The Degree of Cystocele and Rectocele with Hiatal Area Levator Ani
| Main Authors: | Moegni, Fernandi, Santoso, Hari |
|---|---|
| Format: | Article info application/pdf Journal |
| Bahasa: | eng |
| Terbitan: |
Indonesian Society of Obstetrics and Gynecology
, 2017
|
| Online Access: |
http://inajog.com/ojs/index.php/journal/article/view/566 http://inajog.com/ojs/index.php/journal/article/view/566/481 |
Daftar Isi:
- Objective: To investigate the degree of cystocele and rectocelewith a maximum of levator hiatal area (AHL) during Valsava.Methods: Secondary data analysis of 90 patients with uterine prolapseJanuary 2012 to November 2013 in the clinic Urogine-kologiRSCM, Jakarta. 3D/4D ultrasound measurement and pelvic organprolapse system Quantification (POP-Q) stage I-IV cystocele and rectocelestage I-IV. All statistical analyses were analyzed using Stata 20for Windows.Results: Significant difference cystocele stage I-II (n = 25) withstage III-IV (n = 65), the maximum AHL with a difference of 4.33cm2 (p = 0.040). In rectocele stage I-II (n = 64) and stage III-IV (n= 26) of 3.85 cm2 (p = 0.130). AUC values for stage I-II and III-IVcystocele was 0.607 (IK95% from 0.467 to 0.738), and the ROC forrectocele was 0.603 (IK95% from 0.472 to 0.734). The ROC optimalcut point for cystocele stage I-II with III-IV with the highestsensitivity and specificity is 29 cm2 (0.523 sensitivity, specificity0.520), the rectocele is 30 cm2 (0.538 sensitivity, specificity0.584).Conclusion: There is a significant relationship between the degreeof cystocele and area of the levator ani muscles when Valsava, butthere is no relationship at rectocele. The value of maximum areaunder the curve (AUC) hiatal area of the levatorani muscle in distinguishingstage I-II and III-IV cystocele are relatively similar torectocele stage I-II and III-IV. Optimal cut point hiatal area of thelevatorani muscle in distinguishing stage I-II and III-IV cystoceleis 29 cm2, while for rectocele is 30 cm2 with sensitivity andspecificity values were quite good.[Indones J Obstet Gynecol 2017; 5-4: 225-229]Keywords: cystocele, levatorani hiatal area, pelvic organ prolapse,rectocele