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"ABSTRAKLatar Belakang: Nyeri panggul kronik merupakan suatu gejala yang dialami oleh perempuan terutama di usia reproduksi. Kondisi ini menggangu aktivitas harian dan menurunkan kualitas hidup hingga membuat penderita mengalami depresi. Prevalensi nyeri panggul kronis pada perempuan berkisar 3,8 ndash; 40 di seluruh dunia. Kondisi ini merupakan suatu entitas yang masih belum dipelajari dengan baik dan dapat menyebabkan morbiditas yang serius. Proses inflamasi juga berperan dalam mencipatakan rasa nyeri. Hs ndash; CRP merupakan sebuah penanda inflamasi yang nilainya meningkat pada saat terjadi reaksi tersebut.Tujuan: Penelitian ini bertujuan untuk mengetahui prevalensi dan berbagai aspek yang berhubungan dengan nyeri panggul kronik pada perempuan di RSUP Cipto Mangunkusumo.Metode: Penelitian dilakukan dengan desain potong lintang di poliklinik rawat jalan ginekologi dan laboratorium di RSCM selama Januari ndash; Maret 2016. Pasien yang mengeluh nyeri panggul lebih dari 6 bulan dilakukan anamnesis, pemeriksaan fisik, dan pemeriksaan penunjang dan pemeriksaan hs ndash; CRP serum. Dilakukan penghitungan prevalensi dan deskripsi karakteristik klinis dan diagnosis pasien. Kualitas hidup dan kadar hs ndash; CRP dibandingkan antara kelompok derajat nyeri ringan dan berat.Hasil: Didapatkan prevalensi sebesar 9,78 dari total pasien di poliklinik ginekologi RSCM. Ditemukan 96,9 kelainan ginekologi, 1 kelainan urologi, dan 2,1 kelainan muskulo-skeletal. Diagnosis tersering adalah endometriosis. Karakteristik klinis pasien yang ditemukan adalah 62,9 menderita lama nyeri selama 6 bulan ndash; 1 tahun dengan intensitas nyeri VAS 7 ndash; 10 sebanyak 51,5 . Kadar hs ndash; CRP serum sebesar 1,99 0,00 ndash; 404, 53 . Terjadi penurunan kualitas hidup dari domain fisik 56 38 - 81 ; domain psikologi 56 31 - 100 ; domain hubungan sosial 25 - 75 ; domain lingkungan 56 31 - 94 .Kesimpulan: Nyeri panggul kronik pada perempuan dijumpai pada usia reproduksi dengan penyebab tersering endometriosis. Nyeri tersebut menyebabkan penurunan kualitas hidup.

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ABSTRACT Background Chronic pelvic pain is a symptom which experienced by women, especially in the reproductive age. These condition interferes with daily activities and decreses quality of life from the patient who suffers it. The prevalences of chronic pelvic pain in women range from 3.8 to 40 worldwide. This condition is an entity that has not been studied well and can cause serious morbidity. Inflammatory process also plays a role in the creation of pain. Hs CRP is a marker of inflammation that increases in value in the event of such reactions.Purpose This study aimed to determine the prevalence and various aspects that associated with female chronic pelvic pain at Cipto Mangunkusumo hospital. Methods The study was conducted with a cross sectional design in gynecology outpatient polyclinic and laboratory at RSCM during January to March 2016. Patients who complain pelvic pain for more than 6 months. We take the history and was performed physical examination and investigations including hs CRP serum examination. We calculate the prevalence and describe the clinical characteristics and diagnosis of the patient. Quality of life and levels of hs CRP were compared between the group of mild and severe pain. Results The prevalence was 9.78 from the total patients in the RSCM gynecology outpatient clinic. We found 96.9 of gynecological disorders, 1 of urological disorders, and 2.1 of musculo skeletal disorders. The most common diagnosis is endometriosis. The Clinical characteristics of patients were found 62.9 suffer for 6 months 1 year with the intensity of pain VAS 7 10 as much as 51.5 . Levels of hs CRP serum was around 1.99 0.00 404, 53 . We found a decreased in the quality of life of the patient. The physical domain score was 56 38 81 the psychology domain score was 56 31 100 the domain of social relationships was 59 25 75 and the environmental domain score was 56 31 94 . Conclusion Endometriosis is the most common diagnosis in female chronic pelvic pain of reproductive age. The Pain causes a decreased in quality of life who suffer from it. "

