Tesis

Hubungan Keluhan Dengan Profil Usg Adenomiosis Berdasarkan Kriteria Musa (Morphological Uterine Sonography Assessment) Di Rsupn Dr. Cipto Mangunkusumo = correlation between symptoms and adenomyosis ultrasound findings based on MUSA criteria (Morphological uterine sonography assessment) at RSUPN Dr. Cipto Mangunkusumo.

Latar belakang: Adenomiosis salah satu jenis endometriosis yang mempengaruhi wanita dalam usia reproduksi dengan insidensi 5,7 – 69% dan 70,7 % kasus terjadi pada wanita dengan usia diatas 35 tahun. Selain rentang angka kejadiannya yang besar, adenomiosis juga memiliki gejala yang sangat bervariasi, seperti dismenorea, menoragia, perdarahan uterus abnormal, nyeri panggul kronik dan infertilitas. Keparahan dari gejalanya pun bervariasi. Saat ini pemeriksaan USG merupakan salah satu alat bantu dalam penegakan diagnosis. Terdapat kriteria yang saat ini digunakan dalam mendiagnosis adenomiosis yaitu kriteria MUSA (Morphological Uterine Sonography Assessment). Hingga saat ini belum ada studi sebelumnya yang menilai apakah terdapat hubungan antara keluhan dan gambaran USG berdasarkan kriteria MUSA pada penderita adenomiosis. Tujuan: Diketahui hubungan antara keluhan dan gambaran USG pada pasien adenomiosis berdasarkan kriteria MUSA. Metode: Penelitian ini merupakan penelitian retrospektif. Sejumlah 84 pasien adenomiosis yang menjalani pemeriksaan di poliklinik ginekologi dan Imunoendokrinologi RSCM sejak Juli 2022 hingga Agustus 2023, yang menjalani pemeriksaan USG. Dilakukan analisis melihat hubungan antara masing – masing karakteristik gambaran USG dan juga gabungan fenotip USG dengan keluhan dismenorea dan perdarahan uterus abnormal. Hasil: Rerata usia pasien dengan adenomiosis di RSCM adalah 38,7 tahun dengan pasien kanker serviks stadium IA2 – IIA2 di RSCM adalah 52 tahun dengan 53,8% berusia di atas 40 tahun. Untuk keluhan dismenorea terjadi pada 75,6% pasien dan keluhan dismenorea sebanyak 41%. Tidak terdapat hubungan antara keluhan dengan gambaran USG berdasarkan kriteria MUSA. Terdapat hubungan antara jumlah fenotip 4 dengan keluhan dismenore dan jumlah fenotip 5 dengan keluhan perdarahan uterus abnormal. Kesimpulan: rerata penderita adenomiosis berusia 38,7 tahun, 52,5% gambaran USG menunjukkan gambaran adenomiosis difusa. Tidak terdapat hubungan antara keluhan dengan gambaran USG berdasarkan kriteria MUSA. Terdapat hubungan antara jumlah fenotip 4 dan 5 terhadap keluhan dismenorea dan perdarahan uterus abnormal.
Kata kunci: Adenomiosis, kriteria musa, USG, keluhan


Background: Adenomyosis is one form of endometriosis that affect women in her reproductive age from 5,7 – 69% of women and 70,7% cases was found in women more than 35 years old. Apart from the wideness of the incidence, adenomyosis also has varied symptoms such as dysmenorrhoea, menorrhagia, abnormal uterine bleeding, chronic pelvic pain and infertility. The severity of the symptoms varies. Currently, ultrasound examination is an aid in making a diagnosis. There are criteria currently used to diagnose adenomyosis, namely the MUSA (Morphological Uterine Sonography Assessment) criteria. Until now, there has been no previous research that has assessed whether there is a relationship between complaints and ultrasound images based on MUSA criteria in adenomyosis sufferers. Objective: This study aims to determine the relationship between complaints and ultrasound images in adenomyosis patients based on MUSA criteria. Methods: This research is a retrospective study. A total of 84 adenomyosis patients who underwent examinations at the RSCM gynecology and immunoendocrinology outpatient clinic from March 2022 to August 2023, underwent ultrasound examinations. An analysis was carried out looking at the relationship between each characteristic of the ultrasound image and also the combination of ultrasound phenotypes with complaints ofdysmenorrhoea and abnormal uterine bleeding. Results: The average age of patients with adenomyosis at RSCM was 38.7 years. Patients with stage IA2 – IIA2 cervical cancer at RSCM were 52 years with 53.8% aged over 40 years. Dysmenorrhea complaints occurred in 75.6% ofpatients and dysmenorrhea complaints occurred in 41%. There is no relationship between complaints and ultrasound images based on MUSA criteria. There is a relationship between the number of phenotypes 4 and complaints of dysmenorrhea and the number of phenotypes 5 and complaints of abnormal uterine bleeding. Conclusions: The average age of adenomyosis sufferers was 38.7 years, 52,5% of ultrasound images showed diffuse adenomyosis. There is no relationship between complaints and ultrasound images based on MUSA criteria. There is a relationship between the number of phenotypes 4 and 5 with complaints of dysmenorrhoea and abnormal uterine bleeding.
Keywords: Adenomyosis; Musa criteria; ultrasound; complaints