REFLEKSI KASUS

KISTA OVARIUM

Pembimbing:
Dr. dr. Cahyono Hadi, SH, SpOG (K.Fer)

Oleh:
Aldora Sindila Febriana
406172117

Fakultas Kedokteran Universitas Tarumanagara

Kepaniteraan Obstetri & Ginekologi
RSUD RAA Soewondo Pati, Jawa Tengah
Rotasi Klinik Periode 09 Juli – 16 September 2018
 KASUS
S:
Wanita usia 24th P0A0 datang dengan keluhan nyeri perut bagian bawah
Riw. Mens : Teratur, 7 hari.
Riw. Obstetri : -
Riw. Menikah : -
Riw. KB: -
Riw. operasi: (-) Riw. pijat: (-) jamu: (-)
Riw. penyakit dulu: HT (-), DM (-), Asma (-), Alergi (-), jantung (-)

O: A:
• KU : Compos Mentis Kista Ovari
• TD : 110/70 mmHg
HR: 80x/m
RR: 20x/m
S: 36,4C P:
• Mata : CA -/-, SI -/-
laparoskopi
• Thorax : dbN
• Abd : nyeri tekan perut bagian bawah
 KISTA OVARIUM
Kista Ovarium adalah kantong yang berisi cairan atau jaringan yg
terdapat di ovarium

Kista Ovari

Kista Fisiologis Kista Patologis

Kista Follikular Kista Luteal benign, malignant, & borderline

The American College of Obstetricians and Gynecologists. Ovarian Cysts. July 2015. (http://www.acog.org/Patients/FAQs/Ovarian-Cysts)
Abduljabbar HS, et al. Review of 244 cases of ovarian cysts. Saudi Med J 2015; Vol. 36 (7) (www.smj.org.sa)
 KISTA OVARIUM
Kista ovarium fungsional paling sering terjadi pada wanita usia pr
oduktif dan jarang pada wanita menopause.
-24 % kista fungsional
-6% malignan
-70 % kista jinak

Abduljabbar HS, et al. Review of 244 cases of ovarian cysts. Saudi Med J 2015; Vol. 36 (7) (www.smj.org.sa)
Rofe G, Auslender R, Dirnfeld M. Benign ovarian cysts in reproductive-age women undergoing assisted reproductive technology treatment. Open Journal of O
bstetrics and Gynecology, 2013, 3, 17-22
 KISTA OVARIUM
Faktor Risiko
• Premenopause
• Merokok
• Penggunaan tamoxifen

The American College of Obstetricians and Gynecologists. Ovarian Cysts. July 2015. (http://www.acog.org/Patients/FAQs/Ovarian-Cysts)
Abduljabbar HS, et al. Review of 244 cases of ovarian cysts. Saudi Med J 2015; Vol. 36 (7) (www.smj.org.sa)
 Kista Folikel

Pe ↑ stimulasi FSH / ↓ LH ↓ frekuensi

Kista terus Produksi
pada pertengahan siklus menstruasi &
tumbuh estradiol menorrhagia
tepat sebelum ovulasi

Kista Luteal

Jika ovum fertilisasi, corpus Kista

Gagal Kista dpt menyebabkan nyeri
luteum terus mensekresi
progesterone selama 5-9 mgg, corpus pelvis unilateral, tumpul, &
meluruh dapat ruptur  nyeri akut
sampai luruh luteal
 Kista Theca lutein

Luteinisasi & Kista

Stimulasi Predisposisi torsi,
hipertropi dari lapisan Theca- perdarahan & ruptur
berlebihan hCG sel theca interna lutein

Kista stein laventhal

hiperstimuli ovarium dengan Hiperplasi endometrim

↑ kadar LH
produk kista yang banyak atau kariokarsinoma
 KISTA OVARIUM

Manifestasi Klinis
• Pada sebagian besar wanita asimtomatik
• Jika ada kista ovari besar  rasa tidak nyaman pada abdomen
• Jika menekan VU  pe↑ frekuensi kencing
• Nyeri perut bawah, dismenor, dispareuni
• nyeri akut berhubungan dengan komplikasi torsio, infark dan perdarah
an

The American College of Obstetricians and Gynecologists. Ovarian Cysts. July 2015. (http://www.acog.org/Patients/FAQs/Ovarian-Cysts)
Abduljabbar HS, et al. Review of 244 cases of ovarian cysts. Saudi Med J 2015; Vol. 36 (7) (www.smj.org.sa)
 KISTA OVARIUM

Diagnosis
• Vaginal ultrasound
• Laparoscopy
• Blood test – CA 125
• Anti-mullerian hormone (AMH)
CT Scan / MRI

The American College of Obstetricians and Gynecologists. Ovarian Cysts. July 2015.
(http://www.acog.org/Patients/FAQs/Ovarian-Cysts)
Rofe G, Auslender R, Dirnfeld M. Benign ovarian cysts in reproductive-age women undergoing assisted reproductive technology treatment. Open Journal of Obstetrics and Gynecology, 2013, 3, 17-22
 KISTA OVARIUM

Management
• Conservative
• Medical
– Kombinasi kontrasepsi oral
– progesterone, GnRH agonists or antagonists.
• Surgical : cystectomy

Rofe G, Auslender R, Dirnfeld M. Benign ovarian cysts in reproductive-age women undergoing assisted reproductive technology treatment. Open Journal of Obstetrics and Gynecology, 2013, 3, 17-22
The American College of Obstetricians and Gynecologists. Ovarian Cysts. July 2015.
(http://www.acog.org/Patients/FAQs/Ovarian-Cysts)