Genital self-image as predictor of sexual dysfunction in women with pelvic organ prolapse in Indonesia.

BACKGROUND: The incidence of sexual dysfunction increases in women with pelvic organ prolapse. In addition to physical factors, other important components that influence each other in sexual dysfunction are psychological aspects and genital self-image. Sociocultural factors also affect individual sexuality and sexual behavior. Until now, there are no data and the relationship between genital self-image and sexual dysfunction in pelvic organ prolapse is not known in Indonesia. OBJECTIVE: This study aims to analyze the correlation of genital self-image with sexual dysfunction in women with pelvic organ prolapse. METHODS: In this cross-sectional study, 113 consecutive women with pelvic organ prolapse were selected in urogynecology referral centers in Jakarta. Demographic data, physical examination, and guided interviews were filled in to complete the Female Sexual Function Index and Female Genital Self-Image Scale-7 questionnaires. Preliminary research has been carried out in the form of language translation and cultural validation of the Indonesian version of the Female Genital Self-Image Scale-7 questionnaires. RESULTS: There is a significant correlation between genital self-image and sexual dysfunction, where the lower Female Genital Self-Image Scale-7 score significantly predicts the lower Female Sexual Function Index score (p < 0.000; odds ratio: 14.17). CONCLUSION: Genital self-image is the main variable that affects sexual function in women with pelvic organ prolapse. It is necessary to evaluate and treat genital self-image because sexual function is an integrated component of quality of life.

Deep (aggressive) angiomyxoma of the vagina misdiagnosed as Gartner cyst: A case report.

INTRODUCTION AND IMPORTANCE: Aggressive angiomyxoma is a rare soft tissue tumor. Aggressive angiomyxoma is a slow-growing vulvovaginal mesenchymal neoplasm with a marked tendency for local recurrence, but with a low tendency to metastasize. As it has a predilection for the pelvic and perineal regions, Aggressive angiomyxoma is often misdiagnosed. This case report documented rare case of misdiagnosed Aggressive Angiomyxoma as Gartner duct cyst. PRESENTATION OF CASE: This article report a case of 31 year old women who complained mass came out from vagina without any urinary symptom and trauma. Physical examination and ultrasound finding suggested that the mass was Gartner Duct cyst. Management in this case was excision of the vaginal cyst. Histopathology examination revealed Deep (aggressive) angiomyxoma. DISCUSSION: The rarity of Deep (Aggressive) Angiomyxoma makes the preoperative diagnosis fairly difficult. Aggressive angiomyxoma is often misdiagnosed as it may have similar clinical presentation to common lesions such as Bartholin cyst or prolapse vaginal wall, Gartner cyst or levator hernia. Aggressive Angiomyxoma should be considered as differential diagnosis in patient with vaginal cyst. CONCLUSION: Aggressive Angiomyxoma is rare condition. Preoperative diagnosis and management are challenging. Long term follow op and evaluation should be done due to high rate of recurrence.

Secondary cervical elongatio due to large Gartner cyst: A rare case.

INTRODUCTION: The exact mechanism by which pelvic tissues lose their anatomic support and undergo descent through the genital hiatus remains elusive. In this case, large Gartner cyst causes secondary cervix elongatio due to the weight of the cyst. Gartner cyst arise from the remnants of the mesonephric ducts. They are typically located in the anterolateral wall and are small. The rarity of this case is very interesting because of the mass size reaches 15 cm and causes cervical elongation. PRESENTATION OF CASE: This article report a case of 37 years old women who complained large mass came out from vagina. Patient was diagnosed with large anterior vaginal cyst and cervical elongatio. Ultrasound finding suggested that the cyst was originated from anterior wall of vagina in accordance with Gartner cyst. Patient underwent cyst excision, there was no connection between the cyst and urethra. Operation was continued with Manchester Forthegill to restore normal anotomy of the cervix. DISCUSSION: Secondary cervical elongatio in this case was caused by large Gartner cyst, eventhough there are possibility involvement of other factors. Cervical elongatio plays important role in the decision of operation in this case after removal vaginal cyst. CONCLUSION: Secondary cervix elongation due to Large Gartner cyst is rare condition. Enlarge cyst causes secondary cervix elongatio, and operation technique was also challenging.