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Abstrak :
Latar belakang: Krioterapi adalah salah modalitas terapi yang sering dilakukan pada lesi IVA positif di Indonesia. Selain memiliki angka kesembuhan yang cukup tinggi, krioterapi tergolong murah dan mudah dilakukan dengan sumber daya yang terbatas. Namun, efek samping pasca krioterapi seperti keputihan, perdarahan bercak, dan nyeri adalah hal yang tidak bisa dihindari. Beberapa penelitian mengaitkan adanya hubungan derajat dan luas lesi prakanker dengan angka kesembuhan pasca krioterapi. Jenis krioterapi (single-freeze atau double-freeze) juga dihubungkan dengan luas area nekrosis pasca krioterapi. Tujuan: Tujuan penelitian ini adalah untuk mengetahui hubungan luas lesi IVA positif dan jenis krioterapi terhadap efek samping pasca krioterapi Metode: Penelitian ini merupakan studi kohort prosepektif. Populasi terjangkau adalah pasien dengan IVA positif yang menjalani krioterapi oleh Female Cancer Program dari Juli sampai dengan Oktober 2019 di Jakarta. Evaluasi dilakukan dengan pengisian lembar keluhan efek samping krioterapi selama satu bulan. Analisis data dalam bentuk deskriptif dan analitik. Hasil: Didapatkan 43 subjek IVA positif, 27 (62,8%) subjek lesi luas, dan 16 (37,2%) subjek lesi sempit, jenis krioterapi dibagi menjadi 33 (76,7%) subjek double-freeze, 10 (23,3%) subjek single-freeze, setelah sebulan didapatkan keluhan keputihan sebanyak 88,4%; perdarahan bercak 51,2%, nyeri 58,1%; tidak didapatkan hubungan bermakna antara luas lesi IVA positif dengan keputihan (nilai-p 0,63), perdarahan bercak (nilai-p 0,61), dan nyeri (nilai-p 0,54), krioterapi double-freeze berhubungan bermakna dengan efek samping perdarahan bercak (RR 0,5; nilai-p 0,0032; CI 0,3-0,9). Kesimpulan: krioterapi double-freeze berhubungan bermakna dengan efek samping perdarahan bercak pasca krioterap. ......Background: Cryotherapy is a procedure often performed in positive VIA lesions in Indonesia. Not only having a high cure rate, but cryotherapy is also relatively cheap and easy to perform with limited resources. However, side effects such as vaginal discharge, spotting, and pain are unavoidable. Several studies have linked the degree and width of precancerous lesions with cure rate after cryotherapy. Type of cryotherapy (single-freeze or double-freeze) is also related with amount of necrosis area produced after cryotherapy. Objective: To determine the association of positive VIA area and the type of cryotherapy with post-cryotherapy side effects. Method: This is a prospective cohort study. The population are women with positive VIA result who underwent cryotherapy by the Female Cancer Program from July to October 2019 in Jakarta. Evaluation was performed by filling out the patients complaint sheet for one month. Data was analysed descriptively and analytically. Results: There were 43 women with positive VIA results, grouped into 27 (62.8%) large lesion, and 16 (37.2%) small lesion, types of cryotherapy was grouped into 33 (76.7%) double-freeze, 10 (23,3%) single-freeze, after one month follow-up there were complaints of vaginal discharge 88.4%; spotting 51.2%, pain 58.1%; found unsignificantly association between width of positive VIA area with vaginal discharge (p-value 0.63), spotting (p-value 0.61), and pain (p-value 0.54), double-freeze cryotherapy was significantly associated with side effect of spotting (RR 0.5; p-value 0.0032; CI 0.3-0.9). Conclusion: double-freeze cryotherapy is significantly related with side effect of spotting.

Abstrak :
Krioterapi adalah terapi yang rutin dilakukan pada lesi IVA positif di Indonesia. Selain terbukti efektif, krioterapi tergolong murah dan mudah dilakukan. Namun, efek samping pasca krioterapi seperti keputihan, perdarahan bercak, dan nyeri tidak bisa dihindari. Beberapa penelitian mengaitkan adanya hubungan luas lesi prakanker dengan angka kesembuhan. Jenis krioterapi (single-freeze atau double-freeze) juga dihubungkan dengan luas area nekrosis yang terbentuk. Tujuan penelitian ini untuk mengetahui hubungan luas lesi IVA positif dan jenis krioterapi terhadap efek samping krioterapi. Penelitian ini menggunakan studi kohort prosepektif observasional. Populasi terjangkau adalah pasien dengan IVA positif yang menjalani krioterapi oleh Female Cancer Program dari Juli hingga Oktober 2019 di Jakarta. Evaluasi dilakukan dengan pengisian lembar keluhan efek samping krioterapi. Didapatkan 43 subjek IVA positif, 27 (62,8%) subjek lesi luas, dan 16 (37,2%) subjek lesi sempit, jenis krioterapi dibagi menjadi 33 (76,7%) subjek double-freeze, 10 (23,3%) subjek single-freeze, setelah sebulan didapatkan keluhan keputihan sebanyak 88,4%; perdarahan bercak 51,2%, nyeri 58,1%; tidak didapatkan hubungan bermakna antara luas lesi IVA positif dengan keputihan (nilai-p 0,63), perdarahan bercak (nilai-p 0,61), dan nyeri (nilai-p 0,54), krioterapi double-freeze berhubungan bermakna dengan perdarahan bercak (RR 0,5; nilai-p 0,0032; CI 0,3-0,9). ......Cryotherapy is often performed to positive VIA lesions in Indonesia. Not only effective, it is also cheap and easy to perform. However, side effects such as vaginal discharge, spotting, and pain are unavoidable. Several studies have linked the width of lesions with cure rate. Type of cryotherapy (single-freeze or double-freeze) is also related with amount of necrosis area produced. This study was performed to determine the association of positive VIA area and type of cryotherapy with the side effects. This is a observational prospective cohort study. The population are women with positive VIA who underwent cryotherapy by the Female Cancer Program from July to October 2019 in Jakarta. Evaluation was performed by filling out the patients complaint sheet for one month. There were 43 women with positive VIA results, grouped into 27 (62.8%) large lesion, and 16 (37.2%) small lesion, cryotherapy was performed 33 (76.7%) double-freeze, 10 (23,3%) single-freeze, after one month follow-up there were complaints of vaginal discharge 88.4%; spotting 51.2%, pain 58.1%; found no association between width of positive VIA with vaginal discharge (p-value 0.63), spotting (p-value 0.61), and pain (p-value 0.54), double-freeze cryotherapy was significantly associated with side effect of spotting (RR 0.5; p-value 0.0032; CI 0.3-0.9).