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The Effect of Kegel Exercise on the Quality of Life in Post Turp Patients at Muhammadiyah Hospital

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The Effect of Kegel Exercise on the Quality of Life in Post Turp Patients at Muhammadiyah Hospital Journal of Vocational Nursing 02 (2021): 18-24 Volume 2, No 1, May 2021 Journal of Vocational Nursing www.e-journal.unair.ac.id/JoViN/ THE EFFECT OF KEGEL EXERCISE ON THE QUALITY OF LIFE IN POST TURP PATIENTS AT MUHAMMADIYAH HOSPITAL Cucuk Rahmadi Purwanto, Yani Erniyawati, Susilo Hariyanto, Research Report Hafna ILmy Muhalla, Fanni Oviasanti, Endah Sri Wijayanti Faculty of Vocational Studies, Universitas Airlangga A B S T R A C T A R T I C L E I N F O Introduction: Urinary incontinence is a comorbid condition that often Received May 01, 2021 occurs in post TURP clients. Low urinary incontinence scores were Accepted May, 29 2021 found in post TURP clients who did Kegel exercises. The purpose of Online May, 31 2021 this study was to explain the effect of Kegel exercise on urinary incontinence, and quality of life in post- TURP clients. Methods: The *Correspondence: study design was a true experiment pre-post test control group design. The sample size was 32 people who were selected by systematic Cucuk Rahmadi Purwanto random sampling, consisting of 16 people in the control group and 16 people in the group treatment. The independent variable in this study *Email: was Kegel exercise and the dependent variable was quality of life. Data [email protected] were collected using a quality of life questionnaire with WHOQOL- BREF. Inferential analysis used statistical t-test (Independent t-Test and Paired t-Test), MANOVA with a significance level of α < 0.05. Results: The results showed that: Kegel exercises improve quality of life scores of the significance level p = 0.045. Conclusion: Kegel exercise can build pubococcygeus muscle mass, improve blood circulation, and improve the bulbocavernosus and ischiocavernosus Keywords: muscles, thereby reducing urinary incontinence, and quality of life for Kegel exercise, post TURP clients, post TURP clients in a wider population by increasing the reach of the quality of life study population and increasing monitoring of client exercise. INTRODUCTION Benign Prostatic Hyperplasia (BPH) surgery is Benigna Prostate Hypertrofi (BPH) is rare, but 30-40% of clients experience early IU. common in men over the age of 40 years. The Clients who experience urinary prostate gland enlarges, extends upward into incontinence will reduce social interactions, the bladder and blocks the outflow of urine. physical activity, and are associated with poor Incomplete emptying of the bladder and urinary health, emotional and psychological well-being retention resulting in urinary stasis can lead to and sexual intercourse disorders which have an hydronephrosis, hydroureter, and urinary tract impact on their quality of life (Dumoulin et al., infections (UTIs). The cause is unknown, but 2015). Research conducted found that of the evidence suggests hormonal 30 elderly who experienced urinary involvement(Janice & Kerry, 2018) incontinence 28 elderly or 93.3% experienced Retention of urine continues to be the poor quality of life(Rani et al., 2020). cause occurrence inkontinentia urine (IU) is a Early incontinence can occur in up to disorder of the fulfilment of elimination of urine. 30-40% of clients. IU after BPH surgery Urinary incontinence can be in the form of urine requires careful management and evaluation. output that is sometimes very small (a few Early incontinence usually occurs which can be drops), very large, or uncontrollable (occurs due to irritating symptoms such as healing of against the will) (Rani et al., 2020). IU was the fossa or instability of the bladder muscles found in post TURP or Trans Urethral due to prolonged BPH (Zuhirman et al., 2017). Resection of the Prostate clients during the first The bladder will not fill and contract when the control after removal of the catheter tube. catheter is inserted, therefore, the bladder will According to (Bruschini et al., 2011), IU in eventually lose its tone (atony). The detrusor Cucuk Rahmadi Purwanto, et al. | Journal of Vocational Nursing 02 (2021): 18-24 muscle may not be able to contract and the detrusor overactivity (DO). USI occurs as a client cannot eliminate the urine if this happens result of injury to the sphincter mechanism and and the catheter is removed. As the client incontinence is usually associated with bladder recovers and the drainage tube is removed, the dysfunctions (BD), which includes detrusor client shows frequent urination due to the overactivity (DO). In addition, DO is associated inability to achieve bladder control quickly and with increased bladder muscle pressure with a burning sensation after the catheter is urine storage which can result in IU. removed (Hinkle & Cheever, 2018). From the Continuous urinary incontinence with initial survey conducted at the Urology the impact it brings causes the quality of life and Department of Muhammadiyah Hospital, from self-esteem of post-TURP clients to decrease. 