Andalas Obstetrics And Gynecology Journal

Obstructed Hemivagina and Ipsilateral Renal Agenesis (OHVIRA) Syndrome: A Rare Case Report

Ega Atista — 2026-02-02

Introduction: The Herlyn-Werner-Wunderlich (HWW) syndrome, also known as obstructed hemivagina and ipsilateral renal agenesis (OHVIRA), is a rare form of Mullerian Duct Anomalies (MDA). The patient with OHVIRA syndrome has dysmenorrhea, abdominal pain, and a lump in the belly. Although the exact cause and pathology of OHVIRA syndrome are unknown, early diagnosis and treatment can reduce acute symptoms and preserve normal fertility.

Case Report: This article reports a case of 15 a 15-year-old woman who complained of foul mucopurulent discharge. Ultrasound finding uterus didelphys, right obstructed hemivagina with resultant pyocolpos, and suspected of right renal agenesis. The patient was diagnosed with OHVIRA syndrome. The patient underwent vaginal septal resection, and the pyocolpos was drained.

Discussion: Intraoperatively, a completely obstructed longitudinal vaginal septum was identified on the right hemivagina, with purulent fluid consistent with pyocolpos. After septal resection, adequate drainage was achieved and communication between both hemivaginas was established. Postoperatively, the patient showed clinical improvement, with resolution of vaginal discharge and relief of vaginal obstruction. No intraoperative or immediate postoperative complications were observed. During short-term follow-up, the patient remained asymptomatic, with no evidence of recurrent obstruction or infection.

Conclusion: This case highlights several important aspects of OHVIRA syndrome, including its atypical postpartum presentation, diagnostic challenges, and unpredictable reproductive outcomes. Ultrasonography plays a key role in early detection. Vaginal septal resection and drainage are effective in relieving symptoms and preventing complications. Reporting this rare presentation contributes to improved awareness and timely management of OHVIRA syndrome in adolescents.

Double Approach Technique for Cervicovaginal Agenesis: A Case Report

Tyas Priyatini — 2026-02-02

Introduction: Cervicovaginal agenesis is rare female congenital anomalies. The patients usually present with primary amenorrhoea, cyclical abdominal pain, or primary infertility. A conservative surgical approach has been proposed to alleviate obstructive symptoms, construct, and maintain the patency of the genital tract, while still preserving fertility.

Case Report: A Ms. 14 year old was referred with primary amenorrhea and cyclical abdominal pain for 5 months. Physical examination and ultrasound revealed cervical dysgenesis with proximal vaginal dygenesis. Cervical canalization using double approach (laparotomy and trasnvaginally) was done to restore the normal anatomical integrity, maintain the functional cervical canal with a theoretical advantage of protection from ascending infection, and preservation of fertility.

Discussion: Obstructed menstrual blood, causing symptoms such as primary amenorrhea, could be a sign of female congenital anomalies. Hysterectomy has been the mainstay treatment for many decades, due to the risk of reoperation. Advances in surgical technique of conservative treatment marked the overall success rate up to 60% with few cases are reported to have pregnancy.

Conclusions: Double approach technique could be a feasible option for conservative surgery in cervicovaginal agenesis.

Treatment of Prepubertal Labial Adhesion: A Case Report

Ibnuzaer Khalilullah — 2026-02-02

Introduction : Labial adhesion is a condition in which the labia minora adhere to each other, either partially or completely, and is most commonly observed in prepubertal girls. The highest incidence typically occurs between the ages of 3 months and 6 years, a period during which lower estrogen levels make the vulvar mucosa more susceptible to irritation and adhesion.

Objective : To report and discuss a rare case of labial adhesion on prepubertal.

Methods : A prepubertal girl diagnose with labial adhesion at Dr. M. Djamil Central Hospital was reported and discuss the management.

Result : A four-year-old girl was referred to the outpatient urogynecology clinic by a network hospital for labial adhesion. Upon general assessment, the child's development appeared appropriate for her age. Her medical history did not reveal any significant illnesses, surgical procedures, or history of sexual abuse, and her general physical examination was normal. Upon inspection, the labia majora were normal, but he labia minora appeared fused with a 0.2 cm gap at the proximal area of the adhesion. The adhesions appear thick and non-transparent For this patient, we decided to proceed with excision of the labial area without first attempting estrogen therapy. Seven days post-operation, the patient returned for a follow-up visit in good condition. The surgical wound was dry, urination was normal, and the examination showed a normal vaginal opening.

