USULAN PENELITIAN

EKSPRESI KOLAGEN I YANG RENDAH

PADA LIGAMENTUM SAKROUTERINA
SEBAGAI FAKTOR RISIKO TERJADINYA
PROLAPS UTERUS DERAJAT III-IV

I GUSTI NGURAH WARSITA

NIM 1414038107

PROGRAM MAGISTER
PROGRAM STUDI ILMU BIOMEDIK
PROGRAM PASCASARJANA
UNIVERSITAS UDAYANA
DENPASAR
2016
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Lembar Persetujuan Pembimbing

USULAN PENELITIAN INI TELAH DISETUJUI

PADA TANGGAL

Pembimbing I,

Pembimbing II,

Prof. Dr. dr. Ketut Suwiyoga, Sp.OG(K)

NIP. 19530715 198003 1 009

dr. I Gede Mega Putra, Sp.OG(K)

NIP. 19671214 199703 1 004

Mengetahui

Ketua Program Studi

Program Pascasarjana
Universitas Udayana,

Dr. dr. Gde Ngurah Indraguna Pinatih, M.Sc, SpGK

NIP. 19580521 198503 1 002

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Lembar Penetapan Panitia Penguji Usulan Penelitian Tesis

Usulan Pnelitian Tesis Ini Telah Diuji dan Dinilai

Oleh Panitia Penguji pada Tanggal

Panitia Penguji Tesis Berdasarkan SK Direktur Program Pascasarjana

Universitas Udayana No.: .., Tanggal .

Panitia Penguji Usulan Penelitian Tesis adalah:

Ketua

: Prof. Dr. dr. Ketut Suwiyoga, Sp.OG(K).

Anggota :
1

...

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DAFTAR ISI

Halaman
SAMPUL DALAM ..........................................................................................

LEMBAR PERSETUJUAN ............................................................................

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PENETAPAN PANITIA PENGUJI ................................................................

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DAFTAR ISI ....................................................................................................

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DAFTAR GAMBAR. ......................................................................................

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DAFTAR SINGKATAN .................................................................................

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BAB I PENDAHULUAN ...............................................................................

1.1 Latar Belakang .....................................................................................

1.2 Rumusan Masalah ................................................................................

1.3 Tujuan Penelitian .................................................................................

1.4 Manfaat Penelitian ...............................................................................

BAB II TINJAUAN PUSTAKA ...................................................................

2.1 Prolaps Uterus ......................................................................................

2.1.1 Definisi prolaps uterus ...............................................................

2.1.2 Epidemiologi prolaps uterus ......................................................

2.1.3 Anatomi dasar panggul ..............................................................

2.1.4 Faktor risiko prolaps uterus .......................................................

10

2.1.5 Patofisiologi prolaps uterus........................................................

12

2.1.6 Gejala dan tanda prolaps uterus .................................................

13

2.1.7 Standarisasi stadium prolaps uterus berdasarkan klasifikasi

Pelvic Organ Prolapse Quantification (POP-Q) ........................

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2.1.8 Penatalaksanaan prolaps uterus..................................................

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2.2 Ligamentum Sakrouterina ....................................................................

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2.2.1 Anatomi ligamentum sakrouterina .............................................

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2.2.2 Fungsi ligamentum sakrouterina ................................................

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2.3 Matriks Ekstraseluler Ligamentum Sakrouterina ................................

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2.4 Kolagen ................................................................................................

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2.4.1 Sintesis kolagen ........................................................................

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2.4.2 Maturasi kolagen ........................................................................

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2.4.3 Degradasi kolagen .....................................................................

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BAB III KERANGKA BERPIKIR, KONSEP DAN HIPOTESIS

PENELITIAN ..................................................................................................

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3.1 Kerangka Berpikir ................................................................................

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3.2 Konsep Penelitian ................................................................................

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3.3 Hipotesis Penelitian .............................................................................

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BAB IV METODE PENELITIAN ..................................................................

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4.1 Rancangan Penelitian ...........................................................................

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4.2 Tempat dan Waktu Penelitian ..............................................................

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4.3 Penentuan Sumber Data .......................................................................

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4.3.1 Populasi target .............................................................................

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4.3.2 Populasi terjangkau .....................................................................

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4.3.3 Sampel penelitian ........................................................................

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4.3.4 Kriteria inklusi ............................................................................

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4.3.5 Kriteria eksklusi ..........................................................................

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4.3.6 Eligible ........................................................................................

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4.3.6 Besar sampel penelitian ..............................................................

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4.3.7 Cara pemilihan sampel ................................................................

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4.4 Variabel Penelitian ...............................................................................

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4.4.1 Variabel tergantung .....................................................................

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4.4.2 Variabel bebas .............................................................................

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4.4.3 Variabel terkontrol ......................................................................

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4.4.4 Hubungan antar variabel .............................................................

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4.4.5 Definisi operasional variabel ......................................................

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4.5 Bahan dan Cara Pengumpulan Data ....................................................

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4.5.1 Bahan ..........................................................................................

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4.5.2 Cara pengumpulan data...............................................................

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4.6 Prosedur Penelitian ..............................................................................

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4.6.1 Persiapan .....................................................................................

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4.6.2 Alur penelitian ............................................................................

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4.7 Analisis Data ........................................................................................

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DAFTAR PUSTAKA ......................................................................................

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LAMPIRAN-LAMPIRAN. .............................................................................

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DAFTAR GAMBAR

Halaman
Gambar 2.1 Anatomi Dasar Panggul Wanita Menurut DeLancey ..................

10

Gambar 2.2 Hubungan antara Ligamentum Sakrouterina-Kardinale dengan

Otot Levator Ani ..........................................................................

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Gambar 2.3 Enam Titik pada Staging POP-Q ................................................

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Gambar 2.4 Stadium Prolaps Uterus ................................................................

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Gambar 2.5 Komponen Mayor Matriks Ekstraseluler ....................................

26

Gambar 3.1 Konsep Penelitian ........................................................................

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Gambar 4.1 Rancangan Penelitian ..................................................................

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Gambar 4.2 Hubungan Antar Variabel ...........................................................

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Gambar 4.3 Alur Penelitian ............................................................................

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DAFTAR SINGKATAN

AGEs

Advanced glycated endproduct

BM

Basal membrane

ECM

Extra cellular matrix

ER-

Estrogen reseptor

ER-

Estrogen reseptor

Gh

Genital hiatus

MMP

Matrix metalloprotease

MRI

Magnetic resonance imaging

Pb

Perineal body

POP

Prolaps organ panggul

POP-Q

Pelvic Organ Prolapse Quantification

SLRPs

Small leucine rich proteoglicans

TGF-

Transformation growth factor

TIMP

Tissue inhibitor matrix metalloprotease

TSP

Trombospondin

TVL

Total vaginal length

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