Kadınlarda Alt Üriner Sistem Semptomlarının Nadir Bir Nedeni: Üretral Karunkül

Öz

Amaç: Üretral karunkül sıklıkla postmenopozal kadınlarda görülen, eksternal üretral meanın posteriorundan köken alan vasküler tümöral bir oluşumdur. Çalışmamızda üretral karunkül tespit edilen 19 kadın hastaya uygulanan üretral karunkül eksizyonun sonuçlarını sunmayı hedefledik.

Gereç ve Yöntem: Ocak 2013- Mart 2017 tarihleri arasında üretral karunkül eksizyonu yapılan toplam 19 hastanın; yaşı, medikal öyküsü, maksimum idrar akış hızı, postmiksiyonel rezidü idrar miktarı, patoloji sonuçları, operasyon süresi ve hastanede kalış süreleri incelendi. Tüm hastalar Bristol Kadın Alt Üriner Sistem Semptom İndeksinin (BFLUTS) Türkçe versiyonun ilk 19 sorusu ve Uluslararası Prostat Semptom Skorunun 8. sorusu (IPSS-Q8) ile alt üriner sistem semptomları açısından değerlendirildi.

Bulgular: Hastalarının ortalama yaşı 61.21±2.13 yıl idi. Hastaların preoperatif yapılan değerlendirilmesinde maksimum idrar akış hızı, postmiksiyonel rezidü idrar miktarı, BFLUTSve IPSS-Q8ortalama değerleri sırasıyla 7.72±1.82 mL/dk, 43.15±19.43 cc, 40.89±9.01 ve 4,57±1,01 olarak hesaplandı. Tüm hastalara genelveya spinal anestezi altında üretral kitle eksizyonu yapıldı. Tüm hastalarının semptomlarında düzelme oldu ve patoloji sonuçları üretral karunkül olarak rapor edildi. Postoperatif 1. ayda kontrole çağrılan hastalara yapılan değerlendirmede; maksimum idrar akış hızı, ortalama postmiksiyonel rezidü idrar miktarı, BFLUTS ve IPSS-Q8 ortalama değerleri sırasıyla 20,55±5,37 ml/dk, 10,94±8,51 cc, 6.89±4.78ve 1,1±0,93 olarak hesaplandı. Maksimum idrar akış hızı, postmiksiyonel idrar volümü, BFLUTS, IPSS-Q8değer ortalamaları açısından preoperatif ve postoperatif hastalar arasında istatistiksel olarak anlamlı fark izlendi (p≤ 0.0001).

Sonuç: Postmenopozal dönemde alt üriner sistem semptomları ile başvuran kadın hastalarda üretral karunkül gibi üretradan kaynaklı patolojilerin olabileceği akılda tutularak ayrıntılı genitoüriner sistem muayenesi yapılmalıdır.

Anahtar Kelimeler

• Alt üriner sistem semptomları,üretra,karunkül

Urethral Caruncle: A Rare Cause of Lower Urinary System Symptoms in Women

Öz

Aim: Urethral caruncle that originated from posterior wall of the external urethral meatus is a vascular tumor and frequently seen in postmenopausal women. We aimed to present the results of 19 female patients who underwent urethral caruncle excision in this study.

Material and Methods: The data of 19 patients who underwent urethral caruncle excision between January 2013 and March 2017 were reviewed. The patients' age, medical history, maximum urinary flow rate, post-void residual urine volume, pathology results, duration of operation and hospital stay were evaluated. All patients were evaluated for lower urinary tract symptoms with the first 19 questions in the Turkish version of Bristol Female Lower Urinary System Symptom Index (BFLUTS) and the 8th question of the International Prostate Symptom Score (IPSS-Q8).

Results: In the preoperative evaluation, the averages of maximum uroflowmetric flow rates, post-void residual urine volumes, BFLUTS, IPSS-Q8 values were calculated as 7.72 ± 1.82 mL / min, 43.15 ± 19.43 cc, 40.89±9.01 and 4.57 ± 1.01 respectively. All patients underwent urethral tumor excision under general or spinal anesthesia. Symptoms of all patients improved and pathology results were reported as urethral caruncles. The averages of maximum uroflowmetric flow rates, post-void residual urine volumes, BFLUTS and IPSS-Q8 values were calculated as 20.55 ± 5.37 ml / min, 10.94 ± 8.51 cc, 6.89±4.78 and 1.1 ± 0. 93 respectively at the postoperative first month control. A statistically significant difference was observed between the preoperative and postoperative avarages of the maximum uroflowmetric flow rates, post-void urine volumes, BFLUTS and IPSS-Q8 values (p ≤ 0.0001).

Conclusion: A detailed genitourinary system examination should be performed in postmenopausal females who present with lower urinary tract symptoms, taking into account the possibility of urethral origin pathologies such as urethral caruncle.

Anahtar Kelimeler

• Lower urinary tract symptoms,urethra,caruncle

Kaynakça

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