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

Yıl 2018, Cilt: 49 Sayı: 2, 184 - 187, 27.06.2018
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.

Kaynakça

  • 1. Abrams P, Cardozo L, Fall M, et al. The standardisation of terminology of lower urinary tract function: report from the Standardisation Sub-committee of the International Continence Society. Neurourol Urodyn 2002; 21:167.2. Buckley BS, Lapitan MC, Epidemiology Committee of the Fourth International Consultation on Incontinence, Paris, 2008. Prevalence of urinary incontinence in men, women, and children--current evidence: findings of the Fourth International Consultation on Incontinence. Urology 2010; 76:265.3. Markland AD, Richter HE, Fwu CW, et al. Prevalence and trends of urinary incontinence in adults in the United States, 2001 to 2008. J Urol 2011; 186:589.4. Bai SW, Jeon MJ, Kim JY, et al. Relationship between stress urinary incontinence and pelvic organ prolapse. Int Urogynecol J Pelvic Floor Dysfunct 2002; 13:256.5. Maher CM, Feiner B, Baessler K, Glazener CM. Surgical management of pelvic organ prolapse in women: the updated summary version Cochrane review. Int Urogynecol J 2011; 22:1445.6. Jelovsek JE, Maher C, Barber MD. Pelvic organ prolapse. Lancet 2007; 369:1027.7. Jundt K, Wagner S, von Bodungen V, Friese K, Peschers U. Occult incontinence in women with pelvic organ prolapse - does it matter? Eur J Med Res. 2010;15(3):112-6.8. Ellerkmann RM, Cundiff GW, Melick CF, et al. Correlation of symptoms with location and severity of pelvic organ prolapse. Am J Obstet Gynecol 2001; 185:1332.9. Mouritsen L, Larsen JP. Symptoms, bother and POPQ in women referred with pelvic organ prolapse. Int Urogynecol J Pelvic Floor Dysfunct 2003; 14:122.10. Long CY, Hsu SC, Wu TP, Sun DJ, Su JH, Tsai EM. Urodynamic comparison of continent and incontinent women with severe uterovaginal prolapse. J Reprod Med 2004;49(1):33–7.11. Lensen EJ, Withagen MI, Kluivers KB, Milani AL, Vierhout ME. Urinary incontinence after surgery for pelvic organ prolapse. Neurourol Urodyn 2013;32(June (5)):455–9.12. Sinha D, Arunkalaivanan AS. Prevalence of occult stress incontinence in continent women with severe genital prolapse. J Obstet Gynaecol J Inst Obstet Gynaecol. 2007 Feb;27(2):174-6.13. Chaikin DC, Groutz A, Blaivas JG. Predicting the need for anti-incontinence surgery in continent women undergoing repair of severe urogenital prolapse. J Urol. 2000 Feb;163(2):531-4.14. Blaivas JG, Olsson CA. Stress incontinence: classification and surgical approach. J Urol. 1988 Apr;139(4):727-31. 15. Roshanravan SM, Wieslander CK, Schaffer JI, Corton MM. Neurovascular anatomy of the sacrospinous ligament region in female cadavers: Implications in sacrospinous ligament fixation. Am J Obstet Gynecol 2007; 197:660.e1.16.Ghoneim GM,Walters F and Lewis V.The value of the vaginal pack test in large cystoceles. J Urology,1993;152:93117.Mattox TFand Bhatia NN. Urodynamic effects of reducing devices in women with genital prolapse.Int Urogynecol J,1994;5:28318. Cam C, Sakalli M, Ay P, Aran T, Cam M, Karateke A. Validation of the prolapse quality of life questionnaire (P-QOL) in a Turkish population.European Journal of Obstetrics& Gynecology and Reproductive Biology.2007;135(1):132-5.

