Evaluation of Pelvic Floor Dysfunction for Patient with History of Total Vaginal Hysterectomy at Dr Sardjito General Hospital Yogyakarta

Abstract

Introduction: Uterine prolapse is the herniation of the uterus into or beyond the vagina as a result of failure of the ligamentous and fascial supports. It often coexist with prolapse of the vaginal walls, involving the bladder or rectum. A surgical treatment for uterine prolapse is hysterectomy. Changes in pelvic anatomic structure due to hysterectomy can result in impaired pelvic function because of nerve or pelvic muscle structure damage during surgery. Objective: This study aims to evaluate the presence of pelvic floor dysfunction in uterine prolapse patients who have undergone Total Vaginal Hysterectomy (TVH) surgery at Dr Sardjito General Hospital, from November 2018 to September 2019. Evaluations were carried out using Pelvic Floor Distress Inventory (PFDI) questionnaire. Methods: This study is an analytical descriptive research, using secondary data taken from patient’s medical records at Dr. Sardjito General Hospital Yogyakarta. It uses The Pelvic Floor Distress Inventory (PFDI) questionnaire, which consisted of 3 assessment groups, those are Pelvic Organ Prolapse Distress Inventory 6 (POPDI-6), Colorectal-Anal Distress Inventory 8m(CRADI 8), and Urinary Distress Inventory 6 (UDI- 6). The inclusion criteria of this study were patients with diagnoses of uterine prolapse, cystocele and rectocele, who could be contacted and gave consent to conduct telephone interview. Results: There were 14 patients that met the inclusion criteria, they are uterine prolapse, cystocele and rectocele patients with a history of TVH procedure, were assessed using PFDI questionnaire. All patients did not have any pelvic floor dysfunction either from the POPDI-6, CRADI-8 or UDI-6 assessment groups. The weakness of this evaluation is that the PFDI postoperative value cannot be compared with before surgery, so it cannot be proven that the absence of pelvic floor dysfunction in the patient concerned is a positive result of the surgery performed, or not give significant changes. Conclusion: There is no pelvic floor dysfunction in patients with a history of TVH procedure on the indication of uterine prolapse, which was performed at Dr Sardjito General Hospital Yogyakarta.