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"ABSTRAK Pendahuluan: Dispareunia adalah beban utama pada wanita usia reproduktif. Kondisi ini memiliki dampak langsung pada kehidupan pernikahan, sosial dan professional dari wanita usia reproduktif. Faktor yang dapat berkontribusi dalam terjadinya dyspareunia adalah rupture perineum.Metode:Desain studi potong lintang digunakan dengan memberikan kuesioner Female Sexual Function Index FSFI terhadap wanita postpartum yang terdiagnosis dengan ruptur perineum akibat persalinan per vaginam. Penelitian ini dilakukan di Rumah Sakit Cipto Mangunkusumo dan Rumah Sakit Umum Tangerang pada bulan Oktober sampai Desember 2017. Pasien yang memiliki inflamasi panggul kronis dan riwayat dispareunia sebelumnya dieksklusi.Hasil: Sebanyak 93 subjek terlibat dalam studi ini.; 59 subjek memiliki ruptur perineum ringan derajat I dan II sedangkan 34 subjek lainnya memilki ruptur perineum derajat berat derajat III dan IV . Ditemukan bahwa ruptur perineum berkaitan dengan tejradinya dyspareunia setelah 3-6 bulan setelah terjadi rupture perineum. Kesimpulan: Ruptur perineum derajat III dan IV meningkatkan risiiko terjadinya dyspareunia 3-6 bulan postpartum sampai 5 kali lipat. Studi prospektif selanjutnya dengan jumlah sampel yang lebih besar yang menginvestigasi risiko dispareunia pada perempuan dengan rupture perineum sebaiknya dilakukan.

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ABSTRACT

Introduction: Dyspareunia is major burden in reproductive-aged women. In fact, it has a direct impact on their marital, social and professional life. One factor that may contribute to the risk of developing dyspareunia is perineal tear. To this date, studies regarding the association between perineal trauma and dyspareunia 3 to 6 months after perianal rupture are scarce. This study aims to investigate the association between both variables.Methods: A cross-sectional study design was used by giving Female Sexual Function Index FSFI questionnaires to postpartum women diagnosed with perineal tear due to vaginal birth. The study was conducted at Cipto Mangukusumo Hospital and Tangerang General Hospital between October and December 2017. Those who had chronic hip inflammation and previous history of dyspareunia were excluded.Results: A total of 93 subjects were involved in this study; 59 had mild first- and second- degree while 34 had third- and fourth- degree perineal tears. We found that perineal tear was associated with the occurrence of dyspareunia after 3 to 6 months after perineal rupture.Conclusions: Grade III to IV perineal tear increased the risk of dyspareunia 3 to 6 months postpartum up to 5-fold. Further prospective studies with larger samples assessing the risk of dyspareunia in those with perineal tear should be conducted."

"Latar belakang: Dispareunia adalah nyeri pelvik yang muncul saat berhubungan seksual. Ruptur perineum derajat III dan IV dapat menyebabkan nyeri yang lebih berat dibandingkan serajat I dan II. Beberapa faktor yang mempengaruhi trauma sfingter ani obstetri adalah persalinan dengan bantuan alat, paritas, dan berat bayi lahir.Metode: Merupakan studi potong lintang yang menggunakan data sekunder dan wawancara subjek di RSUPN Cipto Mangunkusumo di tahun 2016-2020. Dilakukan evaluasi dispareunia dalam 12 minggu pasca persalinan per vaginam pada perempuan dengan trauma sfingter ani obstetrik.Hasil: Sebanyak 66 subjek memenuhi kriteria inklusi dan eksklusi. Sebanyak 89,4% subjek tidak mengalami dispareunia dalam waktu 12 minggu pasca persalinan per vaginam. Ada 7 subjek yang mengalami dispareunia dan sebanyak 2 subjek tergolong nyeri berat. Ruptur perineum derajat IV memiliki perbedaan yang signifikan terhadap kejadian dispareunia (p 0,001).Kesimpulan: Prevalensi dispareunia pada perempuan dengan trauma sfingter ani obstetric sebesar 10,6%. Terdapat perbedaan yang signifikan pada ruptur derajat IV terhadap kejadian dispareunia. Material benang dan teknik penjahitan, dan faktor-faktor eksternal maish harus dilakukan studi lanjut.

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Introduction: Dyspareunia is a pelvic pain occur during or after sexual intercourse. The incidence of dyspareunia from 1,2% to 56,1%. Third degree and fourth degree tear can cause deliberately much pain than first and second degree tear. Several factors caused obstetric anal sphincter injury after vaginal delivery such as assisted vaginal delivery using vacuum and forceps prolonged second stage of labor, parity, and baby birth weight.