Conclusion: From this case report, we conclude that for long-standing labial adhesion characterized by tissue thickening, labial excision is the appropriate and effective treatment option.

Ascites Due To Pseudomyxoma Peritonei (Pmp): A Rare Case Report

Ferdinal Ferry — 2026-02-02

Introduction: Pseudomyxoma Peritonei (PMP), also known as "jelly-belly," is a rare condition characterized by the accumulation of mucinous ascites in the peritoneal cavity. It often originates from mucinous neoplasms of the appendix and presents with non-specific symptoms like abdominal bloating and discomfort. Diagnosis is often incidental through imaging, surgery, or histopathology.

Objective: To report the diagnosis and management of PMP in a 53-year-old woman presenting with abdominal enlargement.

Case Report: A 53-year-old woman was referred with a two-month history of abdominal enlargement. Initial ultrasound findings suggested ascites due to cirrhosis or ovarian carcinoma. However, further evaluation with abdominal CT revealed ascites and cholelithiasis without signs of cirrhosis or ovarian carcinoma. Diagnostic laparoscopy showed peritoneal carcinomatosis, and 8000 ml of hemorrhagic ascites was drained. Histopathological examination confirmed the diagnosis of PMP, and tissue resection was performed.

Conclusion: The management of PMP requires a comprehensive diagnostic approach, incorporating clinical history, physical examination, imaging, and histopathological evaluation. This systematic approach is crucial for accurate diagnosis and effective treatment of PMP.

The Correlation between High Uric Acid Levels and the Severity of Preeclampsia

I Wayan Artana Putra — 2026-02-02

Introduction: Preeclampsia is a pregnancy complication marked by hypertension and multi-organ dysfunction, contributing to significant maternal and fetal morbidity and mortality, particularly in developing nations. Identifying severe cases early remains challenging due to limited biomarker specificity and predictive accuracy. Uric acid has been proposed as a potential marker, though its reliability in predicting severity remains debated.

Methods: This cross-sectional study included 54 pregnant women diagnosed with preeclampsia at RSUP Prof. Dr. I.G.N.G Ngoerah, Denpasar, with a gestational age of over 20 weeks. Participants were selected through consecutive sampling. Data on serum uric acid, blood pressure, proteinuria, and creatinine levels were analyzed using parametric statistical tests to assess correlations with preeclampsia severity.

Results: Elevated uric acid levels (>6 mg/dL) were significantly associated with severe preeclampsia (p=0.039), with a prevalence ratio of 2.96. Strong correlations were found between uric acid and blood pressure (r=0.71, p=0.012) and proteinuria (r=0.64, p=0.012), while a moderate correlation existed with serum creatinine (r=0.40, p=0.002).

Conclusion: Serum uric acid levels can be a useful indicator for assessing preeclampsia severity. However, its predictive value should be combined with other clinical and biochemical markers to enhance early detection and management strategies

Comparative Sexual Outcomes of Laparoscopic Davydov and SIS Graft for Neovagina in MRKH Patients: Meta-Analysis

Wael Oemar — 2026-02-02

Introduction: Mayer-Rokitansky-Küster-Hauser (MRKH) syndrome is a rare congenital anomaly of the female reproductive system, characterized by the absence of the uterus and upper vagina. Neovaginal reconstruction is the primary treatment to enable normal sexual function. Two commonly used techniques are the laparoscopic Davydov procedure and the use of Small Intestine Submucosa (SIS) grafts.

Methods: A systematic review and meta-analysis were conducted on studies comparing these two surgical techniques in MRKH patients. Literature searches were performed through multiple international databases. Inclusion criteria involved both observational and experimental studies reporting anatomical and sexual function outcomes postoperatively. Statistical analysis was performed to compare the outcomes of both techniques.

Results: The review found that both techniques are effective in achieving satisfactory anatomical and functional neovagina creation. However, differences were observed in parameters such as duration of molding use, vaginal length, and FSFI domain scores. The laparoscopic Davydov procedure showed advantages in anatomical outcomes and shorter molding duration, while SIS grafts demonstrated better scores in some subjective aspects of sexual function.

