ORIJINAL ARAŞTIRMA
Multipl Skleroz Hastalarında Mesane Rehabilitasyonu Takip Çalışması
Bladder Rehabilitation Follow-Up Study in Multiple Sclerosis Patients
Received Date : 13 Mar 2024
Accepted Date : 11 Jul 2024
Available Online : 18 Jul 2024
Ebru ERDENa, Murat ERSÖZa,b, Tülay TİFTİKa
aAnkara City Hospital Physical Therapy and Rehabilitation Hospital, Clinic of Physical Medicine and Rehabilitation, Ankara, Türkiye
bYıldırım Beyazıt University Faculty of Medicine, Department of Physical Medicine and Rehabilitation, Ankara, Türkiye
Doi: 10.31609/jpmrs.2024-102743 - Makale Dili: EN
Turkiye Klinikleri Journal of Physical Medicine and Rehabilitation Sciences. 2024;27(3):192-200.
ÖZET
Amaç: Bu çalışmada, multipl skleroz (MS) hastalarında, ilk
ürodinami ve takip ürodinami sonuçlarının karşılaştırılması, önerilen
medikal ve nonmedikal tedavi yöntemlerinin etkinliğini ve hastaların
tedaviye uyumunu değerlendirmek amaçlandı. Gereç ve Yöntemler:
Çalışmaya 24 MS hastası dâhil edildi. Hastaların ürodinamik analizleri
laboratuvar sonuçları kullanılarak retrospektif olarak yapıldı. Bulgular:
İlk ürodinamik inceleme öncesi hastaların sadece %8,3’ü nörojenik
mesane için medikal tedavi kullanırken, ilk ürodinamik inceleme
sonrası hastaların tamamına nörojenik mesaneye yönelik medikal tedavi
önerildi. Kontrol ürodinami incelemesinde ilk ürodinami incelemesine
göre maksimum sistometrik kapasitede artış, maksimum
sistometrik kapasitedeki detrüsör basıncında azalma ve maksimum detrüsör
basınçtaki azalmada istatistiksel olarak anlamlı farklılık tespit
edildi (sırasıyla p=0,044, p=0,049 ve p<0,001). Kontrol ürodinamik incelemede,
hastaların depolama sorunu ve korunmuş doluluk duyusunda
istatistiksel olarak anlamlı azalma saptanırken, boşaltma sorununda
istatistiksel olarak anlamlı artış tespit edildi (sırasıyla p<0,001, p<0,001
ve p=0,004). Sonuç: İlk ürodinami sonuçlarına göre MS hastalarında
nörojenik mesane disfonksiyonu yönetiminin yetersiz olduğunu, önerilen
medikal ve nonmedikal tedavi yöntemleri ile takip ürodinamilerde
düzelmelerin olduğu belirlenmiştir. MS hastalığının ilerleyici özelliğinden
dolayı hastalar üriner sistem açısından belirli aralıklarla değerlendirilmeli
ve gerekirse tedavileri yeniden düzenlenmelidir.
Anahtar Kelimeler: Multipl skleroz; alt üriner sistem disfonksiyonu; takip ürodinami
ABSTRACT
Objective: This study aimed to compare the results of
the initial and follow-up urodynamic tests in multiple sclerosis (MS)
patients, evaluate the effectiveness of the recommended medical and
non-medical treatment methods, and assess the patients’ compliance
with the treatment. Material and Methods: Twenty-four patients with
MS were included in the study. The urodynamic analyses of the patients
were conducted retrospectively using their laboratory outcomes.
Results: While only 8.3% of patients required medical treatment for
neurogenic bladder before the initial urodynamic examination, all patients
were recommended medical treatment after the examination.
There was an increase in maximum cystometric capacity, a decrease in
detrusor pressure at maximum cystometric capacity, and a decrease in
maximum detrusor pressure at the follow-up urodynamic examination
compared to the initial one, all exhibiting a significant difference
(p=0.044, p=0.049, and p<0.001, respectively). The follow-up urodynamic
examination results revealed a statistically significant decrease
in the storage problem and preserved sensation of bladder fullnes,
whereas it exhibited a statistically significant increase in the emptying
problem (p<0.001, p<0.001, and p=0.004, respectively). Conclusion:
Based on the initial urodynamics results, we concluded that the management
of neurogenic bladder dysfunction in MS patients was inadequate,
and that there were improvements in the follow-up urodynamics
with the recommended medical and non-medical treatment methods.
Due to the progressive nature of MS, the urinary system of the patients
diagnosed with the disease should be evaluated periodically and their
treatment should be rearranged when necessary.
Keywords: Multiple sclerosis; lower urinary tract dysfunction; follow-up urodynamics
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