Sezaryen sırasında mesane flebi oluşumunun uzun süreli rezidüel idrar hacmi ve postoperatif idrar retansiyonu üzerindeki etkileri

Yıl 2020, , 1190 - 1194, 01.12.2020

Derya Kanza Gül , Ayça Şolt

https://doi.org/10.28982/josam.832595

Öz

Amaç: Postpartum idrar retansiyonu hem vajinal hem de sezaryen doğumdan sonra sıklıkla saptanan önemli bir klinik durumdur. Bu çalışma ile sezaryen sırasında mesane flebi olan ve olmayan kadınlarda idrar retansiyonunu ve ayrıca doğum sonrası rezidüel idrar hacmi yüksek olanlarda Kegel egzersizlerinin uzun süreli mesane kas fonksiyonu üzerindeki etkisini değerlendirmek amaçlanmıştır.
Yöntemler: Bu ileriye dönük randomize çalışma, Nisan-Aralık 2019 tarihleri arasında elektif sezaryen operasyonu geçiren 100 primipar gebe kadınla gerçekleştirildi. Deney grubu (mesane flebi grubu, n=50) ve kontrol grup (mesane dışı flep grubu, n=50). Çalışma verileri Anne Bilgi Formu ve UDI-6 ile toplandı. Doğumdan sonraki 2. gün, 5. gün ve 6. haftalarda Kegel egzersiz sonuçları, işeme sonrası rezidüel hacim ve üriner sistem semptomları değerlendirildi.
Bulgular: Gruplar arasında sosyo-demografik özellikler, postoperatif 5. gün ve 6. hafta rezidüel idrar hacmi, postoperatif idrar retansiyon hacmi, üriner sistem semptomları (UDI-6 skorları) ve mesane yaralanması açısından anlamlı farklılık yoktu. İkinci gün değerlendirilen rezidüel idrar hacmi, ameliyat süresi ve ağrı değerleri açısından gruplar arasında anlamlı farklılık vardı (sırasıyla P=0,045, P<0,001 ve P<0,001). Grup içi karşılaştırmalar, Kegel egzersizlerinden sonra rezidüel idrar hacmi yüksek olan katılımcılarda rezidüel idrar hacminde azalma olduğunu gösterdi ve postoperatif 2. gün ve 6. hafta rezidüel idrar hacimleri ve UDI-6 skorları istatistiksel olarak anlamlı farklıydı (P<0,001, P<0,001).
Sonuç: Bu çalışmada sezaryen sırasında yapılan mesane flebin ameliyat sonrası üriner retansiyonu artırdığını belirlemiştir. Yüksek rezidüel idrar hacmine sahip hastalarda yapılan Kegel egzersizinin uzun vadede rezidüel idrar hacimini ve idrar semptomlarını azalttığı bulunmuştur.

Anahtar Kelimeler

Mesane flebi, Mesane flebi açılmaması, İdrar retansiyonu, Sezaryen

Destekleyen Kurum

bulunmamaktadır

Proje Numarası

R.N: 108400098-604.01.01-E.53606, Date:20/12/2018

Effects of creation of bladder flap during cesarean section on long-term residual urine volume and postoperative urinary retention

Öz

Aim: Postpartum urinary retention (PUR) is an important clinical condition that is frequently detected after both vaginal and cesarean delivery. The aim of this study was to evaluate PUR in women who did and did not have bladder flaps created during cesarean section and the effect of Kegel exercises on long-term bladder muscle function in those with high postnatal residual urine volume.
Methods: This prospective randomized study was conducted with 100 primiparous pregnant women who were to undergo elective cesarean section between April and December 2019. Patients were divided into two groups: The experimental group (bladder flap group, n=50) and the control group (non-bladder flap group, n=50). The study data were collected with the Maternal Information Form and UDI-6. Kegel exercise results, post-void residual volume and urinary system symptoms were assessed on the 2nd and 5th postoperative day and 6 weeks after birth.
Results: There were no significant differences between the groups in terms of socio-demographic characteristics, postoperative 5th day and 6th week residual urine volume, postoperative urinary retention volume, urinary system symptoms (UDI-6 scores) and bladder injury. There were significant differences between the groups in terms of residual urine volume, duration of surgery, and pain values assessed on the second day (P=0.045, P<0.001, P<0.001, respectively). Intra group comparisons demonstrated a decrease in residual urine volume in the participants with high residual urine volume after Kegel exercises, and their postoperative 2nd day and 6th week residual urine volumes and UDI-6 scores were significantly different (P<0.001, P<0.001).
Conclusion: The present study determined that bladder flaps created during cesarean section increases postoperative urinary retention. In patients with high residual urine volume, Kegel exercises reduce residual urine volumes and urinary symptoms in the long term.

Anahtar Kelimeler

Bladder flap, Omission of a bladder flap, , Urinary retention, Cesarean section

Proje Numarası

R.N: 108400098-604.01.01-E.53606, Date:20/12/2018

Kaynakça

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