Tesis

Gambaran Klinis Nyeri Panggul Kronis pada Perempuan di RSUP RSCM = Clinical Characteristics of Female Chronic Pelvic Pain in Cipto Mangunkusumo Hospital.

Latar 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 – 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 – 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 – Maret 2016. Pasien yang mengeluh nyeri panggul lebih dari 6 bulan dilakukan anamnesis, pemeriksaan fisik, dan pemeriksaan penunjang dan pemeriksaan hs – CRP serum. Dilakukan penghitungan prevalensi dan deskripsi karakteristik klinis dan diagnosis pasien. Kualitas hidup dan kadar hs – 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 – 1 tahun dengan intensitas nyeri (VAS) 7 – 10 sebanyak 51,5%. Kadar hs – CRP serum sebesar 1,99 (0,00 – 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.
Kata Kunci: Nyeri panggul kronik, derajat nyeri, kualitas hidup, hs - CRP



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 (3194). 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.
Keywords: chronic pelvic pain, intensity of pain, quality of life, hs - CRP