ISSN: 1309 - 3843 E-ISSN: 1307 - 7384
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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
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.
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.
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