfraksi intravaginal menunjukkan kecenderungan untuk mengurangi gejalainkontinensia urine (IU) tipe tekanan.Kata kunci: inkontinensia urin tipe tekanan, terapi laser CO2 terfraksi intravaginal, vaginal rejuvenation.
Role of Ambulatory Laparoscopy in Diagnosis of Ascites with Unknown Etiology Herbert Situmorang; Raymond Surya; Tantri Hellyanti
Indonesian Journal of Obstetrics and Gynecology Volume 9 No. 3 July 2021
Publisher : Indonesian Socety of Obstetrics and Gynecology

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.32771/inajog.v9i3.1362

Abstract

Background: Ascites could be caused by many underlying diseases, mainly portal hypertension, malignancy, and heart failure. Other etiologies include tuberculosis and pancreatitis. Difficulties in confirming the cause of ascites have been seen in many clinical settings. Ambulatory laparoscopy is one of powerful tools to rule out many etiologies of ascites despite being invasive in its nature. This case report would like to show one case of peritoneal TB presenting with ascites. Patient has undergone many laboratory workups in search of ascites origin. Literature study is done to look for evidence about timing and role of laparoscopy in ascites work-up. Case illustration: A-26-year-old P2 woman came to hospital with a history of vaginal delivery 22 days before admission presenting with massive ascites. No obstetric complication was found. Transvaginal ultrasound revealed normal postpartum uterus and ovaries, surrounded with ascites. Both the liver and kidneys were found normal on ultrasound. Abdominal CT scan with contrast showed massive ascites with thickened omentum. ADA was 36 IU/L. We decided to perform diagnostic laparoscopy and biopsy for histopathology. We found massive yellowish ascites and hyperaemic tubal enlargement with thickening of the peritoneum. Pathology examination proved the appearance of chronic salpingitis and granulomatous peritonitis consistent with tuberculosis peritonitis. Conclusion: Laparoscopy as a minimal invasive tool can diagnose ascites with unknown etiology patients after failure to prove diagnosis from clinical laboratory and radiological examination. It is one best alternative to diagnose peritoneal TB presenting with ascites with its superiority in visualizing abdominal cavity and obtaining specimens for histology with lower risk of morbidity.
Blood Transfusion in Obstetric Cases: Transfusi Darah pada Kasus Obstetri Ali Sungkar; Raymond Surya
Indonesian Journal of Obstetrics and Gynecology Volume 8 No. 3 July 2020
Publisher : Indonesian Socety of Obstetrics and Gynecology

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.32771/inajog.v8i3.1376

Abstract

Objective: To discuss about blood loss in an obstetric setting, the role of blood transfusion, and patient blood management.Methods: Literature review.Results: Severe anaemia with hemoglobin level less than 7 g/dL or late gestation (more than 34 weeks) and/ or significant symptoms of anaemia, the recommendation is giving only single unit transfusion followed by clinical reassessment for further transfusion. In postpartum hemorrhage (PPH), massive transfusion protocols are commonly used description as large volume of blood products over a brief period to a patient with uncontrolled or severe hemorrhage, transfusion more than 10 RBC units within 24 hours, transfusion more than 4 RBC units in 1 hour with anticipation of continued need for blood, replacement of more than 50% of total blood volume by blood products within 3 hours. All obstetric units have a clear-cut massive transfusion protocol for the initial management of life-threatening PPH, considering early transfusion therapy with RBCs and FFP.Conclusion: Patient blood management aims to maintain hemoglobin concentration, optimize haemostasis, and minimize blood loss in effort to improve patient outcomes. Massive transfusion protocol in management of life-threatening should depend on each obstetric unit.Keywords: blood transfusion, obstetric cases, patient blood management. Abstrak Tujuan: Untuk mendiskusikan tentang hilang darah dalam obstetric, peran transfusi darah, dan patient blood management.Metode: Kajian pustaka.Hasil: Anemia berat dengan nilai hemoglobin kurang dari 7 g/dL atau kehamilan lanjut (lebih dari 34 minggu) dan/ atau gejala nyata anemia, rekomendasi ialah memberikan satu unit transfusi diikuti dengan penilainan klinis untuk transfusi lebih lanjut. Pada perdarahan postpartum, protokol transfusi massif umum digambarkan sebagai volume darah yang dibutuhkan jumlah banyak dalam periode singkat, transfusi lebih dari 10 sel darah merah dalam 24 jam atau lebih dari 1 jam, penggantian lebih dari 50% total volume darah dalam 3 jam. Seluruh unit obstetric memiliki protokol transfusi massif yang jelas untuk taalaksana awal perdarahan postpartum dengan mempertimbangkan transfusi awal untuk komponen sel darah merah dan FFP.Kesimpulan: Patient blood management bertujuan untuk menjaga konsentrasi hemoglobin, optimalisasi hemostasis, dan minimalisasi hilang darah untuk meningkatkan luaran pasien. Protokol transfusi masfi dalam tatalaksana yang mengancam nyawa sangat bergantung pada setiap unit obstetrik.Kata kunci: kasus obstetri, patient blood management, transfusi darah
Management of Isolated Tubal Torsion (ALADIN) during Emergency Laparotomy in Infertile Women Bella Aprilia; Raymond Surya; Bram Pradipta
Indonesian Journal of Obstetrics and Gynecology Volume 10 No. 4 Oktober 2022
Publisher : Indonesian Socety of Obstetrics and Gynecology

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.32771/inajog.v10i4.1582

Abstract

Introduction: Isolated tubal torsion (ITT) is rare cases with challenging to diagnose. We would like to report ITT and primary infertility patient which came with acute abdominal pain. Case: A 36 yo female came to Koja Hospital with acute abdominal pain without sign of infections. Ultrasound findings show cystic mass on bilateral adnexal sized 76x28x39 mm and 31x51x43 mm with minimal ascites. During laparotomy, proximal right fallopian tube was torsioned four times clockwise. There was hydrosalping founded on contralateral tube, while right and left ovaries and uterus were normal. We performed salpingectomy. Discussion: The clinical presentation of ITT is non-specific and it has become a challenge to physician to develop preoperative diagnosis. The spectrum of imaging findings may be wide range depending on adnexal pathology, degree of severity, and the duration of adnexal torsion. The recommendation of primary approach to tubal torsion is conservative management considering ALADIN (mALignAncy-Death tissue, INfertility). Conclusion: The diagnosis is rarely be made before operation, due to non-specific clinical symptoms and imaging findings. The considerations to perform conservative management are malignancy, death tissue/necrotic, and infertility.