{"paper_id":"8446bcce-576f-4e31-8088-e45b64647609","body_text":"Penurunan Skala Nyeri Penderita Endometriosis Sebelum dan Sesudah Pembedahan Laparoskopi Konservatif dengan atau Tanpa Diikuti Terapi Medikamentosa di RSUD Dr. Soetomo\nDownloads\nTujuan: Mengetahui perubahan keluhan nyeri penderita endo-metriosis sebelum dan sesudah pembedahan laparoskopi konservatif dengan atau tanpa diikuti terapi medikamentosa di RSUD dr. Soetomo.\nBahan dan Metode: Studi ini merupakan penelitian deskriptif analitik pada penderita dengan keluhan nyeri panggul yang dicurigai menderita endometriosis dan akan dilakukan pembedahan laparoskopi konservatif serta memenuhi kriteria inklusi dan eksklusi. Subyek penelitian dievaluasi skala keluhan nyeri panggul kronik, dismenorea, dan dispareunia sebelum dilakukan laparoskopi dan setelah dilakukan laparoskopi pada bulan ke-1, bulan ke-2 dan bulan ke-3 dengan menggunakan skala numerik verbal mulai 0 sampai 10. Terapi medikamentosa yang diterima penderita setelah laparoskopi konservatif juga dicatat. Studi ini dilakukan si RSUD dr.Soetomo bulan Juli sampai Desember 2013.\nHasil: Didapatkan 28 penderita yang memenuhi kriteria inklusi dan eksklusi serta dilakukan pembedahan laparoskopi konservatif, 2 penderita putus uji dan 26 penderita diikuti sampai bulan ke-3 pascapembedahan. Rata-rata skor r-AFS endometriosis 26,27 (rentang 3-60). Berdasarkan uji Wilcoxon, pada 1 bulan pertama didapatkan perubahan rata-rata skala nyeri panggul kronik 0,92 ± 0,24 (p:0,002), dismenorea 2,77 ± 0,33 (p:0,000) dan dispareunia 0,15 ± 0,07 (p:0,046). Pada interval bulan 1 dan bulan 2, didapatkan perubahan rata-rata skala nyeri panggul kronik 0,23 ± 0,10 (p:0,02), dismenorea 0,85 ± 0,19 (p:0,001). Pada interval bulan 2 dan bulan 3, didapatkan perubahan rata-rata skala nyeri panggul kronik 0,15 ± 0,09 (p:0,10), dismenorea 0,31 ± 0,10 (p:0,014).\nSimpulan: Tidak didapatkan perubahan skala dispareuni pada interval bulan 1 dan bulan 2 maupun bulan 2 dan bulan 3. Penurunan bermakna skala nyeri kronik terjadi sampai 2 bulan, penurunan bermakna skala dismenorea terjadi sampai 3 bulan, dan penurunan bermakna skala dispareuni terjadi sampai 1 bulan setelah pembedahan laparoskopi konservatif.Baziad A. Endokrinologi Ginekologi. Media Aesculapius. Fakultas Kedokteran Universitas Indonesia: Jakarta. 2003. h. 21-3.\nSpaczynski RZ and Duleba AJ. Diagnosis of endometriosis. Semin Reprod Med. 2003;21:193-208.\nBulun SE. Mechanism of disease endometriosis. New England Journal Medicine. 2009;360:268-79.\nJamieson D and Steege J. The prevalence of dysmenorrhea, dyspareunia, pelvic pain, and irritable bowel syndrome in primary care practices. Obstet Gynecol. 1996;87:55-8.\nVercellini P, Cortesi I and Crosignani PG. Progestins for symptomatic endometriosis: a critical analysis of the evidence. Fertil Steril. 1997;68:393-401.\nStones RW and Mountfield J. Management of chronic pelvic pain in women. Oxford: In Cochrane Library; 1998.\nYeung PP, Shwayder J and Pasic RP. Laparoscopic management of endometriosis. The Journal of Minimally Invasive Gynecology. 2009;16:9.\nVincent K, Kennedy S and Stratton P. Pain scoring in endometriosis: entry criteria and outcome measures for clinical trials. Fertility and Sterility. 2008;9:56.\nVercellini P, Somigliana E, Vigano P, Abbiati A, Daguati R and Crosignani PG. Endometriosis: current and future medical therapies. Best Pract Res Clin Obstet Gynaecol. 2008;22:275-306.\nVercellini P, Crosignani P, Abbiati A, Somigliana E, Vigano P and Fedele L. The effect of surgery for symptomatic endometriosis: the other side of the story. Human Reproduction Update. 2009;15(2): 177-88.\nAmerican Medical Association. Pathophysiology of pain and pain management. 2012;1:1-21.\nJones KD and Sutton C. Patient satisfaction and changes in pain scores after ablative laparoscopic surgery for stage III-IV endometriosis and endometriotic cysts. Fertil Steril. 2003;79:1086-90.\nJohnson NP and Hummelshoj L. for the World Endometriosis Society Montpellier Consortium. Consensus on current management of endo-metriosis. Human Reproduction. 2013:1–17.\nTokushige N, Markham R, Russell P, Fraser I. Nerve fibres in peritoneal endometriosis. Human reproduction. 2006;21(11):3001-7.\nD'Hooghe TM. Berek and Novak's gynecology 14th Eds. Endometriosis. Philadelphia: Lippincott Williams and Wilkins; 2007.\nVercellini P, Fedele L, Aimi G, Pietropaolo G, Consonni D, Crosignani PG. Reproductive performance, pain recurrence and disease relapse after conservative surgical treatment for endo-metriosis: predictive value of the current classification system. Human Reproduction. 2006;21(10):2679-85.\nSinaii N, Plumb K, Cotton L, Lambert A, Kennedy S, Zondervan K, et al. Differences in characteristics among 1,000 women with endometriosis based on extent of disease. Fertility and Sterility. 2008;89(3):538-45.\nFalcone T and Lue JR. Management of Endometriosis. The American College Of Obstetricians and Gynecologists Practice Bulletin. 2010;116(1):223-36.\nRoyal College of Obstetricians and Gynaecologist. The Investigation and Management of Endo-metriosis. Green-top Guideline. 2010;24:1-14.\nHelsa JS, Jones HW. Te Linde's Operative Gynecology: Endometriosis. Philadelphia: Lippin-cott Williams & Wilkins; 2003. p. 595-630.\nThe Cannadian Consensus Conference on Endo-metriosis. 1999;21(6).\nVercellini P, De Giorgi O, Mosconi P, Stellato G, Vicentini S and Crosig-Nani PG. Cyproterone acetate versus a continuous monophasic oral contraceptive in the treatment of recurrent pelvic pain after conservative surgery for symptomatic endometriosis. Fertil Steril. 2002;77(1):52–61.\n1. Copyright of the article is transferred to the journal, by the knowledge of the author, whilst the moral right of the publication belongs to the author.\n2. The legal formal aspect of journal publication accessibility refers to Creative Commons Attribution-Non Commercial-Share alike (CC BY-NC-SA), (https://creativecommons.org/licenses/by-nc-sa/4.0/)\n3. The articles published in the journal are open access and can be used for non-commercial purposes. Other than the aims mentioned above, the editorial board is not responsible for copyright violation\nThe manuscript authentic and copyright statement submission can be downloaded ON THIS FORM.","source_license":"CC0","license_restricted":false}