Conclusion: Both the laparoscopic Davydov procedure and SIS grafts are effective in neovagina creation for MRKH patients. The Davydov technique offers superior anatomical results and reduced postoperative dilation time, whereas SIS grafts may provide improved sexual desire, arousal, and satisfaction. Further studies with larger and more diverse populations are needed to validate these findings.

Legal Protection for Doctors Performing Pregnancy Termination for Anencephalic Fetuses as Viewed from Undang-Undang Number 17 of 2023 on Health

Yusrawati Yusrawati — 2026-02-02

Introduction: Legal protection for healthcare professionals is a critical issue, particularly concerning pregnancy termination procedures involving medical emergencies. This study focuses on how Indonesian law regulates pregnancy termination in cases involving anencephalic fetuses, especially when the gestational age exceeds 14 weeks, and examines the protection afforded to doctors and the practical challenges they face. The research aims to analyze the legal framework provided under Law Number 17 of 2023 on Health and assess its implementation in the field.

Method: Using a juridical-normative and empirical-juridical approach with a descriptive-analytical method, this study utilizes primary data from interviews with doctors, legal scholars, and religious figures, and secondary data from relevant laws and academic literature.

Result: The findings reveal that while the law allows pregnancy termination under 14 weeks for medical emergencies or pregnancies from sexual violence, it lacks clear provisions for cases exceeding 14 weeks, such as anencephaly. Although anencephaly poses a serious medical risk, legal uncertainty persists for healthcare workers who perform terminations after this threshold.

Conclussion: Terminations conducted following medical standards and with consent should not be criminalized. Therefore, legal reforms and clearer regulatory guidelines are essential to ensure adequate protection for medical personnel handling such exceptional cases.

The Role of Transforming Growth Factor Beta (TGF-β) in Pelvic Organ Prolapse : A Systematic Review

Yulia Margaretta Sari — 2026-02-02

Introduction: Pelvic organ prolapse (POP) is a gynaecological disorder with a rising prevalence, significantly affecting quality of life. While the pathogenesis of POP is multifactorial, alterations in the extracellular matrix (ECM) have been implicated, particularly the role of transforming growth factor-beta (TGF-β) in ECM remodelling. However, the precise relationship between TGF-β and POP remains unclear.

Methods: A systematic review was conducted following PRISMA guidelines. Relevant studies were identified from PubMed, Scopus, Web of Science, and the Cochrane Library. Inclusion criteria focused on studies investigating TGF-β expression in women with POP. Data extraction included study design, patient demographics, TGF-β detection methods, and key findings.

Results: Analysis of nine studies revealed mixed findings. Four studies reported a significant reduction in TGF-β1 expression in POP patients, suggesting impaired ECM regulation via the TGF-β1/Smad3 pathway. Three studies found no significant differences in TGF-β levels between POP and control groups, while one study linked increased TGF-β1 levels to severe prolapse, possibly as a compensatory response. Variations in methodology, sample size, and patient characteristics contributed to inconsistencies across studies.

Conclusion: Current evidence suggests that TGF-β1 plays a role in POP pathogenesis, with lower levels potentially weakening ECM integrity and higher levels in advanced cases reflecting a failed reparative response. Further research is needed to explore TGF-β interactions with other biomarkers and assess its potential as a therapeutic target.

The Relationship Between Parity, History Of Antenatal Care (ANC), Pregnancy Complications, Estimated Fetal Weight and Fetal Presentation To The Selection Of Cesarean Section Action

Helmy Aries Stiawan — 2026-02-02

Introduction: There is an increase in caesarean sections trend globally. Caesarean section is generally performed to assist deliveries that cannot be carried out normally, but this also has a significant impact on both maternal and child health, as well as the economic burden so it is necessary to evaluate the factors that influence decision for caesarean section, to determine the relationship between parity, antenatal care

Method: This study is an analytical observational study with a case control design conducted in July 2024 using medical record data of pregnant women who underwent caesarean section or vaginal delivery at the Pariaman City Regional General Hospital in the urban area and Sungai Dareh Regional Hospital at Dharmasraya in rural areas. The sample for this study were pregnant women who chose caesarean section and women after vaginal delivery who met the inclusion and exclusion criteria