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

Yıl 2018, Cilt: 49 Sayı: 2, 184 - 187, 27.06.2018
https://doi.org/10.16948/zktipb.415708

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

  • 1. Abrams P, Cardozo L, Fall M, et al. The standardisation of terminology of lower urinary tract function: report from the Standardisation Sub-committee of the International Continence Society. Neurourol Urodyn 2002; 21:167.2. Buckley BS, Lapitan MC, Epidemiology Committee of the Fourth International Consultation on Incontinence, Paris, 2008. Prevalence of urinary incontinence in men, women, and children--current evidence: findings of the Fourth International Consultation on Incontinence. Urology 2010; 76:265.3. Markland AD, Richter HE, Fwu CW, et al. Prevalence and trends of urinary incontinence in adults in the United States, 2001 to 2008. J Urol 2011; 186:589.4. Bai SW, Jeon MJ, Kim JY, et al. Relationship between stress urinary incontinence and pelvic organ prolapse. Int Urogynecol J Pelvic Floor Dysfunct 2002; 13:256.5. Maher CM, Feiner B, Baessler K, Glazener CM. Surgical management of pelvic organ prolapse in women: the updated summary version Cochrane review. Int Urogynecol J 2011; 22:1445.6. Jelovsek JE, Maher C, Barber MD. Pelvic organ prolapse. Lancet 2007; 369:1027.7. Jundt K, Wagner S, von Bodungen V, Friese K, Peschers U. Occult incontinence in women with pelvic organ prolapse - does it matter? Eur J Med Res. 2010;15(3):112-6.8. Ellerkmann RM, Cundiff GW, Melick CF, et al. Correlation of symptoms with location and severity of pelvic organ prolapse. Am J Obstet Gynecol 2001; 185:1332.9. Mouritsen L, Larsen JP. Symptoms, bother and POPQ in women referred with pelvic organ prolapse. Int Urogynecol J Pelvic Floor Dysfunct 2003; 14:122.10. Long CY, Hsu SC, Wu TP, Sun DJ, Su JH, Tsai EM. Urodynamic comparison of continent and incontinent women with severe uterovaginal prolapse. J Reprod Med 2004;49(1):33–7.11. Lensen EJ, Withagen MI, Kluivers KB, Milani AL, Vierhout ME. Urinary incontinence after surgery for pelvic organ prolapse. Neurourol Urodyn 2013;32(June (5)):455–9.12. Sinha D, Arunkalaivanan AS. Prevalence of occult stress incontinence in continent women with severe genital prolapse. J Obstet Gynaecol J Inst Obstet Gynaecol. 2007 Feb;27(2):174-6.13. Chaikin DC, Groutz A, Blaivas JG. Predicting the need for anti-incontinence surgery in continent women undergoing repair of severe urogenital prolapse. J Urol. 2000 Feb;163(2):531-4.14. Blaivas JG, Olsson CA. Stress incontinence: classification and surgical approach. J Urol. 1988 Apr;139(4):727-31. 15. Roshanravan SM, Wieslander CK, Schaffer JI, Corton MM. Neurovascular anatomy of the sacrospinous ligament region in female cadavers: Implications in sacrospinous ligament fixation. Am J Obstet Gynecol 2007; 197:660.e1.16.Ghoneim GM,Walters F and Lewis V.The value of the vaginal pack test in large cystoceles. J Urology,1993;152:93117.Mattox TFand Bhatia NN. Urodynamic effects of reducing devices in women with genital prolapse.Int Urogynecol J,1994;5:28318. Cam C, Sakalli M, Ay P, Aran T, Cam M, Karateke A. Validation of the prolapse quality of life questionnaire (P-QOL) in a Turkish population.European Journal of Obstetrics& Gynecology and Reproductive Biology.2007;135(1):132-5.
Toplam 1 adet kaynakça vardır.

Ayrıntılar

Birincil Dil Türkçe
Konular Sağlık Kurumları Yönetimi
Bölüm Orjinal Araştırma
Yazarlar

