POSTPARTUM DÖNEMDE İNKONTİNANS VE YAŞAM KALİTESİ: SON 10 YILLIK ÇALIŞMALAR

Abstract

Postpartum dönemde üriner inkontinans ve fekal inkontinans kadını fiziksel, psikolojik, sosyal olarak etkilemekte ve kadının yaşam kalitesi üzerine olumsuz bir etki yaratmaktadır. Bu derlemede, postpartum dönemde inkontinans ve yaşam kalitesi ile ilgili 2004-2014 yılları arasında Pubmed yoluyla tam metne ulaşılan 28 çalışma incelenmiştir. Bu veri tabanına “Postpartum”, “Quality of Life” ve “Incontinence” anahtar kelimeleri yazılmıştır. Üriner inkontinansın, fekal inkontinansın ve aynı anda her iki tip inkontinansın yaşam kalitesi üzerine olumsuz etkisi olduğu belirlenmiştir. Doğum şekli ve yaşam kalitesi arasında anlamlı bir fark bulunmamaktadır. Üçüncü derecede yırtığı olan kadınların, müdahalesiz vajinal doğum ve elektif sezaryen doğum yapan kadınlara göre yaşam kalitelerinde bozulma olduğu, dördüncü derecede yırtık olan grubun yaşam kalitesi üçüncü derece yırtık olan gruba göre daha olumsuz etkilediği saptanmıştır. Doğumun ikinci fazı uzun süren kadınlar (>90 dk) ile kısa süren (

Keywords

• Postpartum, yaşam kalitesi, inkontinans

Abstract

In postpartum period, urinary incontinence and fecal incontinence affect women physically, psychologically and socially, and create a negative effect on the woman’s quality of life. In this study, we performed a literature search using the keywords of ―Postpartum‖, ―Quality of Life‖ and ―Incontinence‖ and 28 full text publications between 2004 and 2014 about incontinence and quality of life in the postpartum period were reviewed. It was determined that urinary incontinence, fecal incontinence and both types of incontinence at the same time have a negative effect on quality of life. It was determined that women suffering from a third degree tear have a poorer quality of life compared to women who underwent an uncomplicated vaginal delivery or an elective caesarean delivery and quality of life of women suffering from a fourth degree tear was poorer than women with a third degree tear. It is stated that quality of life of groups which performed pelvic floor exercises accompanied with supervisor was better. There was no significant relation between mode of delivery and quality of life. No differences could be found in quality of life between pelvic floor exercises in postpartum period and biofeedback at home in women who had a third degree tear. Quality of life was found similar in women who had prolonged second stage of labour (>90 min) and short second stage (<30 min.)

Keywords

• Postpartum, quality of life, incontinence

References

1. Abrams P, Andersson KE, Birder L, Brubaker L, Cardozo L, Chapple C. et al. Fourth international consultation on incontinence recommendations of the international scientific committee: evaluation and treatment of urinary incontinence, pelvic organ prolapse, and fecal incontinence. Neurourol Urodyn. 2010;29:213-40.
2. Beji NK, Ozbas A, Aslan E, Bilgic D, Erkan HA. Overview of the social impact of urinary incontinence with a focus on Turkish women. Urol Nurs. 2010;30:327-34.
3. Buckley BS, Lapitan MC, Epidemiology Committee of the Fourth International Consultation on Incontinence, Paris, 2008. Prevalence of urinary incontinence in men, women, and children-current evidence: findings of the fourth international consultation on incontinence. Urology. 2010;76:265-70.
4. Basak T, Kok G, Guvenc G. Prevalence, risk factors and quality of life in Turkish women with urinary incontinence: a synthesis of the literature. Int Nurs Rev. 2013;60:448-60.
5. Dedeli Ö, Fadıloğlu Ç, Turan İ, Bor S. İzmir huzurevlerindeki yaşlılarda fekal inkontinans sıklığı ve yaşam kalitesi üzerine etkisi. Türk Geriatri Dergisi. 2008;11:33-41.
6. Whitehead WE, Borrud L, Goode PS, Meikle S, Mueller ER, Tuteja A. et al. Fecal incontinence in us adults: epidemiology and risk factors. Gastroenterology. 2009;137:512-7.
7. Dedeli Ö, Fadıloğlu Ç, Bor S. Fekal inkontinans yaşam kalitesi ölçeğinin Türkçe uyarlaması ve geçerlilik güvenilirlik çalışması. Turk J Gastroenterol Suppl. 2006;17:77.
8. Bilgili N, Akın B, Ege E, Ayaz S. Kadınlarda üriner inkontinans sıklığı ve etkileyen risk faktörleri. Türkiye Klinikleri J Med Sci. 2008;28:487-493.

