Tata Laksana Disfungsi Dasar Panggul Pascasalin

Mochamad Rizkar Arev Sukarsa,(1*) Rena Nurita,(2) Melia Juwita Adha,(3)

(1) Department of Obstetric and Gynecology Faculty of Medicine Universitas Padjadjaran/Dr. Hasan Sadikin General Hospital Bandung
(2) Department of Obstetrics and Gynecology Faculty of Medicine Universitas Padjadjaran/Dr. Hasan Sadikin General Hospital Bandung
(3) Department of Obstetrics and Gynecology Faculty of Medicine Universitas Padjadjaran/Dr. Hasan Sadikin General Hospital Bandung
(*) Corresponding Author

Abstract


Tujuan: melakukan telaah literatur mengenai identifikasi dan tata laksana dini disfungsi dasar panggul pada onset baru atau lama. Gejala dan perubahan anatomis terkait disfungsi otot dasar panggul dapat berhubungan dengan hipertonisitas, hipotonisitas, atau gangguan koordinasi otot dasar panggul. Diagnosis disfungsi dasar panggul pascasalin sering terlewat karena ketiadaan alat skrining disfungsi dasar panggul khusus kehamilan. Evaluasi klinis dan diagnosis paling utama didasari pada gejala yang dilaporkan pasien. Evaluasi klinis mencakup empat domain penilaian yaitu terkait fungsi seksual, fungsi penyokong dasar panggul, fungsi urinasi, dan fungsi defekasi.
Metode: merangkum berbagai referensi termutakhir yang dapat menjadi pedoman dan tata laksana disfungsi dasar  panggul.
Hasil: awal disfungsi dasar panggul pascasalin ditegakkan berdasarkan domain evaluasi klinis yang dikeluhkan oleh pasien. Tata laksana meliputi pertimbangan onset gejala, tidak menganggap normal suatu gejala yang mengganggu, tata laksana konservatif, pemantauan berkala, dan lanjutan. Latihan otot dasar panggul (Kegel) terbukti dapat mengidentifikasi dan menguatkan otot yang berkaitan dengan fungsi miksi, defekasi, dan seksual.
Kesimpulan: Latihan Kegel dapat berperan sebagai tata laksana rutin mandiri pasien dengan disfungsi dasar panggul dengan gejala semua domain. Latihan ini dapat dikombinasikan dengan terapi biofeedback atau modalitas rehabilitasi yang lain.

Management of Pelvic Floor Dysfunction

Abstract
Objective: to perform a literature review the identification and early management of new-onset or pre-existing pelvic floor dysfunction. Symptoms and anatomical changes related to pelvic floor muscle dysfunction may be related to hypertonicity, hypotonicity, or discoordination of the pelvic floor muscles. Diagnosis of pelvic floor dysfunction  after delivery is difficult because there are no pregnancy-specific pelvic floor dysfunction screening tools. Clinical evaluation and diagnosis are primarily based on the patient's reported symptoms, which include four assessment domains related to sexual function, pelvic floor support function, urinary, and defecation.
Methods: summarizes the latest references that provide guidance and treatment for pelvic floor dysfunction. Results: Management of pelvic floor dysfunction after the initial diagnosis was based on the evaluation domain from patient’s symptoms. Management includes considering the symptoms onset, awareness of disturbing symptoms, conservative management, monitoring, and advanced management. Pelvic floor exercises (Kegel) are clinically proven to identify and strengthen the muscles associated with micturition, defecation, or sexual function.
Conclusion: Kegel exercises can act as routine independent management of pelvic floor dysfunction patients with symptoms in all domains. The exercise can be combined with biofeedback therapy or other rehabilitation modalities.

Key words: clinical evaluation, hypertonicity, hypotonicity, kegel exercise,  pelvic floor, rehabilitation



Keywords


evaluasi klinis; hipertonisitas; hipotonisitas; latihan kegel; otot panggul; rehabilitasi

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References


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DOI: http://dx.doi.org/10.24198/obgynia/v5n1.339

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