Emin Erhan Dönmez

Selçuk Selçuk

Hasan Süt Bu kişi benim

Sevcan Arzu Arınkan

Cetin Cam

Yayımlanma Tarihi 27 Haziran 2018
Yayımlandığı Sayı Yıl 2018 Cilt: 49 Sayı: 2

Kaynak Göster

APA Dönmez, E. E., Selçuk, S., Süt, H., Arınkan, S. A., vd. (2018). PELVİK ORGAN PROLAPSUSU OLAN HASTALARIN KONUMA ÖZGÜN PROLAPSUS REDÜKSİYONU YAPILARAK ÜRODİNAMİ SONUÇLARININ KARŞILAŞTIRILMASI. Zeynep Kamil Tıp Bülteni, 49(2), 184-187. https://doi.org/10.16948/zktipb.415708
AMA Dönmez EE, Selçuk S, Süt H, Arınkan SA, Cam C. PELVİK ORGAN PROLAPSUSU OLAN HASTALARIN KONUMA ÖZGÜN PROLAPSUS REDÜKSİYONU YAPILARAK ÜRODİNAMİ SONUÇLARININ KARŞILAŞTIRILMASI. Zeynep Kamil Tıp Bülteni. Haziran 2018;49(2):184-187. doi:10.16948/zktipb.415708
Chicago Dönmez, Emin Erhan, Selçuk Selçuk, Hasan Süt, Sevcan Arzu Arınkan, ve Cetin Cam. “PELVİK ORGAN PROLAPSUSU OLAN HASTALARIN KONUMA ÖZGÜN PROLAPSUS REDÜKSİYONU YAPILARAK ÜRODİNAMİ SONUÇLARININ KARŞILAŞTIRILMASI”. Zeynep Kamil Tıp Bülteni 49, sy. 2 (Haziran 2018): 184-87. https://doi.org/10.16948/zktipb.415708.
EndNote Dönmez EE, Selçuk S, Süt H, Arınkan SA, Cam C (01 Haziran 2018) PELVİK ORGAN PROLAPSUSU OLAN HASTALARIN KONUMA ÖZGÜN PROLAPSUS REDÜKSİYONU YAPILARAK ÜRODİNAMİ SONUÇLARININ KARŞILAŞTIRILMASI. Zeynep Kamil Tıp Bülteni 49 2 184–187.
IEEE E. E. Dönmez, S. Selçuk, H. Süt, S. A. Arınkan, ve C. Cam, “PELVİK ORGAN PROLAPSUSU OLAN HASTALARIN KONUMA ÖZGÜN PROLAPSUS REDÜKSİYONU YAPILARAK ÜRODİNAMİ SONUÇLARININ KARŞILAŞTIRILMASI”, Zeynep Kamil Tıp Bülteni, c. 49, sy. 2, ss. 184–187, 2018, doi: 10.16948/zktipb.415708.
ISNAD Dönmez, Emin Erhan vd. “PELVİK ORGAN PROLAPSUSU OLAN HASTALARIN KONUMA ÖZGÜN PROLAPSUS REDÜKSİYONU YAPILARAK ÜRODİNAMİ SONUÇLARININ KARŞILAŞTIRILMASI”. Zeynep Kamil Tıp Bülteni 49/2 (Haziran 2018), 184-187. https://doi.org/10.16948/zktipb.415708.
JAMA Dönmez EE, Selçuk S, Süt H, Arınkan SA, Cam C. PELVİK ORGAN PROLAPSUSU OLAN HASTALARIN KONUMA ÖZGÜN PROLAPSUS REDÜKSİYONU YAPILARAK ÜRODİNAMİ SONUÇLARININ KARŞILAŞTIRILMASI. Zeynep Kamil Tıp Bülteni. 2018;49:184–187.
MLA Dönmez, Emin Erhan vd. “PELVİK ORGAN PROLAPSUSU OLAN HASTALARIN KONUMA ÖZGÜN PROLAPSUS REDÜKSİYONU YAPILARAK ÜRODİNAMİ SONUÇLARININ KARŞILAŞTIRILMASI”. Zeynep Kamil Tıp Bülteni, c. 49, sy. 2, 2018, ss. 184-7, doi:10.16948/zktipb.415708.
Vancouver Dönmez EE, Selçuk S, Süt H, Arınkan SA, Cam C. PELVİK ORGAN PROLAPSUSU OLAN HASTALARIN KONUMA ÖZGÜN PROLAPSUS REDÜKSİYONU YAPILARAK ÜRODİNAMİ SONUÇLARININ KARŞILAŞTIRILMASI. Zeynep Kamil Tıp Bülteni. 2018;49(2):184-7.