162 Serebrovasküler Hastalık Öyküsü Olan Hastalarda Ürodinamik Bulgular: Aşırı Aktif ve Az Aktif Mesane Örüntüleri ile İnme Alt Tiplerinin Karşılaştırmalı Analizi

Abstract

Amaç: Alt üriner sistem disfonksiyonu (AÜSD), serebrovasküler olayların (SVO) iyi bilinen bir sonucudur. Ancak, detrusör aşırı aktivitesinden (DAA) az aktif mesaneye kadar uzanan ürodinamik anormallik yelpazesi ve bunların inme alt tipiyle ilişkisi henüz yeterince tanımlanmamıştır. Yöntemler: 2020-2022 yılları arasında, SVO öyküsü olan ve AÜSD ile başvuran 25 hastaya ürodinamik inceleme (Üİ) yapıldı. Mesane kompliyansı, detrusör aşırı aktivitesi, maksimum sistometrik kapasite ve işeme sonrası rezidüel hacim kaydedildi ve hasta alt grupları arasında karşılaştırıldı. Bulgular: En baskın bulgu detrusör aşırı aktivitesiydi (%72, n=18); buna karşılık hastaların %28'inde (n=7) artmış kompliyans ve düşük detrusör basıncı ile karakterize az aktif mesane paterni görüldü. Hastaların %40'ında, yüksek basınçla seyreden azalmış kompliyans saptandı. Sistometri sırasında hastaların %20'sinde üriner inkontinans tespit edildi. Ürodinamik profillerin ve bunların patofizyolojik karşılıklarının karşılaştırmalı bir dökümü sunulmuştur. Sonuçlar: SVO, heterojen bir AÜSD yelpazesine yol açar. Aşırı aktif ve az aktif paternlerin birbirinden ayırt edilmesi ve bunların inme alt tipi ile lezyon lokalizasyonuyla ilişkilendirilmesi, kişiye özgü nöroürolojik yönetim açısından büyük önem taşır. Ürodinamik değerlendirme, bu hasta grubunda temel tanı aracı olma niteliğini korumaktadır.

Keywords

• Serebrovasküler Hastalık
• Detrussor aşırı aktivitesi
• inme
• nöroüroloji

Urodynamic findings in patients with history of cerebrovascular disease: A comparative analysis of overactive vs. underactive bladder patterns and stroke subtypes

Abstract

Lower urinary tract dysfunction (LUTD) is a recognized consequence of stroke. However, the spectrum of urodynamic findings — ranging from detrusor overactivity (DO) to low-pressure, high-capacity patterns — remains incompletely characterized. Twenty-five patients with a history of stroke and LUTD underwent urodynamic study (UDS) between 2020 and 2022. Bladder compliance, detrusor overactivity, maximum cystometric capacity, and post-void residual volume were recorded as specified in the study dataset; the available findings were summarized descriptively. Detrusor overactivity was the most common urodynamic observation (72%, n=18), whereas 28% (n=7) showed a low-pressure, high-capacity pattern recorded as increased compliance and low detrusor pressure. Decreased compliance with elevated pressure was reported in 40% of patients. Urinary incontinence during cystometry was detected in 20%. Post-stroke LUTD shows heterogeneous urodynamic patterns. DO and low-pressure, high-capacity findings should not be treated as interchangeable with clinical overactive bladder (OAB) or as confirmed detrusor underactivity (DU) when pressure-flow and PVR parameters are unavailable. Objective urodynamic assessment may help distinguish storage and voiding dysfunction, while larger prospective studies are needed.

Keywords

• Cerebrovascular disease
• detrusor overactivity
• urodynamics
• neurourology

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