Skripsi

Temuan Faktor Uterus Menggunakan Histeroskopi Office Pada Kasus Infertilitas di RS Dr. Cipto Mangunkusumo Jakarta = Uterine Factor Findings Using Hysteroscopy Office in Infertility Cases at Dr. Cipto Mangunkusumo Jakarta Hospital.

Latar belakang: Infertilitas merupakan kegagalan mencapai kehamilan setelah 12 bulan atau lebih hubungan seksual teratur tanpa kontrasepsi. Secara global diperkirakan terdapat 48 juta pasangan dan 186 juta orang mengalami infertilitas yang juga dialami 10- 15% pasangan usia reproduktif di Indonesia. Infertilitas dapat bersifat primer dan sekunder yang disebabkan oleh fakor perempuan, laki-laki, dan idiopatik. Pada perempuan, infertilitas dapat disebabkan oleh berbagai kelainan ovarium, uterus, saluran tuba, dan sistem endokrin. Histeroskopi merupakan baku emas evaluasi uterus yang dapat mendeteksi kelainan uterus yang mengganggu proses implantasi dan kehamilan serta mengevaluasi manfaat modalitas terapi dalam memperbaiki endometrium. Penelitian ini bertujuan mengidentifikasi peran dan temuan histeroskopi office pada diagnosis faktor uterus kasus infertilitas. Metode: Penelitian ini menggunakan studi cross sectional dengan metode deskriptif kuantitatif. Data yang digunakan adalah data sekunder rekam medis pasien RSCM Kintani pada kurun waktu 1 Juli 2020−30 Juni 2022. Sampel dipilih menggunakan metode consecutive sampling, diinput dan ditabulasi dalam bentuk tabel pada aplikasi Microsoft Excel yang kemudian disajikan dalam bentuk tabel, diagram, dan narasi deskriptif. Seluruh data dianalisis dengan analisis univariat deskriptif. Hasil: Temuan faktor uterus menggunakan histeroskopi office sebanyak 148 temuan terdiri dari 132 (89,19%) temuan abnormal dan 16 (10,81%) temuan normal uterus. Temuan abnormalitas yang diidentifikasi melalui histeroskopi office pada kasus infertilitas mencakup temuan mioma uteri sebanyak 12 (9,09%) temuan, adhesi (sinekia intrauterin) sebanyak 9 (6,82%) temuan, polip endometrium sebanyak 46 (34,85%) temuan, polip serviks sebanyak 17 (12,88%) temuan, stenosis OUI sebanyak 13 (9,85%) temuan, kelainan kongenital sebanyak 5 (3,79%) temuan, endometritis sebanyak 9 (6,82%) temuan, malignansi sebanyak 7 (5,30%) temuan, dan hiperplasia endometrium sebanyak 14 (10.61%) temuan. Kesimpulan: Temuan faktor uterus menggunakan histeroskopi office pada kasus infertilitas adalah 132 (89,19%) abnormal dan 16 (10,81%) normal. Dari 132 kasus abnormal, kasus terbanyak ialah polip endometrium 46 (34,85%), kemudian polip serviks sebanyak 17 (12,88%), hiperplasia endometrium sebanyak 14 (10,61%), stenosis OUI sebanyak 13 (9,85%), mioma uteri sebanyak 12 (9,09%), endometritis sebanyak 9 (6,82%), adhesi (sinekia intrauterine) sebanyak 9 (6,82%), malignansi sebanyak 7 (5,30%), dan kelainan kongenital sebanyak 5 (3,79%).
Kata kunci: Histeroskopi Office, Infertilitas, Faktor Uterus, RSCM



Introduction: Infertility is the failure to achieve pregnancy after 12 months or more of regular sexual intercourse without contraception. Globally, estimates suggest 48 million couples and 186 million individuals live with this problem. Infertility experienced by 10- 15% of couples of reproductive age in Indonesia. Hysteroscopy is the gold standard for evaluating the uterine. Hysteroscopy has a role in infertility examination, namely detecting uterine abnormalities that can interfere with the implantation process, pregnancy, and also evaluating the benefits of therapeutic modalities in repairing the endometrium. This study aims to identify the role and findings of hysteroscopy office for diagnosis of uterine factors in infertility case. Method: This study was conducted using cross-sectional study with quantitative descriptive methods. The data used is secondary data from medical records of RSCM Kintani patients in the period July 1, 2020−June 30, 2022. The sample was selected using the consecutive sampling method, inputted and tabulated in tabular form in the Microsoft Excel application which was then presented in the form of tables, diagrams, and descriptive narratives. The data was analyzed by descriptive univariate analysis. Result: Uterine factor findings using office hysteroscopy totaled 148 findings consisting of 132 (89,19%) abnormal findings and 16 (10,81%) normal findings. Abnormal findings identified through office hysteroscopy in infertility cases included findings of uterine myoma in 12 (9,09%) findings, adhesions (intrauterine synechiae) in 9 (6,82%) findings, endometrial polyps in 46 (34,85%) findings, cervical polyps 17 (12,88%) findings, OUI stenosis 13 (9,85%) findings, congenital abnormalities 5 (3,79%) findings, endometritis 9 (6.82%) findings , malignancy in 7 (5,30%) findings, and endometrial hyperplasia in 14 (10,61%) findings. Conclusion: Uterine factor findings using office hysteroscopy in infertility cases were 132 (89.19%) abnormal and 16 (10,81%) normal. Of the 132 abnormal cases, the most common was endometrial polyps 46 (34,85%), then cervical polyps in 17 (12,88%), endometrial hyperplasia in 14 (10,61%), OUI stenosis in 13 (9,85% ), uterine myoma in 12 (9,09%), endometritis in 9 (6.82%), adhesions (intrauterine synechiae) in 9 (6,82%), malignancy in 7 (5.30%), and congenital abnormalities in 5 (3,79%).
Keywords: Office Hysteroscopy, Infertility, Uterine Factors, RSCM