Prostatektomi sonrası üriner inkontinansı olan bireylerde semptom şiddeti ile fiziksel aktivite düzeyi, cinsel işlev ve yaşam kalitesinin ilişkisi

Yıl 2023, Cilt: 10 Sayı: 3, 228 - 234, 29.12.2023

Neyzar Kılınç , Mehmet Yıldızhan , Şeyda Toprak Çelenay

https://doi.org/10.15437/jetr.1277951

Öz

Amaç: Bu çalışmanın amacı, prostatektomi sonrası üriner inkontinansı (Üİ) olan bireylerde semptom şiddeti ile fiziksel aktivite düzeyi, cinsel işlev ve yaşam kalitesi arasındaki ilişkiyi incelemekti.
Yöntem: Prostatektomi sonrası Üİ tanısı olan 43 birey (yaş: 66,67±5,18 yıl; vücut kütle indeksi: 29,17±3,64 kg/m2) çalışmaya dahil edildi. Hastaların fiziksel, demografik ve klinik özellikleri kaydedildi. Bireylerin Üİ şiddeti Uluslararası İnkontinans Konsultasyon Anketi-Kısa Formu (ICIQ-SF) ile, fiziksel aktivite düzeyi Uluslararası Fiziksel Aktivite Anketi Kısa Formu (IPAQ-7) ile, cinsel işlevi Uluslararası Cinsel İşlev İndeksi-5 Formu (IIEF-5) ile, yaşam kalitesi King Sağlık Anketi (KSA) ile değerlendirildi. Analiz için Spearman korelasyon testi kullanıldı.
Bulgular: ICIQ-SF değeri ile IPAQ-7 değeri arasında orta düzeyde ve negatif yönlü bir ilişki tespit edildi (r=-0,606; p<0,001). ICIQ-SF ile IIEF-5 değerleri arasında ilişki olmadığı bulundu (p>0,05). ICIQ-SF değeri ile KSA arasında sırasıyla; genel sağlık (r=0,441; p=0,002), rol limitasyonu (r=0,485; p=0,001), fiziksel limitasyon (r=0,577; p<0,001), sosyal limitasyon (r=0,679; p<0,001), duygu (r=0,491; p=0,001), uyku enerji düzeyi (r=0,511; p<0,001) ve ciddiyet ölçüm (r=0,615; p<0,001) değerleri arasında orta düzeyde pozitif yönlü bir ilişki tespit edildi.
Sonuç: Bu çalışmada prostatektomi sonrası Üİ olan bireylerin semptom şiddeti arttıkça fiziksel aktivite düzeyinin azaldığı ve yaşam kalitesinin ise kötüleştiği bulundu. Kliniklerde bu bireylerin Üİ şiddeti ile fiziksel aktivite düzeyleri ve yaşam kalitesi arasındaki ilişkilerin değerlendirilmesi, pelvik taban rehabilitasyonuna yönlendirilmesi, uygun fiziksel aktivite ve egzersiz programlarının oluşturulması önemli olabilir.

Anahtar Kelimeler

Prostatektomi; Üriner inkontinans, Fiziksel aktivite, Erektil disfonksiyon, Yaşam kalitesi

Relationship between symptom severity and physical activity level, sexual function, and quality of life in individuals with urinary incontinence after prostatectomy

