Evaluation of urodynamics parameters in different age and incontinence group of women

Öz

Aim: Overactive bladder syndrome (OAB) is known to have a negative impact on quality of life, and cause discomfort daily. Population-based studies on females report a prevalence of OAB which varies between 9.7% and 35.7%, with a substantial rise with increasing age. The primary aim of this analysis was to assess whether age was associated with differences in urodynamic testing parameters, using age as a continuous variable, and comparing women within wider age groups to understand physiologic variation. Methods: In this retrospective cohort study, we evaluated the patients who were admitted to the Department of Gynecology and Obstetrics Department of Istanbul Education and Research Hospital between January 2017 and January 2020 with lower urinary tract symptoms (LUTS). Results: We found that age, first sensation and first desire to void were strongly correlated (P=0.007, P=003 respectively), but a strong desire to void and maximum cystometric capacity were not (P=0.09, P=0.11 respectively). There was a weak negative correlation between detrusor pressure (Pdet) and age (p=0.08). Histogram analysis of bladder compliance among stress, urge, mix incontinence and normal patients revealed that maximum compliance occurred in women of reproductive age. Conclusion: Aging is associated with decreased self-control, thus, increased prevalence of LUTS symptoms among older women might be more accurately considered as the loss of an adaptive threshold to urinary control rather than age-associated decline in urinary functions.

Anahtar Kelimeler

• Age
• Stress incontinence
• urge incontinance
• urodynamic test

Farklı yaş ve inkontinans gruplarındaki kadınlarda ürodinamik parametrelerin değerlendirilmesi

Öz

Amaç: Aşırı aktif mesane sendromunun (OAB) yaşam kalitesi, normal günlük yaşam fonksiyonlarında rahatsızlık verdiği bilinmektedir. Kadınlar üzerinde yapılan nüfusa dayalı çalışmalar, artan yaşla birlikte% 9.7 ve% 35.7 arasında değişerek artan OAB prevalansı olduğunu bildirmektedir. Bu çalışmamızın ilk amacı, yaşın sürekli bir değişken olarak ürodinamik parametrelerde kullanılması veya ürodinami sonuçlaruyla ilişkisini değerlendirmek ve daha geniş yaş aralığındaki kadınların sonuçlarını karşılaştırarak fizyolojik değişiklikleri anlamaya çalışmaktır. Yöntemler: Bu retrospektif kohort çalışmamızda, Ocak 2017 - Ocak 2020 tarihleri arasında İstanbul Eğitim ve Araştırma Hastanesi Kadın Hastalıkları ve Doğum Anabilim Dalı'na alt üriner sistem semptomları (AÜSS) ile başvuran hastaları değerlendirdik. Bulgular: Özellikle ilk idrar duyum hissi ve işeme için ilk arzu ve yaş arasında çok güçlü negatif korelasyon saptadık (sırasıyla P=0,007, P=0,03). Ancak işeme için güçlü istek ve maksimum sistometrik kapasite ile yaş arasında ilişki bulamadık(sırasıyla P=0,09, P=0,11). Detrüsör basıncının (Pdet) yaşla zayıf negatif korelasyonunu bulduk (P=0,08). Stres, urge, mix inkontinansı ve normal hastalarda mesane kompliansının histogram analizinde, üreme çağındaki kadınlarda maksimum komplians saptadık. Sonuç: Menopozun inkontinans prevalansında bağımsız bir faktör olduğuna dair kanıtlar eksiktir ve gelecekte daha geniş yaş grubu kadınlarla araştırmalara ihtiyaç duyulmaktadır. Çalışmamız, büyük, heterojen ikincil bakım popülasyonunda ürodinami parametrelerini inceleyen az sayıdaki çalışmadan biridir. Yaşlanma, öz kontrolün azalmasıyla ilişkilidir, bu nedenle yaşlılarda artan AÜSS semptomları, üriner fonksiyonlarda yaşlı ilişkili düşüşten ziyade üriner kontrolde eşik kaybı olarak düşünülebilir.

Anahtar Kelimeler

• Yaş
• Stres inkontinans
• Urge inkontinans
• Ürodinamik test

Teşekkür

Ürodinami Hemşiremiz Nuray Yılmaz' a katkılarından dolayı teşekkür ederiz

Kaynakça

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