Öz
Amaç: Kadın hastalarda sakral
nöromodülasyon (SNM) işleminin etkinliğini ve sağlıkla ilişkili yaşam kalitesi
üzerine etkisini ortaya koymayı amaçladık.
Gereç ve Yöntem: Hacettepe Üniversitesi Hastanesinde 1999-2016
tarihleri arasında SNM işlemi yapılan hastaların verileri retrospektif olarak
değerlendirildi. SNM işlemi başarılı olan ve kalıcı pil yerleştirilen kadın
hastalar çalışmaya dahil edildi. Hem SNM hastalarına hem de kontrol grubuna Bristol Female Lower Urinary Tract Symptoms
(BFLUTS) anketinin Türkçe geçerliliği yapılmış şekli uygulandı ve BFLUTS’un
skorlanmış formuna uyarlandı.
Bulgular: SNM işlemi uygulanan toplam hasta
sayısı 35 idi. Bu hastalar içinden testi başarılı olan ve kalıcı pil
yerleştirilen toplam 19 kadın hastaya anket formu gönderildi ve ankete cevap
veren 9 kadın çalışmaya dahil edildi. Kontrol grubunu 18 kadın hasta oluşturdu.
SNM hastalarının ortalama yaşı 46.7±12.8 yıl iken kontrol grubunun ortalama
yaşı 44.2±8.2 yıl olup gruplar arasında yaş açısından anlamlı farklılık
bulunmamakta idi ( p= 0.544). Dolum ve işeme semptomları SNM hasta grubunda
daha sık gözlenirken inkontinans semptomları SNM hastaları ve kontrol grubunda
benzerdi. SNM hastalarının seksüel fonksiyonlarında kontrol grubundakilere göre
bir kötüleşme saptanmadı. SNM hastalarının yaşam kaliteleri kontrol grubuna
göre anlamlı olarak azalmış bulundu.
Sonuç: SNM işlemi alt üriner sistem
disfonksiyonu (AÜSD) olan hastalarda tercih edilebilecek bir tedavi yöntemidir.
SNM işlemi geçiren kadın hastaların idrar kaçırma durumları ve seksüel
fonksiyonları aynı yaş grubundaki erişkinler ile benzerlik göstermektedir.
Anahtar Kelimeler
Sakral nöromodülasyon inkontinans yaşam kalitesi seksüel fonksiyon.
Kaynakça
- Tanagho EA, Schmidt RA. Electrical stimulation in the clinical management of the neurogenic bladder. J Urol 1988;140(6):1331-9.
- Banakhar M, Hassouna M. Sacral neuromodulation for genitourinary problems. Prog Neurol Surg 2015;29:192-9.
- Van Kerrebroeck PE, Marcelissen TA. Sacral neuromodulation for lower urinary tract dysfunction. World J Urol 2012;30(4):445-50.
- Zabihi N, Mourtzinos A, Maher MG, Raz S, Rodriguez LV. Short-term results of bilateral S2-S4 sacral neuromodulation for the treatment of refractory interstitial cystitis, painful bladder syndrome, and chronic pelvic pain. Int Urogynecol J Pelvic Floor Dysfunct 2008;19(4):553-7.
- Gokkaya CS, Oztekin CV, Doluoglu OG, et al. Validation of Turkish version of Bristol Female Lower Urinary Tract Symptom Index. J Clin Anal Med 2012;3(4):415-8.
- Brookes ST, Donovan JL, Wright M, Jackson S, Abrams P. A scored form of the Bristol Female Lower Urinary Tract Symptoms questionnaire: Data from a randomized controlled trial of surgery for women with stress incontinence. Am J Obstet Gynecol 2004;191(1):73-82.
- Jackson S, Donovan J, Brookes S, Eckford S, Swithinbank L, Abrams P. The Bristol Female Lower Urinary Tract Symptoms questionnaire: Development and psychometric testing. Br J Urol 1996;77(6):805-12.
- Aboseif S, Tamaddon K, Chalfin S, et al. Sacral neuromodulation in functional urinary retention: An effective way to restore voiding. BJU Int 2002;90(7):662-5.