Öz

Purpose: The aim of this study was to examine the relationship between symptom severity and physical activity level, sexual function, and quality of life in individuals with urinary incontinence (UI) after prostatectomy.
Methods: Forty-three individuals (age: 66.67±5.18 years; body mass index: 29.17±3.64kg/m2) diagnosed with UI after prostatectomy were included in this study. The physical, demographic and clinical characteristics of the patients were recorded. UI severity, physical activity level, sexual function and quality of life of individuals were evaluated with the International Consultation on Incontinence Questionnaire-Short Form (ICIQ-SF), International Physical Activity Questionnaire-7(IPAQ-7), International Sexual Function Index-5 (IIEF-5), and King Health Questionnaire (KHQ), respectively. Spearman correlation test was used for analysis.
Results: A moderate and negative correlation was found between the ICIQ-SF value and the IPAQ-7 value (r=-0.606; p<0.001). No correlation was found between ICIQ-SF and IIEF-5 values (p>0.05). Between ICIQ-SF and KHQ domain scores, moderate positive correlations were found (for general health: r=0.441; p=0.002, for role limitation: r=0.485; p=0.001, for physical limitation: r=0.577; p<0.001, for social limitation: r=0.679; p<0.001, for emotion: r=0.491; p=0.001, for sleep energy level: r=0.511; p<0.001, and for severity measurement: r=0.615; p<0.001).
Conclusion: In this study, it was found that as the symptom severity of individuals with UI increased after prostatectomy, the physical activity level decreased and the quality of life worsened. It may be important to evaluate the relationship between the severity of UI, physical activity levels and quality of life of these individuals in clinics, to direct them to pelvic floor rehabilitation and to establish appropriate physical activity and exercise programs.

Anahtar Kelimeler

Prostatectomy; Urinary incontinence, Physical activity, Erectile dysfunction, Quality of life

