2018 Uluslarası kanıta dayalı polikistik over sendromu değerlendirme ve yönetim rehberi doğrultusunda tanıdaki ‘yeniler’ ve ‘yineler’

Yıl 2019, Cilt: 12 Sayı: 3, 595 - 602, 30.09.2019

Erkan Alataş , Derya Kılıç Tolga Güler

https://doi.org/10.31362/patd.563485

Cited By: 1

Öz

Reprodüktif
çağda %8-13’lere kadar yüksek oranlarda görülen Polikistik Over Sendromu (PKOS)
önemli bir toplum sağlık sorunudur. Sendromun heterojen yapısı nedeniyle kimi
hastada reprodüktif, kimi hastada metabolik bozukluklar ön plana çıkmakta ve
tedavi modaliteleri kişiden kişiye ve uygulayıcı hekime hatta branşlara göre
farklılık gösterebilmektedir. Halbuki PKOS olgularının tanı ve yönetiminde
ideal olan uluslarası kabul görmüş tanı ve tedavi kriterlerini içeren ve
bireysel farklılıkları gözardı etmeyen rehberlerin oluşturulmasıdır. Birçok
dernek ve kuruluşun kendi bakış açılarıyla tanımlamaya çalıştığı PKOS’ un daha
objektif ve detaylı tanımlanması amaçlanarak ‘European Society of Human
Reproduction and Embriology’ (ESHRE) ve ‘American Society of Reproductive
Medicine’ (ASRM) nin de ortaklık ettiği ‘2018 Uluslarası kanıta dayalı PKOS
değerlendirme ve yönetim rehberi’ (2018 PKOS Rehberi) yakın tarihte yayınlanmıştır.
Bu rehberde birçok “yeni” nokta belirtilirken, bazı eski bilgiler ise “yine”
vurgulanmaya devam etmiştir. PKOS reprodüktif (irregüler menstruel sikluslar,
hirsutizm, infertilite, gebelik komplikasyonları..vb), metabolik (insulin
rezistansı, metabolik sendrom, diyabet, kardiyovasküler hastalıklar..vb),
psikolojik (anksiyete, depresyon, vücut algı bozuklukları, seksüel fonksiyon
bozuklukları, yeme bozuklukları vb) özellikleri ile multisitemik bir
hastalıktır. Bireysel komponentler üzerinden düşünüldüğü zaman belirgin klinik
varyasyon göstermesi tanı ve tedavide farklılıklarla sonuçlanmaktadır. Bu durum
ise gecikmiş tanı ve yetersiz bakıma yol açabilmektedir. Bu anlamda 2018
Uluslarası kanıta dayalı PKOS değerlendirme ve yönetim rehberinin eski rehberlerden
farklı olarak gündeme getirdiği net tanımlamalar ve pratik öneriler ile
olguların değerlendirilmesi ve yönetimindeki standardizasyonun sağlanması için
önemli bir adım olduğu düşünülmektedir.

 

    Polycystic ovary
syndrome (PCOS) is an important public health problem that can have a high
prevalence as 8-13%. This syndrome has a heterogeneous nature and may present
either with reproductive or metabolic problems in different women. The treatment
modalities therefore may differ among patients and also for distinct
specialties. However, the ideal approach should consist of standardized
diagnostic criteria and the therapeutic applications should consider individual
disparities.  ‘International evidence-based
guideline for the assessment and management of polycystic ovary syndrome’ has
been recently published. This guideline includes views of various groups and
societies, and defines PCOS more objectively and exhaustively. This consensus
guideline states some new perspectives along with reiterating several other
facts. PCOS is a multisystem disease consisting of reproductive (irregular
menstrual cycles, hirsutizm, infertility, pregnancy complications, etc.),
metabolic (insulin resistance, metabolic syndrome, diabetes, cardiovascular
disorders, etc.), and psychological (anxiety, depression, body dysmorphic
disorder, sexual function problems, eating disorders, etc.) aspects. Individual
disparities result in different diagnostic and therapeutic approaches. With
respect to the heterogeneous nature of the syndrome, this new consensus
guideline that brings new and more objective definitions along with practical
recommendations, has an important value to further improving evaluation and
management standards of the syndrome.

Anahtar Kelimeler

polikistik over sendromu, amenore, obezite, insülin direnci

Kaynakça

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