10 clients who were control, there were 3 clients Conditions of quality of life and low self-esteem who experienced urinary incontinence, but data cause anxiety about life and can eventually lead on the decline in quality of life were not to depression. Handling inkontinentia urine documented. In other studies, it is stated that depends on the causes (Hinkle & Cheever, BPH occurs mainly at the age of over 40 years 2018). Successful management depends on The treatment plan depends on the the type of IU and the contributing factors. IU cause, severity of the obstruction, and the can be temporary or reversible, after the client's condition (Hinkle & Cheever, 2018). underlying cause has been resolved, the Contemporary data suggest that 10% of clients client's urination pattern will return to normal, so require surgery (Bruschini et al., 2011). it is necessary to evaluate the nursing and/or According to (Zuhirman et al., 2017), TURP is medical treatment (Hinkle & Cheever, 2018). still the gold standard for managing benign BPH Hospital standards for treating urinary by reducing the complication rate. TURP is the incontinence are pharmacological therapy and standard surgical treatment for BPH clients. intermittent insertion of catheter tubes. The TURP is the treatment of choice for the drugs given are a class of urinary tract prostate, but has a significant postoperative spasmolytic drugs that are not free from side morbidity rate. TURP can lead to complications effects. The intermittent catheter is inserted for such as postoperative bleeding, urethral 2 weeks with a success rate of 80%, but 20% of stricture, urinary incontinence, retrograde clients still experience recurrence within 2 days ejaculation, and TURP syndrome (Janice & after removal of the catheter tube (preliminary Kerry, 2018; Zuhirman et al., 2017). study at Muhammadiyah Hospital Lamongan). TURP is the most common procedure Catheter placement has a side effect of swelling and can be done through an endoscope. of the urethra and can lead to urinary tract Surgical and optical instruments are inserted infections and sepsis (Perry et al., 2014). directly through the urethra into the prostate, which can then be viewed directly. The gland is MATERIALS AND METHODS removed in small incisions with an electric This study used a true experimental cutting loop. This procedure does not require design with a pre-post test control group incisions, and is used for glands of various sizes design. The population in this study posted and is ideal for clients who have small glands TURP clients who control at the Poli Urology and who are considered to have a bad surgical Muhammadiyah Hospital Lamongan, recorded risk (Hinkle & Cheever, 2018). as many as 162 people. Samples were clients This approach shortens the day of stay, post TURP in Poli Urology Hospital however, strictures often arise and re-treatment Muhammadiyah Lamongan that meet the may be required (Hinkle & Cheever, 2018). criteria of inclusion as follows: Klien post-TURP According to (Zuhirman et al., 2017), the 1 week after discharge streamng catheter (3 stricture rate varies from 2.2% to 9.8%. weeks post-TURP), klien understand Stricture is a condition in which the urethra is instructions either orally or in writing narrowed due to a scar on the wall of the characterized by the client is able to explain the urethra so that it blocks the flow of urine which researcher's question again, the client is can increase pressure on the bladder and cooperative, the client has a legitimate, the age increase the activity of the detrusor muscle to is less than 65 years The exclusion criteria: push urine out. As a result, the client's inability client cognitively impaired. Samples were to control urination (BAK) and the desire for involved in the research have amounted to 32 BAK is more frequent and sudden. people, case: 16 people and control 16 votes, According to (Bruschini et al., 2011) the with the technique of sampling used by causes of IU post TURP are highly systematic random sampling (Dahlan, 2011) multifactorial, including urinary sphincter The independent variable in this study insufficiency (USI) or bladder dysfunction (BD) is the Kegel exercise. The dependent variable which is defined as decreased development or in this study is quality of life. Instruments of 19 Cucuk Rahmadi Purwanto, et al. | Journal of Vocational Nursing 02 (2021): 18-24 research that used the intervention of this analysis is presented to explain the research is SAP, guidebooks Kegel exercise, characteristics of respondents including age, Kegel exercise workout schedule cards, and education, occupation, and whether or not they the observation sheet activities. While the tools have had operations displayed in the form of used to measure the dependent variable of the distribution values and test frequency. study consist of WHOQOL-BREF, which is a independent t-test to compare differences in the short version of WHOQOL 100. WHOQOL- data pre in the control and treatment groups BREF consists of 26 items, (Refitlianti & and post in the treatment group and control, as Isfandiari, 2017; Vahedi, 2010) well as the use of multivariate analysis Location and Time of Research This MANOVA with the level of significance 0, 05 research was conducted at the Urology Poly at (Nursalam, 2016) the Muhammadiyah Hospital in Lamongan, from February to June 2018.
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