Kaynakça

• Rawla P Epidemiology of prostate cancer. World J Oncol. 2019;10:63-89.
• Van Hemelrijck M, Sparano F, Moris L, et al. Harnessing the patient voice in prostate cancer research: Systematic review on the use of patient‐reported outcomes in randomized controlled trials to support clinical decision‐making. Cancer Med. 2020;9:4039-4058.
• Kong EH, Deatrick JA, Bradway CK Men's experiences after prostatectomy: A meta-synthesis. Int J Nurs Stud. 2017;74:162-171.
• Schraudenbach P, Bermejo C. Management of the complications of radical prostatectomy. Curr Urol Rep. 2007;8:197-202.
• Who.int [Internet]. Physical Activity; 2020 [cited 2022 April 16]. Available from: https://www.who.int/news-room/fact-sheets/detail/physical-activity.
• Warburton DE, Bredin SS. Health benefits of physical activity: a systematic review of current systematic reviews. Curr Opin Cardiol. 2017;32:541-56.
• Chekroud SR, Gueorguieva R, Zheutlin AB, et al. Association between physical exercise and mental health in 1· 2 million individuals in the USA between 2011 and 2015: a cross-sectional study. Lancet Psychiatry. 2018;5:739-746.
• Bø K, Nygaard IE. Is Physical Activity Good or Bad for the Female Pelvic Floor? A Narrative Review. Sports Med. 2020;50:471–484
• Mungovan SF, Huijbers BP, Hirschhorn AD, et al. Relationships between perioperative physical activity and urinary incontinence after radical prostatectomy: an observational study. BMC Urol 2013;1:13-17.
• Sanda MG, Dunn RL, Michalski J, et al. Quality of life and satisfaction with outcome among prostatecancer survivors. N Engl J Med. 2008;358:1250.
• EAU 2016 erkek cinsel disfonksiyon kılavuzları. https:// uroweb.org/guideline/male-sexual-dysfunction/
• Lopes MHB, Higa R, Cordeiro SN, et al. Life experiences of Brazilian men with urinary incontinence and erectile dysfunction following radical prostatectomy. J Wound Ostomy Continence Nurs. 2012;39:90-4.
• Bacon G, Murray A, Mittleman A, et al. Prospective Study of Risk Factors for Erectile Dysfunction. J Urol. 2006;176:217-221.
• Pizzol D, Demurtas J, Celotto S. Urinary incontinence and quality of life: a systematic review and meta-analysis. Aging Clin Exp Res.2021;33:25-35.
• Sazonova NA, Kiseleva MG, Gadzhieva ZK. Urinary incontinence in women and its impact on quality of life. Urologia. 2022;2:136-139.
• Saboia DM, Firmiano MLV, Bezerra KC. Impact of urinary incontinence types on women's quality of life. Rev Esc Enferm USP. 2017;21:51.
• Powel LL. Quality of life in men with urinary incontinence after prostate cancer surgery. J Wound Ostomy Continence Nurs. 2000;27:174-178.
• Corcos J, Beaulieu S, Donovan J, et al. Quality of life assessment in men and women with urinary incontinence. J Urol. 2002;168:896-905.
• Güngen C, Ertan T, Eker E, et al. Standardize mini mental test’in Türk toplumunda hafif demans tanısnda geçerlik ve güvenilirliği. Türk Psikiyatri Dergisi. 2002;273–81.
• Jani B, Marsicano E Constipation: Evaluation and Management Mo Med 2018;115(3):236-240.
• Bulent Cetinel BO, Gunay Can. ICIQ-SF Türkçe versiyonu validasyon (geçerlilik) çalısması Türk Üroloji Dergisi 2004;30:332-338.
• Saglam M, Arikan H, Savci S, et al. International activity questionnaire: reliability and validity of the Turkish version. Percept Mot Skills. 2010;111:278-284.
• Turunç T, Deveci S, Güvel S, et al. Uluslararası cinsel işlev indeksinin 5 soruluk versiyonunun (IIEF-5) Türkçe geçerlilik çalışmasının değerlendirilmesi. Türk Üroloji Dergisi, 2007;33:45-9.
• Kaya S, Akbayrak T, Toprak Celenay S, et al. Reliability and validity of the Turkish King's Health Questionnaire in women with urinary incontinence. Int J Urogynecol. 2015;26:1853-1859.
• Faul F, Erdfelder E, Lang AG. G*Power 3: A Flexible statistical power analysis program for the social, behavioral, and biomedical sciences. Behav Res Methods 2007;39:175-91.
• Schober P, Boer C, Schwarte LA. Correlation coefficients: appropriate use and interpretation, Anesth Analg., 2018. 126:1763-1768.
• Groutz A, Blaivas JG, Chaikin DC, et al. The pathophysiology of post-radical prostatectomy incontinence: a clinical and video urodynamic study. J Urol 2000;163:1767-1770.
• Bacon G, Murray A, Mittleman A, et al. Prospective study of risk factors for erectile dysfunction. J Urol. 2006;176:217-221.
• Raheem OA, Parsons JK. Associations of obesity, physical activity and diet with benign prostatic hyperplasia and lower urinary tract symptoms. Curr Opin Urol. 2014;24:10-14.
• Değirmendereli AR, Oskay K, Toprak Çelenay Ş. Yetişkin erkeklerde fiziksel aktivite düzeyine göre alt üriner sistem semptomlarının karşılaştırılması. İKÇÜSBFD. 2022;7:495-499.
• DiMeo PJ. Psychosocial and relationship issues in men with erectile dysfunction. J Urol Nurs 2006;26:442-446.
• Petry H, Berry DL, Spichiger E, et al. Responses and experiences after radical prostatectomy: perceptions of married couples in Switzerland. Int J Nurs Stud 2004;41:507-513.
• Arslan, DT, Ağırbaş, İ. Sağlık Çıktılarının Ölçülmesi: QALY ve DALY, Sağlıkta Performans ve Kalite Dergisi. 2017;13:99-126.
• Ouanes Y, Hermi A, Chaker K, et al. Impact of Urinary Incontinence on the Quality of Life After Open Retropubic Radical Prostatectomy Cureus 2022;14(8):e28106.
• Sosnowski R, Szymański M, Wolski JK, et al. Urinary incontinence after radical prostatectomy – experience of the last 100 cases. Cent European J Urol. 2011;64:213-217.
• US Department of Health and Human Services (HHS) Physical activity guidelines for Americans.Washington: HHS; 2008.