Results: In this study there were 354 pregnant women who underwent CS (n=177) and vaginal delivery (n=177). Bivariate analysis showed a relationship between parity (OR: 1.64 [95% CI: 1.07-2.52]; p=0.023), history of ANC (OR: 1.64 [95% CI: 1.06-2, 55]; p=0.026), pregnancy complications (OR:3.16 [95% CI: 1.98-5.03]; p=0.000), fetal presentation (OR: 2.02 [95% CI: 1.26-3.24]; p=0.003) and estimated fetal weight (OR: 1.98 [95% CI: 1.19-3.30]; p= 0.008) with the decision making of caesarean section. Multivariate analysis showed that the most influencing factors on the decision making of caesarean section were pregnancy complications (OR 4.35 [95% CI: 2.58 – 7.34]; p= 0.000), fetal presentation (OR 3.21 [95% CI : 1.85 – 5.55]; p=0.000) and parity (OR 1.59 [95% CI: 1.01 – 2.52]; p=0.044).

Conclusion: The factors that most influence the decision making of caesarean section are pregnancy complications, fetal presentation, and parity.

Relationship Between Age And Menopausal Status With The Incident Of Epithelial Ovarian Carcinoma At RSUP Dr. M. Djamil Padang

Carmiyana Puja Harsby — 2026-02-02

Introduction : High Grade Serous Ovarian Carcinoma (HGSOC) been the dominant subtype and accounted for the highest mortality rate of epithelial ovarian cancer. Therefore, knowledge of the risk factors for epithelial ovarian cancer was needed for early detection. Age and menopausal status were examples of risk factors. This study aimed to determine the relationship between age and menopausal status with the incidence of epithelial ovarian cancer subtype of HGSOC at M Djamil Central Hospital Padang.

Method : This type of research is an observational analytic research design cross-sectional. The form sample is secondary data used in the total sampling method, which comes from 90 patients of ovarian cancer. Research in analysis univariate and bivariate presented in form table frequency.

Result : In this study, it was found that epithelial ovarian cancers subtype HGSOC was found mostly in women aged > 50 years (68,9%) and who had experienced menopause (80%). In the analytic test, the p value for age and menopausal status was 0.382 and 0.104.

Conclusion: Concluded there is no relationship between age and menopausal status with the incidence of epithelial ovarian cancer subtype HGSOC at M Djamil Central Hospital Padang

The Relationship of Age with TNF-α Levels in Pregnancy and Abortion

Cici Monika — 2026-02-02

Introduction: Tumor Necrosis Factor Alpha (TNF-α) plays a crucial role in the early control of abortion. This increase can be influenced by age. The purpose of this study was to analyze the relationship between age and TNF-α in both normal pregnancies and abortion.

Method: The type of research is analytic with a cross sectional design, collecting samples using total sampling technique, resulting in 36 patients who were subsequently assessed for TNF-α levels at the Biomedical Laboratory of Andalas University. The source of research data is secondary data. Data analysis involved the Spearman correlation test, Independent T-test, and Mann-Whitney test.

Result: The average gestational age was younger, the average maternal age was older, and the average TNF-α levels were higher in abortion compared to normal pregnancy. The BMI of all patients was normal. There is a significant difference between age in normal pregnancy and abortion (p = 0.001), there is no relationship between age and TNF-α levels in normal pregnancy (p = 0.429), there is no relationship between age and TNF-α levels in abortion (p = 0.862), and there is no difference in TNF-α levels between normal pregnancy and abortion (p = 0.248).

Conclusion: there is a significant difference between age in normal pregnancy and abortion.

The Relationship Between Microplastic Samples in Blood and The Stage of Epithelial Ovarian Cancer at Dr. M. Djamil Padang General Hospital

Annisa Anzar Aprilianti — 2026-02-02

Introduction: Ovarian cancer is the primary cause of cancer-related mortality in women, with epithelial ovarian cancer (EOC) ranking as the second greatest cause of death among gynaecological malignancies. The rising use of plastics has resulted in increased microplastic exposure among the population. This exposure aligns with recognised risk factors for ovarian cancer, including genetic, hormonal, and lifestyle elements.

This study aimed to investigate the relationship between microplastics in blood samples and the stage of epithelial ovarian cancer at Dr. M. Djamil General Hospital, Padang.

Methods: Between August 2024 and January 2025, a cross-sectional analytical correlational investigation was carried out. Forty individuals with histopathologically verified epithelial ovarian carcinoma were consecutively recruited. Blood samples were examined for di(2-ethylhexyl) phthalate (DEHP) microplastics utilizing Liquid Chromatography–Mass Spectrometry (LCMS). Data were evaluated utilizing descriptive statistics and the Chi-square test, with p < 0.05 being significant.

