Parkinson Hastalarında Ürodinamik İnceleme Bulguları: Tek Tersiyer Merkez Sonuçları

Year 2024, , 42 - 45, 14.03.2024

Mehmet Fatih Şahin , Murat Akgül , Çağrı Doğan , Arzu Malak , Serkan Şeramet , Cenk Murat Yazıcı

https://doi.org/10.18521/ktd.1299284

Abstract

Amaç: Parkinson hastalığında (PH), alt üriner sistem semptomları (AÜSS) yaygın olarak, %25 ila %57 arasında değişen bir prevalansla görülür. AÜSS için medikal tedaviye yanıt vermeyen hastalarda mesane dinamiklerini daha iyi anlamak için ürodinamik inceleme ve basınç akış çalışması (ÜD-BAÇ) gerekebilir. ÜD-BAÇ incelemeleri AÜSS patofizyolojisinin anlaşılmasına katkı sağlayabilir. Bu çalışmada Parkinson hastalarının demografik ve klinik bulgularının ÜD-BAÇ tetkiklerinin sonuçları ile birlikte değerlendirilmesi amaçlanmıştır.
Metod : 2010-2020 yılları arasında takip edilen 155 Parkinson hastasının verileri retrospektif olarak incelendi. AÜSS’ları medikal tedaviden fayda görmeyen 42 Parkinson hastasına ÜD-BAÇ uygulandı. Hastaların klinik ve demografik verileri ile ÜD-BAÇ bulguları ayrı ayrı değerlendirildi.
Bulgular: ÜD-BAÇ uygulanan hastaların 28'i erkek, 14'ü kadındı. ÜD'de ilk idrar hissi 86.00±68.77cc, maksimum sistometrik kapasite 322.07±194.25cc idi. 16 hastada hipo-kompliyan mesane, 25'inde (%59,5) normo-kompliyan bir mesane vardı. BAÇ’ta işeme fazındaki Qmax ve maksimum detrüsör basıncı sırasıyla 12,72±10,08 mL/sn ve 43,93±15,56 cm-H2O idi. 6 (%15) hastada stres tipi üriner inkontinans saptandı. Detrusor foksiyonu değerlendirildiğinde ise 18 (%44,0) hastada nörojenik detrusor aşırı aktivitesi, 8 (%19) hastada detrusor arefleksi ve 16 (%22) hastada normal ÜD-BAÇ saptandı.
Sonuç: Hastaların çoğunda azalmış mesane kapasitesi ve hipersensitivite ile nörojenik detrüsör aşırı aktivitesi vardı. AÜSS klinikleri ile medikal tedaviye dirençli PH grubundaki seçilmiş hastalarda ÜD-BAÇ, hastaların AÜSS klinikleri hakkında değerli bilimsel veriler sağlar ve tedavi yönetiminde faydalı olabilir.

Keywords

Ürodinamik inceleme, Basınç Akım Çalışması, Parkinson Hastalığı

Urodynamic Findings of The Patients with Parkinson’s Disease: A Single Tertiary Center Results

Abstract

Objective :In Parkinson’s disease (PD), lower urinary tract symptoms (LUTS) are common with a prevalence ranging from 25% to 57%. Patients who are resistant to medical treatment for LUTS may require urodynamic examination and pressure flow study (UD-PFS) to better comprehend the bladder's dynamics. To be able to comprehend the pathophysiology of LUTS, UD-PFS examinations should be performed. In this study, the demographics and clinical properties of PD patients were presented along with their UD-PFS examinations.
Method : The data of 155 patients with PD followed up between 2010-2020 were retrospectively analyzed. UD-PFS was applied to 42 PD patients resistant to medical treatment of LUTS. Patients' demographic and clinical data with their UD-PFS findings were studied separately.
Result : Twenty-eight of the patients underwent UD-PFS were male, and 14 were female. In UD, the first urinary sensation was 86.00±68.77cc, and the maximum cystometric capacity was 322.07±194.25cc. Sixteen patients had a hypo-compliant bladder, 25 (59.5%) had a normo-compliant bladder. In PFS, Q max and peak detrusor pressure during voiding were 12.72±10.08 mL/sec and 43.93±15.56 cm-H2O, respectively. Stress-type urinary incontinence was detected in 6 (15%) of the patients. When evaluating the detrusor activity, neurogenic detrusor overactivity in 18 (44%) patients, detrusor areflexia in 8 (19%) and normal UD-PFS in 16 (22%) patients.
Conclusion: The majority of the patients presented with neurogenic detrusor overactivity accompanied by diminished bladder capacity and hypersensitivity. In the selected PD patients who are resistant to medical treatment with LUTS clinics, UD-PFS provides useful scientific information about the LUTS clinics of patients and may be helpful in treatment management.

Keywords

Urodynamic examination, Pressure flow study, Parkinson’s disease

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