Faktor Risiko Penderita Prolapsus Organ Panggul terhadap Hiatus Genitalis, Panjang Total Vagina, dan Perineal Body

Abstract

Prolapsus organ panggul (POP) merupakan kondisi yang umum pada perempuan usia lanjut. Keluhannya bersifat prolapsus organ panggul (POP) merupakan kondisi umum bersifat progresif pada perempuan usia lanjut. Saat ini belum ada laporan mengenai hubungan antara komponen faktor risiko dan anatomi. Penelitian ini untuk mengetahui faktor risiko klinis POP serta pengaruhnya pada komponen anatomi penentu tahapan klinis kelainan tersebut. Penelitian dilakukan di Departemen Obstetri dan Ginekologi Fakultas Kedokteran Unpad/Rumah Sakit Dr. Hasan Sadikin Bandung periode Desember 2009–Mei 2010. Limapuluh dua pasien POP dibagi menjadi dua kelompok yaitu 30 subjek POP tingkat III dan 22 POP tingkat I-II. POP berasosiasi signifikan dengan usia, paritas, menopause, serta TSH. Usia ≥50 tahun (OR=0,08; 95% IK=0,018-0,333 versus <50 tahun), paritas ≥3 (OR=5,56; 95% IK=0,02-0,55 versus paritas <3), dan status menopause (OR=5,14; 95% IK=1,18-22,49 versus tidak menopause). Korelasi positif signifikan panjang hiatus genitalis (HG) dengan usia (r=0,656) dan paritas (r=0,539). Ukuran perineal body (PB) korelasi negatif signifikan dengan usia (r= -0,298) dan paritas (r=-0,335). Kelompok menopause menunjukkan peningkatan panjang HG dan penurunan ukuran PB yang signifikan. Panjang PB meningkat signifikan pada kelompok yang menerima TSH. Hubungan yang signifikan antara panjang total vagina (PTV) dan faktor-faktor risiko hanya menemukan pemendekan PTV signifikan pada usia >50 tahun. Simpulan, usia, paritas, dan menopause merupakan faktor risiko kemungkinan POP serta mempunyai korelasi dengan panjang GH dan PB dan progresivitas POP. [MKB. 2014;46(1):57–60]

Kata kunci: Hiatus genitalis, panjang total vagina, perineal body, prolapsus organ panggul

Risk Factors for Patients with Pelvic Organ Prolapse on Hiatus Genitalis, Total Vaginal Length, and Perineal Body

Pelvic organ prolapse (POP) is a common and progressive condition in elderly women. Currently, there are no report regarding the relationship between risk factor and anatomical components. This research was to identify risk factors and its influence on the POP clinical anatomy component determining clinical stages of this disorder. The study was conducted at the Department of Obstetrics and Gynaecology, Faculty of Medicine Universitas Padjadjaran/Dr. Hasan Sadikin General Hospital Bandung during the period of December 2009–May 2010. Fifty-two POP patients were participated, 30 subjects were in grade III and 22 subjects were in grade I–II. Found a significant association between age, parity, menopause, and hormone replacement therapy (HRT) and the incidence POP. Age >50 years (OR=0.08, 95% CI=0.018 to 0.333 versus <50 years), parity >3 (OR=5.56, 95% C1=0.02 to 0.55 versus parity <3), and menopausal status (OR=5.14, 95% CI=1.18 to 22.59 versus not menopausal). Long hiatus genetalis (HG) had a significant positive correlation to age (r=0.656), while HG had a significant positive correlation to parity (r=0.539). Size of the perineal body (PB) showed a significant negative correlation with age (r=-0.298) and parity (r=-0.335). Menopausal group showed significant increase in HG length and decrease in size of the PB compared to the premenopausal group. The PB length increased significantly in those receiving HRT (p=0.018). Significant relationship between total length of the vagina (PTV) and the risk factors was only found in the form of significant shortening of PTV at aged >50 years. In conclusion, age, parity, and menopause are risk factors for POP probability and has a correlation with HG length, PB and progression of POP. [MKB. 2014;46(1):57–60]

Key words: Genital hiatus, pelvic organ prolapse, perinael body, total vaginal length

DOI: 10.15395/mkb.v46n1.229