Results: The average age of patients was 49.1±10.59 years, with the majority being multiparous, married, and of normal weight. The histological subtypes comprised mucinous (37.5%), serous (30%), endometrioid (20%), and clear cell (12.5%). Microplastics were identified in 30% of blood samples, with the greatest prevalence observed in mucinous (40%) and endometrioid (37.5%) subtypes. Statistical study indicated no significant correlation between microplastic occurrence and the stage of epithelial ovarian cancer (p = 0.869).

Conclusion: Microplastics were identified in the blood of around one-third of patients with epithelial ovarian cancer, present across all histological subtypes. However, no substantial link was identified between the presence of microplastics and the cancer stage.

The Effect of Inositol On Malondialdehyde Serum Levels in Medical Students With PCOS

Eldisha Nofityari — 2026-02-02

Introduction: Polycystic ovary syndrome involves the endocrine system, metabolic system, as well as the reproductive system contributing to anovulatory infertility. Polycystic ovary syndrome affects 5-20% of reproductive age and 6-12% of adolescents. Oxidative stress is known to play an important role in the pathogenesis of PCOS resulting in excessive formation of ROS (malondialdehyde). ROS can be controlled by the antioxidant inositol and has minimal side effects. To determine the effectivity of inositol antioxidant on malondialdehyde serum levels in female students Medical faculty, Andalas University with clinical PCOS.

Methods: This study is a clinical trial research with a pure experimental study design (true experimental design). There were 23 samples for the experimental group and 23 samples for the control group selected by probability sampling. Normality test using Shapiro-Wilk test. Data analysis using Independent T test and Mann Whitney Test.

Results: There was a significant decrease in malondialdehyde serum levels in PCOS students who consumed inositol therapy for 3 months.

Conclusion: There is an effect of inositol antioxidant consumption on malondialdehyde serum levels in female students Medical faculty, Andalas University with clinical polycystic ovary syndrome.

Determinants of VIA Test Acceptance among Women of Reproductive Age at Padang Pasir

Putri Aqischa Cahyani — 2026-02-02

Introduction: Visual Inspection with Acetic Acid (VIA) is an early detection method for cervical precancerous lesions. VIA coverage in Indonesia remains low. This study aimed to analyze the association of sociodemographic factors, information sources, and husband’s support with VIA test acceptance among women of reproductive age at Padang Pasir Health Center, Padang City.

Method: An analytic observational study with a cross-sectional design was conducted in December 2023. The population consisted of women of reproductive age in the working area of Padang Pasir Health Center. A total of 100 respondents were selected using consecutive sampling. Data were collected through structured interviews with questionnaires and analyzed statistically.

Result: The analysis revealed no significant association between age, education, occupation, or socioeconomic status and VIA acceptance. In contrast, information sources and husband’s support were significantly associated with acceptance. No significant relationship was found between acceptance and actual participation in VIA screening.

Conclusion: Sociodemographic factors did not influence VIA acceptance. Information access and husband’s support were key determinants of willingness to undergo VIA testing. Strengthening health promotion and involving husbands in cervical cancer prevention programs are recommended strategies to increase VIA coverage.

Identification of Gender in Early Pregnancy Using Cell-Free Fetal Dna

Budi Junio Hermawan — 2026-02-02

Introduction: Traditionally, chorionic villus sampling and amniocentesis can be used to help identify fetal gender around 11 weeks of pregnancy. However, the risk of miscarriage with these procedures is approximately 1 to 3%. The discovery of cell-free fetal DNA (cffDNA) fragments in the plasma and serum of pregnant women carrying male fetuses has made reliable and accurate diagnosis using non-invasive procedures an option for determining fetal gender.

To determine the success rate of fetal gender identification in early pregnancy using Cell Free Fetal DNA.

