Orta Derecede Fonksiyonel Bozukluğu Olan Aşırı Aktif Mesane Hastalarında İntravezikal Botulinum Toksin Tedavisinin Yaşam Kalitesini İyileştirmedeki Etkinliğinin Değerlendirilmesi

Year 2024, , 103 - 109, 30.10.2024

Necmi Bayraktar , Sadrettin Tuğcu

https://doi.org/10.33719/nju1461979

Abstract

Amaç: Aşırı aktif mesane (AAM) yaşam kalitesini önemli ölçüde etkilemekte ve cinsiyetten bağımsız olarak çeşitli yaş gruplarındaki bireyleri etkilemektedir. Konvansiyonel tedaviler mevcut olsa da, Doğu Kooperatif Onkoloji Grubu Performans Skoru (ECOG PS3) ile işaretlenen orta derecede fonksiyonel bozukluğu olan hastalar için genellikle yetersiz kalmaktadır. İntravezikal botulinum toksin tedavisi, özellikle geleneksel farmakoterapiye yanıt vermeyenler için umut verici bir alternatif olarak ortaya çıkmıştır.
Amaç: Bu çalışmada amacımız, daha önce konvansiyonel tedavilere yanıt vermemiş AAM ve Performans Skoru ECOG PS3 olan hastalarda intravezikal botulinum toksin tedavisinin yaşam kalitesini iyileştirmedeki etkinliğini değerlendirmektir.
Gereç ve Yöntem: 2020-2023 yılları arasındaki bu retrospektif çalışmada, AAM için botulinum toksin tedavisi ile tedavi edilen hastalardan elde edilen verileri analiz ettik. Dahil edilen hastalar, mesane kapasitesi en az 200 mililitre olan ECOG PS3 hastalarıydı. Toplanan veriler arasında tıbbi öyküler, işeme günlüğü ve yaşam kalitesi skorları (ICIQ-SF ve I-QOL) yer aldı.
Bulgular: Araştırma 46 kişiyi içeriyordu ve tedaviyi takiben yaşam kalitesinde istatistiksel olarak anlamlı bir ilerleme olduğunu gösterdi. İnkontinans epizodları ve işeme günlüğü skorlarının parametreleri istatistiksel olarak anlamlı artışlar sergiledi. Tedaviyi takiben rezidüel idrar veya idrar yolu enfeksiyonlarında gözlenebilir bir artış olmaması dikkat çekicidir.
Sonuç: İntravezikal botulinum toksin tedavisi, AAM'den muzdarip ve orta derecede fonksiyonel bozukluk sergileyen hastalarda yaşam kalitesinde belirgin bir iyileşme göstermiştir. Bununla birlikte, bulguları doğrulamak ve güvenilirliklerini korumak için çok merkezli randomize çalışmalar şeklinde daha fazla araştırmaya ihtiyaç vardır.

Keywords

Aşırı aktif mesane, Botulinum toksin A, Doğu Kooperatif Onkoloji Grubu Performans Skoru, Yaşam kalitesi, ICIQ-SF, IQOL, ECOG PS, intravezikal botulinum toksin tedavisi

Assessing the Effectiveness of Intravesical Botulinum Toxin Therapy in Improving Quality of Life for Overactive Bladder Patients with Moderate Functional Impairment

Abstract

Objective: Overactive bladder (OAB) significantly impacts the quality of life, affecting individuals across various age groups irrespective of gender. While conventional treatments exist, they often fall short for patients with moderate functional impairment, marked by an Eastern Cooperative Oncology Group Performance Score (ECOG PS3). Intravesical botulinum toxin therapy has emerged as a promising alternative, especially for those unresponsive to traditional pharmacotherapy.
Material and Methods: In this retrospective study from 2020 to 2023, we analyzed data from patients treated with botulinum toxin therapy for AAM. Included patients were ECOG PS3 patients with a bladder capacity of at least 200 milliliters. Data collected included medical histories, voiding diary, and quality of life scores (ICIQ-SF and I-QOL).
Results: The research featured 46 individuals and demonstrated a statistically substantial advancement in quality-of-life following treatment. The parameters of incontinence episodes and voiding diary scores exhibited statistically significant enhancements. It is noteworthy that there was no observable increase in residual urine or urinary tract infections subsequent to treatment.
Conclusion: Intravesical botulinum toxin therapy has demonstrated a marked improvement in the quality of life for patients suffering from AAM and exhibiting moderate functional impairment. Nevertheless, further research is required in the form of multicenter randomized trials to substantiate the findings and maintain their credibility.

Keywords

Overactive bladder, Botulinum toxin A, Eastern Cooperative Oncology Group Performance Score, Quality of life, ICIQ-SF, IQOL, ECOG PS, intravesical botulinum toxin treatment

Ethical Statement

KKTC Burhan Nalbatoğlu Sitate Hospital Ethic Committee: 03.04.2024 EK:19/24.

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