Tesis

Evaluasi Dispareunia pada Perempuan dengan Trauma Sfingter Ani Obstetrik = Evaluation of Dyspareunia on Women with Obstetric Anal Sphincter Injury.

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
Kata kunci: dispareunia, OASIS, trauma sfingter ani obstetri


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.
Keywords : dyspareunia, obstetric anal sphincter injury, OASIS