UI - Tugas Akhir :: Kembali

UI - Tugas Akhir :: Kembali

Kejadian inkontinensia urin tekanan de novo dan faktor risiko yang berhubungan pada pasien prolaps organ panggul pasca-operasi pervaginam = The occurrence and clinical characteristic of de novo stress urinary incontinence after vaginal repair surgery on pelvic organ prolapse patients in Ciptomangunkusumo Hospital Jakarta.

Ihya Ridlo Nizomy; Budi Iman Santoso, supervisor; Joedo Prihartono, supervisor; H. Junizah, examiner; Suskhan Djusad, examiner; Surahman Hakim, examiner; Tyas Priyatini, examiner; Fernandi Moegni, examiner (Fakultas Kedokteran Universitas Indonesia, 2018)

 Abstrak

Latar Belakang: Inkontinensia urin (IU) menurut ICS didefinisikan sebagai keluarnya urin yang tidak dapat dikendalikan atau dikontrol, yang secara obyektif dapat diperlihatkan dan merupakan suatu masalah sosial dan higienis. Pada perempuan, gangguan fungsi berkemih ini sering kali didapatkan pasca-operasi koreksi kelainan Prolaps Organ Panggul (POP). Inkontinensia Urin Tekanan de novo (IUT de novo) adalah IU yang terjadi pada pasien POP pasca-operasi pervaginam yang tidak didapatkan sebelum operasi.
Tujuan: Untuk mengetahui kejadian IUT de novo dan faktor risiko yang berhubungan pada pasien POP pasca-operasi pervaginam di Divisi Uroginekologi dan Rekonstruksi Departemen Obstetri dan Ginekologi RSCM Jakarta.
Metode: Studi klinis potong lintang yang dilakukan pada 75 orang pasien POP pasca-operasi pervaginam di Divisi Uroginekologi dan Rekonstruksi Departemen Obstetri dan Ginekologi RSCM Jakarta pada bulan Januari 2016 sampai Juli 2017. Penilaian kejadian IUT de novo dan faktor risiko yang berperan dilakukan berdasarkan data Rekam Medik, lembar penilaian Kuesioner QUID (Questionnaire for Urinary Incontinence Diagnosis) versi Indonesia dan dikonfirmasi dengan pemeriksaan Cough Stress Test secara kualitatif dan tes pembalut pad test secara kuantitatif.
Hasil: Dari 75 subyek penelitian didapatkan angka kejadian IUT de novo sebesar 8% (6/75). Uji analisis statistik menunjukkan hanya 2 faktor risiko yang berperan secara bermakna (p < 0,05) terhadap kejadian IUT de novo pada pasien POP pasca-operasi pervaginam di RSCM Jakarta, yaitu derajat POP yang berat dan penyakit Diabetes Mellitus dengan nilai OR 0,13 (95% CI 0,02-1,63) dan 23,75 (95%CI 2,29-590,2).
Kesimpulan: Pada penelitian ini, angka kejadian IUT de novo pada pasien POP pasca-operasi pervagnam adalah 8% dengan faktor risiko yang berperan adalah derajat POP preoperatif yang berat dan penyakit Diabetes Mellitus.

Background: Stress Urinary Incontinence remains a main women's health problem due to its devastating impacts to the quality of life. Some patients with pelvic organ prolapse (POP) may suffer from stress urinary incontinence (SUI) named de novo SUI after pelvic floor reconstruction2. The epidemiology study of de novo SUI in Indonesia is not known yet. In the world, a few studies have reported a wide range (2-43%) in incidence of de novo SUI following surgical repair of POP in previously continent patients. This study aimed to investigate the occurrence of de novo SUI and determined related risk factors after vaginal surgery on POP patients in Ciptomangunkusumo Hospital Jakarta. Methods: This is a cross-sectional study of 108 patients who underwent pelvic floor vaginal surgery due to pelvic organ prolapse (POP) at the Department of Obstetry and Gynecology, Urogynecology and Recontruction Division in Indonesian University-Ciptomangunkusumo Hospital from January 2016 to December 2017. According to the inclusion and exclusion criteria, 75 patients were enrolled in the study with consecutive sampling technique. The occurrence of de novo SUI was determined 6-12 months postoperatively by using Indonesian version of Questionnaire for Urinary Incontinence Diagnosis (QUID), and objectively by positive Cough Stress Test (CST) during gynecological examination after negative Preoperative Prolapse Reduction Stress Test (PPRST). The clinical characteristic of positively de novo SUI patients identified were age, parity, Body Mass Index, menopause periode before surgery, degree of Pelvic Organ Prolapse based on POP-Q system, type of vaginal surgery and clinical result of Diabetes Mellitus. Thes significant risk factors that contribute for the occurrence of de novo SUI determined by multivariate statistical analysis (95% CI and 𝛼 0.05).
Results: The occurrence of de novo SUI was 8% or 6 from 75 patiens 6-7 month postoperative for pelvic floor reconstruction due to POP. Average of age, parity, BMI, menopause periode before surgery, respectively were 56.17 ± 4.67, 3.17 ± 1.07, 28.58 ± 5.18, and 12,8 ± 7,0. There were 50,0% (3/6) patients with severe degree of POP and 50% (3/6) with mild degree of POP with most of them 66,7% (4/6) had underwent non colpocleisis procedure for POP reconstruction. All of the patient but one were positively Diabetes Mellitus according to clinical hystory and laboratory finding, and most of them about 83,3% (5/6) were in menopause state. There were two significant risk facors that contribute to the occurrence of de novo SUI which are severe degree of preoperative POP (p 0.038; OR 0.13 95% CI 0,02-0,63) and Diabetes Mellitus (p 0.02; OR 23.75 95% CI 2.29-590.2).
Conclusion: The occurrence of de novo SUI after vaginal surgery of Pelvic Organ Prolapse patients in Ciptomangunkusumo Hospital Jakarta was 8%. Most of them were average of age < 60 years old, parity < 4, non- obese women, in menopausal periode, and diabetic patient. The determinant significant risk factors contribute to the occurrenceof de novo SUI were evere degree of preoperative POP and Diabetes Mellitus.

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 Metadata

Jenis Koleksi : UI - Tugas Akhir
No. Panggil : SP-pdf
Entri utama-Nama orang :
Entri tambahan-Nama orang :
Entri tambahan-Nama badan :
Program Studi :
Subjek :
Penerbitan : Jakarta: Fakultas Kedokteran Universitas Indonesia, 2018
Bahasa : Ind
Sumber Pengatalogan : LibUI ind rda
Tipe Konten : text
Tipe Media : computer
Tipe Carrier : online resource
Deskripsi Fisik : xvii, 63 pages : illustration + appendix.
Naskah Ringkas :
Lembaga Pemilik : Universitas Indonesia
Lokasi : Perpustakaan UI, Lantai 3
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No. Panggil No. Barkod Ketersediaan
SP-pdf 145-18-138883618 TERSEDIA
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