Üriner İnkontinans Tedavisinde Pelvik Taban Egzersizleri Nöromodülasyon-Biofeedback İçin Evde Egzersiz Eğitim Uygulaması Kısa Dönem Sonuçları

Yıl 2019, Cilt: 9 Sayı: 4, 365 - 372, 31.12.2019

Yılda Arzu Aba Deniz Sarıcı Ramazan Özyurt Bulat Aytek Şık

https://doi.org/10.16899/jcm.580712

Öz

Amaç: Bu çalışmada amacımız
üriner inkontinans tedavisinde FemiScan Home Trainer (Mega Electronics Ltd.,
Finlandiya) ile evde pelvik taban kas egzersiz tedavisinin kısa dönem
değişikliklerin incelenmesi amaçlanmıştır.

Materyal ve Metod: Çalışmamıza
ürojinekoloji polikliniğine üriner inkontinans(Üİ) şikayetiyle başvuran ve
inkontinansı objektif olarak gösterilebilen, tedavide evde egzersiz eğitimi
için FemiScan biofeedback cihazı verilmiş olan 30 kadın hasta dahil edilmiş
olup bu hastaların dosyaları retrospektif olarak taranmıştır. Evde egzersiz
eğitimini kesintisiz olarak uygulayabilmiş olan hastalar çalışmaya dahil
edilmiştir. Ayrıntılı anamnez formu, pelvik taban kuvvet muayenesi bulguları,
ürodinamik inceleme kayıtları, doldurmuş oldukları inkontinans anketleri
incelenmiştir. Hastaların, üçüncü ay sonundaki kas gücü sonuçları, ürodinami
değerleri ve inkontinans anketleri başlangıç değerleri ile karşılaştırılmıştır.

Bulgular: FemiScan ile yapılan
biofeedback ile pelvik taban kas egzersizi sonuçlarını değerlendirken objeftif
kriter olarak EMG amplitüd farkı, MD, VB ve MD/VB farkı dikkate alınmıştır. Bu
verilerin istatistiksel analizi sonucu EMG amplitüdünde (p< 0,0001), MD
değerlerinde (p< 0,0001) ve MD/ VB oranında da tedavi sonrasında
istatistiksel olarak anlamlı olacak şekilde bir artış gözlenmiştir (p<
0,01). VB’da ise tedavi sonrasında anlamlı bir değişiklik izlenmemiştir. Tedavi
sonrası hastaların idrara çıkma sayısında ve bir seferde kaçırılan idrar
miktarında azalma, idrar akışını durdurabilme yeteneğinde istatistiksel olarak
anlamlı bir iyileşme izlenmiştir.

Sonuç: Çalışmamız FemiScan (Mega
Electronics Ltd., Finlandiya)’ nin Üİ tedavisinde etkin bir yöntem
olabileceğini göstermektedir.

Anahtar Kelimeler

Üriner inkontinans, Overaktif Mesane, nokturi

Home pelvic floor muscle training with electromyographic biofeedback to treatment of the urinary incontinence: A prospective analysis

Öz

Abstract

Aim: Pelvic floor muscle training is an accepted therapy to
improve or cure symptoms of urinary incontinence. In this study, examination of short term changes in home treatment
of pelvic floor muscle training with FemiScan Home Trainer in treatment of
urinary incontinence was aimed.

Material
and Method: Prospective analysis in a tertiary-level center. 30 female patients admitted to
urogynecology polyclinic with complaints of urinary incontinence (UI) who were
given FemiScan biofeedback device for home exercise treatment were included in
our study. Patients who could apply home exercise training continuously were
included in the study. Detailed anamnesis form, pelvic floor force examination
findings, urodynamic examination records and incontinence forms they filled
were examined. Muscle force results, urodynamic values and incontinence forms
of patients at the end of third month were compared to initial values.

Results: While evaluating results of pelvic
floor muscle exercise with biofeedback performed using FemiScan, Electromyography
(EMG) amplitude difference, Bladder fullness (BF), Vesical pressure (VP) and
BF/VP difference were taken as objective criteria. In the result of statistical
analysis of these data, statistically significant increase was observed in EMG
amplitude (P <0.0001), BF values (P <0.0001) and BF/VP ratio after the
treatment (P <0.01). No significant change was recorded in VP after the
treatment. Number of urinations and amount of urine leaked decreased and
statistically significant recovery in ability to stop urine flow were observed.

Conclusions: Our study shows that FemiScan (Mega Electronics Ltd,
Finland) might be an effective method in UI treatment.

Anahtar Kelimeler

Urinary incontinence; Overactive bladder; Nocturia

Kaynakça

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