Tesis

Perbandingan Fungsi Seksual Perempuan 3 Bulan Pascapersalinan Spontan Dengan Seksio Sesaria Di RSUPN Cipto Mangunkusumo Jakarta = Comparison of Female Sexual Function at Three Months Postpartum between Spontaneous and Cesarean Section in CiptoMangunkusumo National General Hospital.

Latar belakang: Perubahan fungsi seksual perempuan pascapersalinan berkisar 23% - 86% dan mempunyai dampak yang signifikan dalam keharmonisan keluarga. Berbagai studi dan penelitian tentang fungsi seksual perempuan pascapersalinan banyak dilakukan dengan hasil yang berbeda karena adanya perbedaan alat ukur, waktu pengukuran serta pengontrolan variabel perancu. Penelitian ini sebagai konfirmasi dari penelitian sebelumnya serta belum adanya data yang pasti terutama di Jakarta dan Indonesia umumnya. Tujuan: mengetahui perbandingan dorongan, bangkitan, orgasme, nyeri dan kepuasan fungsi seksual perempuan 3 bulan pascapersalinan spontan dengan seksio sesaria di Rumah Sakit Cipto Mangunkusumo Jakarta Metode: Penelitian observasional, subyek kelompok persalinan spontan dan seksio sesaria, pengukuran fungsi seksualnya 3 bulan pascapersalinan menggunakan kuisioner Female Sexual Function Index (FSFI) desain penelitian cross sectional (potong lintang), pengambilan sampel consecutive sampling. Analisis komparatif katagorik tidak berpasangan dengan chi square atau uji fisher. Analisis variabel perancu dilakukan analisis multivariat regresi logistik. Hasil: Dari 150 responden 3 bulan pascapersalinan spontan dan seksio sesaria didapatkan 43,3% disfungsi seksual dengan 52 % spontan dan 34 % seksio sesaria. Analisa bivariat terjadinya disfungsi seksual 3 bulan pascapersalinan spontan 1,5 kali lebih besar (IK 95% 1,02-3,19) dibandingkan seksio sesaria. Gangguan hasrat/dorongan seksual 2 kali lebih besar (IK 95% 1,17-3,40) dibandingkan seksio sesaria, sedangkan gangguan orgasme 8 kali lebih besar (IK 95% 1,90-3,58) dengan variable perancu adanya robekan perineum. Gangguan bangkitan seksual, lubrikasi, kepuasan seksual dan nyeri tidak berbeda secara bermakna pada persalinan spontan dengan seksio sesaria. Analisa multivariat variabel persalinan spontan bermakna secara statistik untuk disfungsi seksual pasien 3 bulan pascapersalinan pada variabel disfungsi dorongan seksual dan pencapaian orgasme, dengan nilai p=0,008, RR 2,716 dan p=0,031 RR 6,952, sedangkan variabel usia lebih dari 30 tahun bermakna secara statistik pada disfungsi seksual pada variabel bangkitan seksual dengan p=0,021 dan RR 2,601 Kesimpulan: persalinan spontan bermakna secara statistik untuk terjadinya disfungsi seksual 3 bulan pascapersalinan, terutama variabel dorongan seksual dan tercapainya orgasme. Sedangkan variabel usia lebih dari 30 tahun merupakan variabel yang berpengaruh pada disfungsi seksual terutama pada variabel bangkitan seksual.


Background: The alteration of postpartum sexual function on female is about 23%-86% and has a significant impact in a family’s tranquility. Many studies and research regarding postpartum sexual function on female were performed by various comparison variables such as Glasner, Barret, Thomson and Rochelle with different results because of the difference of measuring instruments, time of measurement and the control of confounding variables. Objective: To know the comparison of encouragement, stimuli, orgasm, pain and satisfaction of female sexual function at 3 months post partum between spontaneous and cesarean section in Cipto Mangunkusumo National General Hospital in Jakarta Methods: This was an observational research involving subjects starting from identification of spontaneous and cesarean section group, and then their sexual function was measured at three months postpartum with Female Sexual Function Index (FSFI) questionnaire. The study design used was cross sectional with consecutive sampling. Analysis for non-paired of category comparative were chi square or fisher analysis. Analysis for confounding variables with multivariate logistic regression. Results: From 75 respondents of spontaneous and Cesarean Section 43,3% have sexual dysfunction with 52% of spontaneous and 34% of cesarean section. Bivariate analysis of happening of sexual dysfunction at three months spontaneous was 1.5 times higher (IPK 95% 1,02-3,19) compared with cesarean section. Sexual encouragement shows a twice higher value (IPK 95% 1,17-3,40) compared to cesarean section. However, orgasm disturbance was 8 times higher (IPK 95% 1,90-3,58) with confounding variable of perineum rupture. Disturbance of sexual stimuli, satisfaction and pain were not significantly different between spontaneous and cesarean section. Multivariate analysis of vaginal labor was statistically significant for sexual dysfunction at three months postpartum in patient with sexual encouragement dysfunction and orgasm accession, with value of p=0,008, RR 2,716 and p=0,031 RR 6,952. However, more than 30 years old of age variable was statistically significant in sexual dysfunction variable with value of p=0,021 and RR=2,60. Conclusion: Spontaneous labor is statistically significant for sexual dysfunction at three months postpartum, especially for sexual encouragement variable and orgasm accession. Meanwhile, the variables with the age of 30 years old or olde