Sacrospinosus Fixation Efectivity in Pelvic Organ Prolapse Patient

Abstract

Sacrospinosus Fixation Efectivity in Pelvic Organ Prolapse Patient Efektivitas Fiksasi Sakrospinosus pada Penderita Prolaps Organ Panggul Yulius Adriansyah 1 , Amir Fauzi 1 , Firmansyah Basir 1 , Theodorus 2 1 Department Obstetrics and Gynecology 2 Research Unit of Health and Medicine Faculty of Medicine Universitas Sriwijaya Dr. Mohammad Hoesin Hospital Palembang Abstract Abstrak Objective : to determine the effectiveness of SSF in patients with POP at dr. Mohammad Hoesin hospital (RSMH) Palembang Tujuan : untuk mengetahui efektivitas SSF pada penderita prolaps organ panggul di rumah sakit dr. Mohammad Hoesin (RSMH) Palembang Methods : Randomized clinical trial (RCT) was performed at RSMH Palembang from January to September 2017. There were 30 samples of pelvic organ prolapse who met the inclusion criteria. Data frequency and distribution were described in table form, and the effectiveness of SSF was analysed by Wilcoxon / paired t-test while the effectiveness ratio was analysed by Mann Whitney / independent t-test. Data were analysed using SPSS version 16.0. Metode : Uji klinis acak berpembanding (RCT) dilakukan di RSMH Palembang sejak bulan Januari sampai September 2017. Didapatkan sampel sebanyak 30 penderita prolaps organ panggul yang memenuhi kriteria inklusi. Frekuensi dan distribusi data dijelaskan dalam bentuk tabel dan efektivitas SSF dianalisis dengan uji Wilcoxon/paired t-test dan perbandingan efektivitas dianalisa dengan uji Mann Whitney/independent t-Test menggunakan SPSS versi 16.0. Results : There were no differences in patient characteristics (age, parity, body weight, height, and occupation) between the two treatment groups (p <0.05). There were differences of breech pain (proctalgia) before and after 1, 3, and 6 months post operation in SSF group (p <0.05), in which proctalgia was more exquisite after than before surgery. The results showed that SSF was effective in reducing urinary disorders, defecation disorders, vaginal prolapse, cystocele and rectocele, and effectively improving the quality of life of POP patients. In addition, there was a difference of proctalgia and vaginal prolapse 1, 3, and 6 months after surgery between two groups where the adverse outcome of the proctalgia was more signifi cant in SSF group but the vaginal prolapse was more signifi cant in the non-SSF group. There were no differences in bleeding complications (p = 1,000) and infection (p = 1,000) between the two groups. Hasil : Analisis statistik tidak terdapat perbedaan karakteristik pasien baik usia, paritas, berat badan, tinggi badan, dan pekerjaan antara kedua kelompok perlakuan (p< 0,05). Didapatkan bahwa SSF efektif mengurangi gangguan berkemih, gangguan defekasi, prolaps vagina, sistokel dan rektokel serta meningkatkan kualitas hidup pasien POP, namun terdapat perbedaan nyeri bokong (proktalgia) sebelum dan sesudah 1 bulan, 3 bulan dan 6 bulan operasi pada group SSF (p <0,05). dimana proktalgia lebih dirasakan setelah operasi dibandingkan sebelum operasi. Selain itu terdapat perbedaan proklatgia dan prolaps vagina 1,3 dan 6 bulan setelah operasi antar kedua group dimana proktalgia lebih dirasakan pada kelompok SSF namun prolaps vagina lebih banyak dialami oleh kelompok non SSF. Tidak terdapat perbedaan komplikasi perdarahan (p = 1,000) dan infeksi (p = 1,000) antara kedua kelompok. Conclusions : Sacrospinous fi xation effectively reduced the Kesimpulan : Fiksasi sakrospinosus efektif mengurangi vaginal prolapse of pelvic organ prolapse patients. Keywords : cystocele, defecation, proclatgia, quality of life, rectocele, sacrospinous fi xation, urinary prolaps vagina pasien prolaps organ panggul. Kata kunci : berkemih, defekasi, fi ksasi sacrospinosus, kualitas hidup, nyeri bokong, rektokel, sistoke