İnme Hastalarında Nörojenik Alt Üriner Sistem Disfonksiyonunun Değerlendirilmesi

Öz

Nörojenik alt üriner sistem disfonksiyonu (NAÜSD) inme sonrası sık görülen ve hastaların fonksiyonel durumunu ve yaşam kalitesini olumsuz etkileyen bir durumdur. Bu çalışmada, kronik inmeli hastalarda mesane fonksiyonlarını değerlendirmeyi ve NAÜSD için risk faktörlerini araştırılması amaçlanmıştır. Çalışmaya en az 6 ay önce inme atağı öyküsü olan 71 hasta dahil edildi. Vaka grubu ürodinamik çalışma ile NAÜSD tanısı konan 35 hastadan, kontrol grubu ise herhangi bir üriner şikayeti olmayan 36 hastadan oluşturuldu. Hastaların demografik özellikleri değerlendirildi. Ayrıca hastaların başvuru şikayetleri, idrar öyküleri ve işeme yöntemleri sorgulandı. Üriner yakınmaları olan inmeli hastaların mesane fonksiyonları ürodinamik çalışma raporları ile değerlendirildi. Her iki grup arasında yaş, cinsiyet, eğitim durumu, inme sonrası süre, lezyon tarafı ve lezyon tipi açısından anlamlı fark yoktu (p>0,05). Ürodinamik çalışmalar hastaların %85,7'sinde aşırı aktif detrüsör ve azalmış mesane kapasitesi olduğunu gösterdi. Üriner disfonksiyon lezyon tarafına ve etyolojisine göre anlamlı farklılık göstermedi (p˃0,05). Geniş lezyonlu hastalarda üriner disfonksiyon oranı anlamlı olarak daha yüksekti (p=0,019). Geniş enfarktüs, düşük bilişsel düzey ve eşlik eden patolojilerin varlığı NAÜSD için risk faktörleri olarak tanımlanmıştır. NAÜSD tanısında ayrıntılı bir öykü ve videourodinamik değerlendirme önemlidir. 

Anahtar Kelimeler

• İnme Rehabilitasyonu
• Mesane
• Ürodinami

The Evaluation of Neurogenic Lower Urinary Tract Dysfunction in Stroke Patients

Öz

Neurogenic lower urinary tract dysfunction (NLUTD) is common after stroke, and it is a condition that negatively affects the functional status and quality of life of the patients. This study aimed to evaluate bladder functions and explore the risk factors for NLUTD in chronic stroke patients. Seventy-one patients with a history of stroke attack at least 6 months ago were included in the study. Case group consisted of 35 patients having NLUTD diagnosed by urodynamic study and the control group consisted of 36 patients without any urinary complaints. The demographics of the patients were evaluated. In addition, presenting complaints, urinary histories and voiding methods of the patients were questioned. Bladder functions of stroke patients with urinary complaints were evaluated through urodynamic study reports. There were no significant differences between both groups in terms of age, gender, educational status, time since stroke, lesion side and lesion type (p>0.05). Urodynamic studies revealed overactive detrusor and decreased bladder capacity in 85.7% of the patients. Urinary dysfunction did not show any significant difference (p˃0.05) according to lesion side and etiology. The rate of urinary dysfunction was significantly higher (p=0.019) in patients with large lesions. Large infarct size, low cognitive level, and presence of accompanying pathologies were described as risk factors for NLUTD. A detailed history and videourodynamic evaluation are important in the diagnosis of NLUTD.

Anahtar Kelimeler

• Stroke Rehabilitation
• Urinary Bladder
• Urodynamics

Kaynakça

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