Ürologların Noktüriye Yaklaşımı: Rutin veya Standardize Yaklaşım

Abstract

Amaç: Noktüri şikayeti olan hastalarda ürologların rutin yaklaşımı ile standardize yaklaşımının hastalık yönetimi ve tedavi sonuçlarına etkisini karşılaştırmayı amaçladık. Gereç ve Yöntem: Çalışma, Mart-Temmuz 2023 tarihleri arasında randomize olmayan prospektif kohort çalışması olarak tasarlandı. İlk aşamada 6 üroloji uzmanının rutin klinik yaklaşımı değerlendirildi. Hastaların demografik verileri, komorbiditeleri, başlangıçtaki noktüri sayısı, yaşam kalitesi ve multidisipliner yaklaşım tercihleri kaydedildi (Grup-1). İkinci aşamada hastaların demografik verileri, komorbiditeleri ve ayrıca işeme günlüğü ve “Sonuçlara Yönelik Bireyin Noktüri Etiyolojisinin Hedeflenmesi” (TANGO) anketi sorgulandı (Grup-2). Verilen tedavilerin/önerilerin ardından tüm hastalar ilk ayda tekrar değerlendirildi. İki yaklaşım arasında multidisipliner yaklaşımdaki fark ile hastaların noktüri sayısı ve yaşam kalitesindeki değişim karşılaştırıldı. Bulgular: Her gruba 47 hasta dahil edildi. Her iki gruptaki hastaların demografik ve klinik özellikleri istatistiksel olarak benzerdi. Charlson komorbidite indeksi Grup-2’de daha yüksekti (p=0,01). Multidisipliner tedavi yaklaşımı Grup-2’de daha yüksek düzeydeydi (%59,6 vs %8,5, p=0,001). Grup-1’de ortalama noktüri sayısı 4,6’dan 2,19’a düşerken, grup-2’de 5,15’ten 1,21’e düştü. Birinci ayda noktüri sayısı ve yaşam kalitesi skorları grup-2’de daha düşüktü. Grup-2’de ortalama noktüri sayısı ve yaşam kalitesindeki azalma grup-1’e göre istatistiksel olarak anlamlı derecede daha yüksekti. Sonuç: Noktüriye yaklaşımda komorbiditelerin sorgulanması ve multidisipliner yönetimin uygulanması noktüri tedavisinde daha anlamlı sonuçlar sağlamakta ve yaşam kalitesini arttırmaktadır.

Keywords

• alt üriner sistem semptomları
• multidisipliner
• noktüri
• sorgulama formu
• yaşam kalitesi

Urologists’ Approach to Nocturia: Routine vs. Standardized Approach

Abstract

Objective: We aimed to compare the effect of urologists’ routine approach and standardized approach on disease management and treatment results in patients suffering from nocturia. Material and Methods: The study was designed as a non-randomized prospective cohort study between March and July 2023. In the first stage, the routine clinical approach of 6 urology specialists was evaluated. Demographic data, comorbidities, baseline nocturia number, quality of life, and multidisciplinary approach preference of the patients were recorded (Group 1). In the second stage, the patients’ demographic data, comorbidities, and additionally the voiding diary and “Targeting the individual’s Aetiology of Nocturia to Guide Outcomes” (TANGO) questionnaire were questioned (Group 2). All patients were re-evaluated in the first month of the treatments/recommendations given. The difference in the multidisciplinary approach and the change in the number of nocturia and the quality of life of the patients were compared between the two approaches. Results: Forty-seven patients were included in each group. The demographic and clinical characteristics of the patients in both groups were statistically similar. Charlson’s comorbidity index was higher in Group 2 (p=0.01). The multidisciplinary treatment approach was at a higher level in Group 2 (59.6% vs 8.5%, p=0.001). While the average number of nocturia decreased from 4.6 to 2.19 in group 1, it decreased from 5.15 to 1.21 in group 2. In the first month, the number of nocturia and quality of life scores were lower in group 2. The decrease in the average number of nocturia and quality of life in group 2 was statistically significantly higher than in group 1. Conclusion: In the approach to nocturia, questioning comorbidities and applying multidisciplinary management provides more meaningful results in nocturia treatment and increase the quality of life.

Keywords

• lower urinary tract symptoms
• multidisciplinary
• nocturia
• questionnaire
• quality of life

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