PELVİK ORGAN PROLAPSUSU OLAN HASTALARIN KONUMA ÖZGÜN PROLAPSUS REDÜKSİYONU YAPILARAK ÜRODİNAMİ SONUÇLARININ KARŞILAŞTIRILMASI

Yıl 2018, , 184 - 187, 27.06.2018

Emin Erhan Dönmez , Selçuk Selçuk , Hasan Süt Sevcan Arzu Arınkan , Cetin Cam

https://doi.org/10.16948/zktipb.415708

Öz

Amaç: Evre
2 ve üzerinde prolapsusu olan hastaların prolabe olan kompartmanın lokal
redüksiyonu ile okült inkontinans oranını saptamak.

 

Bireyler ve
Yöntem: Eylül 2014 ve Şubat 2015 tarihleri arasında pelvik organ prolapsusu
tanısı konan 65 hasta çalışmaya alındı. .Hastalara ürodinami yapıldı ve aynı
zamanda hayat kalitesi sorgu formlarından UDI-6, IIQ-7, PISQ-12 ve PQoL  anketleri doldurtuldu. Anket sonuçları
prolapsus hastaları arasında değerlendirildi

 

Bulgular: Hastaların %55.4 ‘ü( n: 36) evre 2, %29.2’si (n : 19)
evre 3 ve %15.4 ‘ü (n: 10) evre 4 prolapsusu vardı.Prolapsusu olan hastaların 4
tanesinde ( % 6.2) aşikar üriner inkontinans saptandı. İnkontinansı olmayan
hastalarda ise spekulum ve ring forceps ile yapılan lokal redüksiyon sonrası
okült inkontinans oranı %18.5, peser ile redüksiyon sonrası ise okült
inkontinans oranı % 24.6 olarak saptandı.Ürodinamik parametrelerden ise her iki
grup  Pdet Qmax, Qmax, Qave, Qmax
(liverpol), Qave ( liverpol),PVR açısından değerlendirildi, İstatistksel olarak
her iki grup arasında anlamlı bir fark saptanmadı.( p>0.05). Prolapsus
lokalizasyonu açısından da her iki grup arasında istatistiksel olarak anlamlı
fark saptanmadı. Hayat kalitesi değerlendirme formları yapılmış olan diğer
çalışmalar ile tutarlılık göstermesine rağmen her iki grup arasında
İstatistiksel olarak anlamlı bir fark saptanmadı.

 

Sonuç:
Üriner inkontinans ile
pelvik organ prolapsusu sıklıkla bir arada bulunabilir. Ciddi prolapsusu olan
hastalarda okült inkontinans bulunabilir. Bu nedenle pelvik organ prolapsusu
nedeni ile cerrahi tedavi planlanan hastaların preoperatif dönemde ürodinamik
olarak ayrıntılı şekilde değerlendirilmesi gerekmektedir.

Anahtar Kelimeler

Pelvik organ Prolapsusu, peser

Comparision of Urodynamic Results of Patients Who Had Reduced Pelvic Organ Prolapse According to Position

Öz

Objectives: Detection of occult incontinence proportion
inpatients who have pelvic organ prolapse quantitation system
[POP-Q] stage II to IV with reducting of prolapse compartment.

 

Methods: 2015.A total of 65 cases who had stage II to
IV pelvic organ prolapse, patients with stage I prolapse were excluded. Occult
incontinence rates was detected and urodynamic parameters were compared. Before the urodynamic study patients were answered the
questionnaire about quality of life such as UDI-6, IIQ-7, PISQ-12 ve
PQoL.

 

Results: %55.4 ( n:36) of the patients had stage II, %29.2 (
n:19) of them hade stage III and %15.4 ( n: 10) of them had stage IV pelvic
organ prolapsus. Four of women who had prolapse (%6.2) were also having  evidant urinary incontinece.% 18.5  of patients had occult incontinence after
reduction with speculum,and % 24.6 of patients had also occult urinary
incontinence after passary reduction 
among the patients who hadn’t incontinece. But between this two group,
there was not anystatistically significant difference in term of urodynamic
parameters such as grup  Pdet Qmax, Qmax,
Qave, Qmax (liverpol), Qave ( liverpol),PVR ( p>0.05).And also between two
groups there was not any statistically significant difference in terms of prolapse
localization. Results of this questionnaire were similar with previous
study,but there were not any statistically significant difference between
reduction with speculum and pessary.

 

Conclusion: Pelvic organ prolapse (POP) and
urinary incontinence (UI) are common conditions.But patients who had serious
prolapse have occult incontinence also. So Urodynamic testing
is helpful when the diagnosis of urinary occult incontinence is unclea. Before
prolapse surgery treatment patients should be evaluated in detail.

Kaynakça

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