9. Onur R, Deveci SE, Rahman S, Sevindik F, Acik Y. Prevalence and risk factors of female urinary incontinence in Eastern Turkey. Int J Urol. 2009;16:566-9.
10. Zhu L, Li L, Lang J, Xu T, Wong F. Epidemiology of mixed urinary incontinence in China. Int J Gynaecol Obstet. 2010; 109:55-8.
11. Işıklı B, Yenilmez A, Kalyoncu C. Eskişehir Alpu ilçesi 18 yaş üstü kadınlarda üriner inkontinans, risk faktörleri ve yaşam kalitesine etkisi: bir toplum tabanlı çalışma. Nobel Med. 2011; 7:34-39.
12. Kirss F, Lang K, Toompere K, Veerus P. Prevalence and risk factors of urinary incontinence among Estonian postmenopausal women. Springerplus. 2013;17:524.
13. Çelik AS, Türkoğlu N, Pasinlioğlu T. Annelerin doğum sonu yaşam kalitesinin belirlenmesi. Anadolu Hemşirelik ve Sağlık Bilimleri Dergisi. 2014;17:151-157.
14. Altuntuğ K, Kızılırmak A, Kartal B, Başer M. Vajinal doğumlarda perine travmasının önlenmesinde perine masajının etkisi. Anadolu Hemşirelik ve Sağlık Bilimleri Dergisi. 2010; 13:62-65.
15. Hermansen IL, O’Connell BO, Gaskin CJ. Women's explanations for urinary incontinence, their management strategies, and their quality of life during the postpartum period. J Wound Ostomy Continence Nurs. 2010;37:187-92.
16. Lo J, Osterweil P, Li H, Mori T, Eden KB, Guise JM. Quality of life in women with postpartum anal incontinence. Obstet Gynecol. 2010;115:809-14.
17. Bugg GJ, Hosker GL, Kiff ES. Routine symptom screening for postnatal urinary and anal incontinence in new mothers from a district. Int Urogynecol J Pelvic Floor Dysfunct. 2005;16:405-8.
18. Handa VL, Zyczynski HM, Burgio KL, Fitzgerald MP, BorelloFrance D, Janz NK. et al. The impact of fecal and urinary incontinence on quality of life 6 months after childbirth. Am J Obstet Gynecol. 2007;197:636.e1-6.
19. Arrue M, Dies-Itza I, Ibanez L, Paredes J, Murgiondo A, Sarasqueta C. Factors involved in the persistence of stress urinary incontinence from pregnancy to 2 years postpartum. Int J Gynaecol Obstet. 2011;115:256-9.
20. Valeton CT, do Amaral VF. Evaluation of urinary incontinence in pregnancy and postpartum in Curitiba mothers program: a prospective study. Int Urogynecol J. 2011;22: 813-8.
21. Kocaöz S, Talas MS, Atabekoğlu CS. Urinary incontinence among Turkish women: an outpatient study of prevalence, risk factors, and quality of life. J Wound Ostomy Continence Nurs. 2012;39:431-9.
22. Leroy Lda S, Lopes MH. Urinary incontinence in the puerperium and its impact on the health-related quality of life. Rev Lat Am Enfermagem.2012;20:346-53.
23. Chuang CM, Lin IF, Horng HC, Hsiao YH, Shyu IL, Chou P. The impact of gestational diabetes mellitus on postpartum urinary incontinence: a longitudinal cohort study on singleton pregnancies. BJOG. 2012;119:1334-43.
24. Pauls RN, Occhino JA, Dryfhout V, Karram MM. Effects of pregnancy on pelvic floor dysfunction and body image: a prospective study. Int Urogynecol J Pelvic Floor Dysfunct. 2008;19: 1495-501.
25. Espuna-Pons M, Solans-Domenech M, Sanchez E, Pelvic Floor Research Group (Grup de Recerca del Sol Pelvia, GRESP). Double incontinence in a cohort of nulliparous pregnant women. Neurourol Urodyn. 2012;31:1236-41.
26. Torrisi G, Minini G, Bernasconi F, Perrone A, Trezza G, Gaurdabasso V. et al. A prospective study of pelvic floor dysfunctions related to delivery. Eur J Obstet Gynecol Reprod Biol. 2012;160:110-5.
27. Liang CC, Wu MP, Lin SJ, Chang SD, Wang HH. Clinical impact of and contributing factors to urinary incontinence in women 5 years after first delivery. Int Urogynecol. 2013;24: 99104.