Methods: An analytical observational research method to identify fetal gender in early pregnancy through Cell Free Fetal DNA examination in maternal blood. A total of 70 samples were collected using quota sampling technique. Data analysis was performed using sensitivity and specificity tests, as well as cross-sectional analysis to determine the relationship between PCR test results and gender at birth.
Results: The PCR test has low sensitivity (14.29%), meaning the test is less effective in correctly detecting male gender, resulting in many false negatives. However, it has high specificity (98.11%), indicating its excellent ability to detect female gender with very few false positives. Additionally, the Pearson Chi-Square statistical test resulted in a p-value of 0.033 (p < 0.05), indicating a statistically significant relationship between PCR test results and gender at birth.
Conclusion: Statistically, this test is better at identifying females than males, with a lower error rate for females.

The Relationship Between Short Chain Fatty Acids and Menarche in Elementary School Students in Padang City

Zulfiqar MS — 2026-02-02

Introduction: Early menarche is associated with long-term health problems. Currently, adolescent girls are increasingly experience the change of menarche age. Short chain fatty acids (SCFA) are known to play a role in the early release of GnRH which induces an earlier onset of menarche. However, so far there have been no human studies assessing SCFA levels in individuals with early menarche.

Method: This is a case-control study in elementary school students in Padang which conducted from July 2024 to November 2024. The sample was all elementary school students in Padang who met the inclusion and exclusion criteria. The data collected were demographic data and SCFA levels measured in faecal samples using the ELISA method. Bivariate analysis was performed using the unpaired T-test.

Result: In this study, there were 25 students with early menarche and 25 normal students. Students with early menarche experienced the earliest age of menarche in 9 years old, 56% had excessive BMI, 20% had mother history of early menarche, 20% were born prematurely, 52% had high-fat diet, 100% lived with their parents and had no history of pornography exposure. This study found the differences in fecal SCFA levels based on age of menarche with the mean SCFA levels found to be higher in the early menarche group compared to normal menarche (39.09 ± 6.64 vs 26.91±5.01 μmol/gram; p=0.000)

Conclusion: This study found the differences in fecal SCFA levels based on age of menarche

Efficacy of Autologous Platelet-Rich Plasma (PRP) on Perineal Wound Healing: A Controlled Non-Randomized Clinical Trial.

Muhammad Fadli — 2026-02-02

Introduction: Perineal wounds are a very common complication of vaginal birth. Perineal trauma associated with childbirth is defined as damage to the skin, perineal muscles, as well as the sphincter and anal epithelium complex. This study aims to determine the effect of PRP use on perineal wounds.

Method: A single-center, controlled, non-randomized, non-blinded clinical trial was designed in patients with perineal wounds after vaginal delivery. PRP was taken from each patient's serum (autologous). Perineal wound healing after intervention was assessed using the Redness, Oedema, Ecchymosis, Discharge, Approximation (REEDA) scale. Perineal wound pain was assessed using the Visual Analog Scale (VAS).

Result: The current study involved 56 samples, 28 people per group. The average age of the patients was 28.38 ± 6.280 years. The highest education was high school, 42.9%, while the lowest was elementary school (21.4%). The highest VAS scale was 3 (42.9%) and the lowest was 1 (5.4%). The prevalence of the highest degree of perineal wounds in general was degree 2 (98.2%). The highest score was in the moderately healed group on PRP administration (92.9%). In contrast to the control group, the mildly healed category was 21.4% and not healed 14.4%.

Conclusion: There is a significant relationship between the PRP to healing perineal wounds in vaginal delivery patients at the Seberang Padang Health

Smartphone-Based Kegel Exercises for Stress Urinary Incontinence: A Systematic Review and Meta-Analysis of RCT

Surahman Hakim — 2026-02-02

Introduction : To evaluate the effectiveness of smartphone-based applications in supervising Kegel exercises for women with Stress Urinary Incontinence (SUI), specifically in improving treatment adherence and reducing symptom severity as measured by the ICIQ-UI-SF score.

Method : This study compares smartphone-based applications for supervising Kegel exercise in women with SUI. Article retrieved from 3 databases using specific keywords. ICIQ-UI-SF scores and adherence data is the main outcome in this article.

Results : Five RCTs with a total of 475 participants were included. Three studies demonstrated improved adherence among intervention groups using smartphone applications. Meta-analysis revealed that application based supervision resulted in significantly better post-treatment ICIQ-UI-SF Score (SMD: -0.46, CI [-0.65,-0.28], p < 0.00001)

Conclusion : Smartphone applications as a supervision tool for SUI patients who underwent Kegel exercise as a conservative treatment is proven to reduce severity and increasing adherence of the therapy.