Methods : This study design is cross sectional using secondary data (medical records) and subjects interview which evaluates the prevalence of dyspareunia in 12 weeks after vaginal delivery on women with obstetric anal sphincter injury. This study took place in Cipto Mangunkusumo Hospital ( 2016-2020).

Results : Sixty six subjects were enrolled into this study after met the criteria. The results were based on demographic, clinical characteristics, and bivariate analysis. Based on the dyspareunia, showed 89,4% subjects did not have dyspareunia in 12 weeks after vaginal delivery. Total 7 subjects suffered from dyspareunia.The study showed the degree of perineal rupture was significantly correlated with dyspareunia on subjects ( p 0,001).

Conclusion : The prevalence of dyspareunia on women with OASIs is 10,6%. There was statistically significant association between the degree of rupture and dyspareunia. Suturing material and technique, and wound healing factors are still need to be analysed more in the further study."

"ABSTRAKLatar Belakang : Hubungan antara endometriosis dan nyeri pelvik telah banyak diketahui, namun penjelasan tentang mengapa hal ini bisa terjadi masih belum jelas diketahui. Dapat ditemukan keluhan nyeri hebat pada penderita endometriosis ringan, namun sebaliknya, dijumpai pula penderita endometriosis derajat berat tanpa keluhan nyeri berarti.Tujuan : Penelitian ini bertujuan mencari hubungan antara tampilan susukan endometriosis dan karakteristik nyeri pelvik.Metode : Rancangan penelitian ini menggunakan desain studi retrospektif dengan metode analisis korelasi antara dua variabel numerik. Penelitian ini dilakukan di Rumah Sakit Umum Pusat Rujukan Nasional dr. Cipto Mangunkusumo, Jakarta. Pengumpulan data dilakukan dengan mengambil data retrospektif rekam medis dari 131 pasien yang dilakukan laparoskopi atas indikasi endometriosis dari tahun 2012-2016.Hasil: Endometriosis minimal terdapat pada 2 pasien, endometriosis ringan pada 3 pasien, endometriosis sedang di 26 pasien, dan endometriosis berat pada 104 pasien. Berdasarkan tampilan makroskopik, endometriosis ovarium terdapat pada 92,4 , endometriosis peritoneal 82,4 , ESD 40,5 , dan adenomiosis pada 19,1 . Terdapat korelasi positif bermakna antara skor ASRM total, subskor kista endometriosis, endometriosis superfisial, obliterasi kavum douglas, dan adhesi adneksa dengan VAS dismenorea r=0,303; 0,187; 0,203; 0,278; 0,266, p

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ABSTRACTBackground Controversies on relationship between endometriosis stage, adhesion, lesion type, and severity of pelvic pain remains for years, eventhough clinical experience have connected those with severity of pelvic pain.Objective To evaluate the association between ASRM score in endometriosis and pelvic pain in a group of women with endometriosis.Methods A total of 131 patients with pelvic pain who conduct laparoscopy for diagnosis and therapy of endometriosis, have pain symptoms 3 months, and absense of pelvic anomalies. Dysmenorrhea, deep dyspareunia, dyschezia, dysuria, and chronic pelvic pain were evaluated using 10 point visual analogue scale. The data was collected by assessing the medical record and retrospective analysis was performed. Disease stage according to American Society of Reproductive Medicine, presence of adhesion, lesion type Deep Infiltrating Endometriosis DIE or without DIE , and severity of pain symptoms were analyzed by Spearman analysis. Different VAS between DIE vs non DIE group was analyzed by Mann Whitney analysis.Results Minimal endometriosis was present in 2 patients, mild in 3, moderate in 26, and severe in 104. Based on the macroscopic appearance, ovarian endometriosis accounts for 92,4 , peritoneal endometriosis 82,4 , DIE was 40,5 , and adenomyosis was 19,1 . Stage IV endometriosis accounts for 79.4 . Based on the macroscopic appearance, ovarian endometriosis accounts for 92.4 , peritoneal endometriosis 82.4 , DIE was 40.5 , and adenomyosis was 19.1 . There was significant correlation between total ASRM, ovarian endometriosis, peritoneal lesion, Douglas pouch obliteration, adnexal adhesion score and VAS dysmenorrhea r 0.303 0,187 0,203 0,278 0,266, p"