"Latar Belakang :Prolaps organ panggul adalah penurunan dari organ visera pelvik (panggul) akibat dari turunnya fungsi sistem penyokong panggul. Hal ini jarang mengakibatkan hal yang serius, tetapi menjadi faktor penting pada kualitas hidup pasien. Walaupun etiologi dan faktor risiko dari prolaps organ panggul bersifat multifaktorial, kebanyakan menerima bahwa otot dasar panggul, yaitu levator ani, berperan sangat penting dalam menyokong dasar panggul.Penelitian-penelitian sebelumnya menyebutkan adanya hubungan antara derajat prolaps organ panggul dengan fungsi dan integritas otot levator ani yang dinilai dengan pemeriksaan USG dan perineometer. Namun saat ini di indonesia tidak ada penelitian yang secara lengkap menggambarkan hal diatas tujuan dari penelitian ini adalah untuk melihat perbandingan antara kekuatan otot, area hiatus, dan avulsi otot levator ani pada penderita derajat prolaps organ panggul derajat ringan dan derajat berat.Metode:Penelitian analitik observasional, dengan disain kasus-kontrol. subjek penelitian 60 wanita, 30 wanita dengan derajat prolaps ringan, 30 wanita prolaps derajat berat. Untuk melihat perbandingan antara kekuatan otot levator ani pada saat kontraksi dan istirahat, area hiatus dan avulsi otot levator ani pada pasien normal dan prolaps organ panggul derajat ringan dibandingkan dengan prolaps organ panggul derajat berat.Hasil:Pada penelitian ini didapatkan perbedaaan bermakna (p<0,001) antara kekuatan otot levator ani baik saat istirahat maupun kontraksi pada kelompok kasus (derajat berat) dan kelompok kontrol (derajat ringan). Nilai median dari kekuatan otot pada kelompok kasus saat istirahat dan kontraksi berturut-turut adalah 2,0 dan 5,33 mmHg sementara pada kelompok kontrol sebesar 6,0 dan 11,30 mmHg. Didapatkan perbedaaan bermakna antara area hiatal otot levator ani pada kedua kelompok (p<0,001). Nilai median kelompok derajat berat sebesar 35,07 cm2 (20,7-61,8 cm2) sementara kelompok derajat ringan sebesar 20,75 cm2 (9,04 - 41,52 cm2). Tidak didapatkan perbedaaan bermakna antara kejadian avulsi pada kedua kelompok (p = 0,162). Pada kelompok derajat berat angka kejadian avulsi sebanyak 10%.Kesimpulan:Terdapat perbedaan bermakna antara kekuatan otot dan area hiatus otot levator ani pada penderita prolaps organ panggul derajat berat dan ringan. tidak terdapat perbedaan bermakna pada avulsi otot levator ani pada kedua kelompok.

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Pelvic organ prolapse is a herniation of visceral pelvic organ as a result of weakening of pelvic supporting system function. This rarely leads to serious health problem, however it is an important factor when it comes to patient’s quality of life. Even though the aetiology and risk factors of pelvic organ prolapse are multifactorial, levator ani muscle is believed playing substantial role in supporting pelvic system.Previous studies have shown that there was correlation between the degree of pelvic organ prolapse and levator ani muscle function and integrity assessed with USG and perineometer examination. Unfortunately, research focusing on this study is still limited in Indonesia. The aim of this study is to see comparison between muscle strength, hiatal area, anal levator muscle avulsion in mild and severe degree of pelvic organ prolapse.Method:This is observational comparative analytic study with case-control design. There were 60 participants involved. We devided them into two groups. Thirty participants with mild prolapse were assigned to control group and the rest with severe prolapse were assigned to second group. We compared the levator ani muscle stregth between mild prolapse with severe prolapse during contraction and relaxation, also hiatal area and avulsion.Result:In this study we found that there was a significant difference (p<0.001) in levator ani strentgh during contraction and relaxation between case (severe prolapse) and control group (mild prolapse). The median score of muscle strength during relaxation and contraction were 2.0 and 5.33 mmHg, respectively. Meanwhile, the score of 6.0 and 11.30 mmHg were revealed in control group. A significant difference was found between levator ani hiatal area in case and control group (p<0.001). The median score was 20.75 cm2 (9,04 – 41,52) for control group and 35,07 cm2 (20,7 – 61,8) for case group. There was no significant difference between avulsion incidence in case and control group (p=0.162). In case group, the incidence of avulsion was 10 %.Conclusion:There is a significant difference in muscle strength and hiatal area levator ani in pelvic organ prolapse. There is no difference in levator ani avulsion between 2 groups."