Tesis

Efek Akupunktur Tanam Benang dan Transcutaneous Tibial Nerve Stimulation (TTNS) terhadap Volume Berkemih, Nilai Post Void Residual (PVR), Qmax, dan Skor Kualitas Hidup Penderita Detrusor Underactivity (DU) = The Effect of Thread-Embedding Acupuncture and Transcutaneous Tibial Nerve Stimulation (TTNS) in Voided Volume, Post Void Residual (PVR), Qmax, and Quality of life scoring changes of Detrusor Underactivity (DU) Patients

Detrusor underactivity (DU) adalah berkurangnya kekuatan dan/atau durasi kontraksi yang mengakibatkan pengosongan kandung kemih yang memanjang atau inkomplit. Meskipun jumlah penderita yang terbukti DU tidak banyak, gejala yang ditimbulkan dapat mengganggu kualitas hidup dan berhubungan dengan biaya dan beban hidup penderita. Berdasarkan penelitian sebelumnya, akupunktur dapat meningkatkan volume berkemih dan menurunkan nilai Post Void Residual (PVR) penderita DU secara signifikan. Sebanyak enam pasien dengan diagnosis DU diinklusikan dalam penelitian ini. Akupunktur tanam benang dilakukan dengan menggunakan polydioxanone (PDO) yang ditusukkan di titik akupunktur BL33 dan CV3 dengan teknik penetrating needling. Akupunktur tanam benang dilakukan sebanyak satu kali. Transcutaneous tibial nerve stimulation (TTNS) dilakukan sebanyak 3 kali seminggu selama 4 minggu. Penilaian objektif dari efek akupunktur tanam benang dan TTNS adalah dengan penilaian volume berkemih, PVR, Qmax, dan skor kualitas hidup. Hasilnya penelitian menunjukkan tidak terdapat perbedaan bermakna antara rerata volume berkemih sebelum (72,00 ±70,48) dan setelah (158,17 ± 139,58) akupunktur tanam benang dan TTNS, p = 0,115, namun didapatkan peningkatan volume berkemih dengan rerata 86,17 ± 110,80. Tidak terdapat perbedaan bermakna antara nilai PVR sebelum (164,00 ± 173,69) dan setelah (74,83 ± 126,28) terapi, p = 0,151, namun didapatkan penurunan sebesar 89,17 ± 129,07. Tidak terdapat perbedaan bermakna antara rerata Qmax sebelum (4,12 ± 3,28) dan setelah (12,35 ± 9,20) terapi, p = 0,085, namun didapatkan peningkatan sebesar 8,23 ± 9,41. Terdapat perbedaan bermakna antara skor kualitas hidup sebelum dan setelah terapi dengan p = 0,017. (Kesimpulan : akupunktur tanam benang dan TTNS dapat meningkatkan volume berkemih, menurunkan PVR, dan meningkatkan Qmax penderita DU, namun secara statistik tidak signifikan, dan dapat memperbaiki kualitas hidup penderita DU secara signifikan.)
Kata kunci : detrusor underactivity, akupunktur tanam benang, polydioxanone, transcutaneous tibial nerve stimulation, volume berkemih, post void residual, Qmax, skor kualitas hidup


Detrusor underactivity (DU) is a contraction of reduced strength and/or duration resulting in prolonged and/or incomplete bladder emptying. Although the amount of DU patients is inconsiderable, symptoms arises from DU could decrease quality of life and increase cost of living. Based on previous research, acupuncture is an effective treatment to increase voided volume and reduce Post Void Residual (PVR) of DU patients significantly. A total of six patients with DU were included in this research. We did thread-embedding acupuncture by inserting polydioxanone (PDO) into BL33 and CV3 acupuncture points with penetrating needling techniques. Thread-embedding acupuncture was given once. Transcutaneous tibial nerve stimulation (TTNS) was given 3 times in a week during 4 weeks. To conduct an objective assessment of threadembedding acupuncture and TTNS effects, voided volume, PVR, Qmax, and quality of life scoring was measured. The results showed no significant differences between before and after treatment on voided volume (72,00 ±70,48 and 158,17 ± 139,58), p = 0,115, but there was improvement of voided volume with mean 86,17 ± 110,80. There was no significant difference between before and after treatment on PVR (164,00 ± 173,69 and 74,83 ± 126,28), p = 0,151, but there was improvement of PVR with mean 89,17±129,07. There was no significant difference between before and after treatment on Qmax (4,12 ± 3,28 and 12,35 ± 9,20), p = 0,085, but there was improvement of Qmax with mean 8,23 ± 9,41. There was significant difference between before and after treatment on quality of life scoring with p = 0,017. (Conclusion : thread embedding acupuncture and TTNS increase voided volume, decrease PVR, increase Qmax, but statistically not significant, and improve quality of life in in detrusor underactivity patients significantly.)
Keywords : detrusor underactivity, thread-embedding acupuncture, polydioxanone, transcutaneous tibial nerve stimulation, voided volume, post void residual, Qmax, quality of life scoring