Diskrepansi Diagnosis Preoperatif dan Hasil Patologi Anatomi Postoperatif Serta Gangguan Pola Haid Pada Tuberkulosis Genital
Authors:   KSM/ Dep Obstetri & Ginekologi Fakultas Kedokteran Universitas Padjadjaran/RSUP Dr. Hasan Sadikin Bandung, Deviano Sandi , Djuwantono Tono , Achmad Eppy Darmadi , Tjahyadi Dian 
Published: March 2022

Tujuan: Mengevaluasi diskrepansi diagnosis preoperatif dan hasil patologi anatomi postoperatif pada kasus tuberkulosis genital dan mengevaluasi gangguan pola haid yang terjadi. Metode: Penelitian ini merupakan studi deskriptif dengan pendekatan potong lintang terhadap pasien yang terdiagnosis tuberkulosis genital berdasarkan hasil patologi anatomi. Populasi diambil dari rekam medis pasien dengan diagnosis tuberkulosis genital berdasarkan kode ICD 10 yang sesuai dalam kurun Januari 2017 hingga Juni 2021. Sampel penelitian didapat secara total sampling, sesuai kriteria inklusi dan eksklusi yang ditetapkan. Dilakukan pembandingan diagnosis preoperatif terhadap hasil patologi anatomi postoperatif. Pasien dengan hasil histopatologi tuberkulosis genital kemudian diwawancara melalui telepon untuk memnetukan pola gangguan menstruasi berdasarkan kriteria FIGO 2018. Hasil: Terdapat 11 pasien dalam studi ini. Terdapat diskrepansi diagnosis preoperatif dengan hasil patologi anatomi postoperatif pada 6 pasien (54,55%). Pada pasien tuberkulosis genital ditemukan gangguan menstruasi berupa amenorea dan oligomenorrhea. Terapi tuberkulosis lini 6 bulan diberikan kepada 3 dari 5 pasien yang terkonfirmasi tuberkulosis genital. Kesimpulan: Terdapat diskrepansi pada penegakan diagnosis preoperatif dengan hasil patologi anatomi postoperatif pada tuberkulosis genitalia. Diskrepansi ini berdampak terhadap pilihan pengobatan pasca-operasi yang adekuat. Gangguan menstruasi yang terjadi pada tuberkulosis berupa oligomenore diikuti oleh amenore. Perbaikan pola mentruasi terjadi pada pasien yang mendapatkan anti-tuberkulosis. Discrepancy of Pre Operative Diagnosis and Post Operative Pathology Result of Genital Tuberculosis and Related Menstruation Abnormalities Abstract Objective: To evaluate the discrepancy between preoperative diagnosis and postoperative histopathological results in genital tuberculosis cases and evaluate the related changes of menstrual pattern. Methods: This was a descriptive study with cross-sectional approach to patients diagnosed with genital tuberculosis based on histopathological examination. Study population was taken from medical records of patients diagnosed with genital tuberculosis based on ICD 10 from January 2017 to June 2021. Total sampling method was used, with determined inclusion and exclusion criteria. Preoperative diagnosis was compared with postoperative histopathological results. Patients with histopathological result of genital tuberculosis were then interviewed via call to determine menstrual disorder patterns according to FIGO 2018 criteria. Results: There were 11 patients included in this study. Discrepancy in preoperative diagnosis and histopathological restult was found in 6 patients (54.55%). Menstrual disorders in the form of amenorrhea and oligomenorrhea were found in genital tuberculosis patients. Six-month first line tuberculosis therapy regimen was given to 3 out of 5 patients with confirmed genital tuberculosis. Conclusion: There is a large discrepancy between preoperative diagnosis and postoperative histopathological result of genital tuberculosis. This discrepancy impacted postoperative treatment options and delayed adequate tuberculosis therapy. Oligomenorrhea, followed by amenorrhea are the two main menstrual disorders in tuberculosis. Improvements in menstrual pattern were found in patients receiving complete anti-tuberculosis therapy. Key words: Uterine bleeding, Diagnostic discrepancy, Genital tuberculosis, Treatment of genital tuberculosis.