28. Koc O, Duran B, Ozdemirci S, Bakar Y, Ozengin N. Is cesarean section a real panacea to prevent pelvic organ disorders? Int Urogynecol. 2011;22:1135-41.
29. van Brummen HJ, Bruinse HW, van de Pol G, Heintz AP, van der Vaart CH. The effect of vaginal and cesarean delivery on lower urinary tract symptoms: what makes the difference?. Int Urogynecol J Pelvic Floor Dysfunct. 2007;18:133-9.
30. Samarasekera DN, Bekhit MT, Wright Y, Lowndes RH, Stanley KP, Preston JP. et al. Long-term anal continence and quality of life following postpartum anal sphincter injury. Colorectal Dis. 2008;10:793-9.
31. Andrews V, Shelmeridine S, Sultan AH, Thakar R. Anal and urinary incontinence 4 years after a vaginal delivery. Int Urogynecol J. 2013;24:55-60.
32. van Delft K, Sultan AH, Thakar R, Schwertner-Tiepelmann N, Kluivers K. The relationship between postpartum levator ani muscle avulsion and signs and symptoms of pelvic floor dysfunction. BJOG. 2014;121:1164-71.
33. Tin RY, Schulz J, Gunn B, Flood C, Rosychuk RJ. The prevalence of anal incontinence in postpartum women following obstetrical anal sphincter ınjury. Int Urogynecol. 2010;21:92732.
34. Badiou W, Bousquet PJ, Prat-Pradal D, Monrozies X, Mares P, de Tayrac R. Short vs long second stage of labour: is there a difference in terms of postpartum anal incontinence? Eur J Obstet Gynecol Reprod Biol. 2010;152:168-71.
35. Scheer I, Thakar R, Sultan AH. Mode of delivery after previous obstetric anal sphincter injuries (oasıs)—a reappraisal? Int Urogynecol J Pelvic Floor Dysfunct. 2009;20:1095-101.
36. American College of Obstetricians and Gynecologists (ACOG). http://www.acog.org/About-ACOG/News-Room/News Releases/2006/ACOG-Recommends-Restricted-Use-ofEpisiotomies. 2006. Erişim Tarihi: 06.07.2015
37. Liljestrand J. Episiotomy for vaginal birth. The WHO Reproductive Health Library. http://apps.who.int/rhl/pregnancy_childbirth/childbirth/2nd_stag e/jlcom/en/. 2003. Erişim Tarihi: 06.07.2015
38. Bertozzi S, Londero AP, Fruscalzo A, Driul L, Delneri C, Calcagno A. et al. Impact of episiotomy on pelvic floor disorders and their influence on women’s wellness after the sixth month postpartum: a retrospective study. BMC Womens Health 2011; 11:12. doi: 10.1186/1472-6874-11-12.
39. Rikard- Bell J, Iyer J, Rane A. Perineal outcome and the risk of pelvic floor dysfunction: a cohort study of primiparous women. Aust N Z J Obstet Gynaecol. 2014;54:371-6.
40. Pauls RN, Occhino JA, Dryfhout VL. Effects of pregnancy on female sexual function and body image: a prospective study. J Sex Med. 2008;5:1915-22.
41. Andrews V, Thakar R, Sultan AH. Outcome of obstetric anal sphincter injuries (oasıs)--- role of structured management. Int Urogynecol J Pelvic Floor Dysfunct. 2009;20:973-8
42. Soerensen MM, Bek KM, Buntzen S, Højberg KE, Laurberg S. Long-term outcome of delayed primary or early secondary reconstruction of the anal sphincter after obstetrical injury. Dis Colon Rectum. 2008;51:312-7.
43. Peirce C, Murphy C, Fitzpatrick M, Cassidy M, Daly L, O’Connell PR. et al. Randomised controlled trial comparing early home biofeedback physiotherapy with pelvic floor exercises for the treatment of third-degree tears (EBAPT Trial). BJOG. 2013;120:1240-7
44. Kim EY, Kim SY, Oh DW. Pelvic floor muscle exercises utilizing trunk stabilization for treating postpartum urinary incontinence: randomized controlled pilot trial of supervised versus unsupervised training. Clin Rehabil. 2012;26:132-4