- Kessler TM, La Framboise D, Trelle S, et al. Sacral neuromodulation for neurogenic lower urinary tract dysfunction: Systematic review and meta-analysis. Eur Urol 2010;58(6):865-74.
- Wollner J, Krebs J, Pannek J. Sacral neuromodulation in patients with neurogenic lower urinary tract dysfunction. Spinal Cord 2016;54(2):137-40.
- Engeler DS, Meyer D, Abt D, Muller S, Schmid HP. Sacral neuromodulation for the treatment of neurogenic lower urinary tract dysfunction caused by multiple sclerosis: A single-centre prospective series. BMC Urol 2015;15(2):105.
- Lombardi G, Musco S, Celso M, Del Corso F, Del Popolo G. Sacral neuromodulation for neurogenic non-obstructive urinary retention in incomplete spinal cord patients: A ten-year follow-up single-centre experience. Spinal Cord 2014;52(3):241-5.
- Cappellano F, Bertapelle P, Spinelli M, et al. Quality of life assessment in patients who undergo sacral neuromodulation implantation for urge incontinence: An additional tool for evaluating outcome. J Urol 2001;166(6):2277-80.
- Das AK, Carlson AM, Hull M, Group USM-S. Improvement in depression and health-related quality of life after sacral nerve stimulation therapy for treatment of voiding dysfunction. Urology 2004;64(1):62-8.
- Foster RT Sr, Anoia EJ, Webster GD, Amundsen CL. In patients undergoing neuromodulation for intractable urge incontinence a reduction in 24-hr pad weight after the initial test stimulation best predicts long-term patient satisfaction. Neurourol Urodyn 2007;26(2):213-7.
Öz
Aim: We aimed to determine the efficacy
of sacral neuromodulation (SNM) and affects on health-related quality of life
in women.
Materials and Methods: The records of patients undergone
SNM at Hacettepe University Hospital between 1999 and 2016 were analyzed.
Female patients with a successful SNM procedure who were placed permanent
battery were included the study. Both the SNM patients and the control group
were administered the Turkish validated version of the Bristol Female Lower
Urinary Tract Symptoms (BFLUTS) questionnaire and adapted to the scored form of
BFLUTS.
Results: In total 35 patients had undergone
SNM. Among these patients, a total of 19 female patients who had been tested
successfully and were placed permanent batteries were sent a questionnaire and
9 women who answered the questionnaire were included in the study. The control
group consisted of 18 female patients. The mean age of the SNM patients was
46.7±12.8 years, while the mean age of the control group was 44.2±8.2 years.
There was no significant difference between the groups in terms of age
(p=0.544). Filling and voiding symptoms were more frequent in the SNM patient
group, whereas incontinence symptoms were similar in the SNM patients and
control group. There was no deterioration in sexual function of SNM patients
compared to controls. The quality of life of SNM patients was significantly
lower than the control group.
Conclusion: SNM would be the choice of treatment
for patients with lower urinary tract dysfunction. Urinary incontinence and
sexual functions of female patients who underwent SNM treatment are similar to
adults of the same age group.
Anahtar Kelimeler
Sacral neuromodulation incontinence quality of life sexual function.
Kaynakça
- Tanagho EA, Schmidt RA. Electrical stimulation in the clinical management of the neurogenic bladder. J Urol 1988;140(6):1331-9.
- Banakhar M, Hassouna M. Sacral neuromodulation for genitourinary problems. Prog Neurol Surg 2015;29:192-9.
- Van Kerrebroeck PE, Marcelissen TA. Sacral neuromodulation for lower urinary tract dysfunction. World J Urol 2012;30(4):445-50.
- Zabihi N, Mourtzinos A, Maher MG, Raz S, Rodriguez LV. Short-term results of bilateral S2-S4 sacral neuromodulation for the treatment of refractory interstitial cystitis, painful bladder syndrome, and chronic pelvic pain. Int Urogynecol J Pelvic Floor Dysfunct 2008;19(4):553-7.
- Gokkaya CS, Oztekin CV, Doluoglu OG, et al. Validation of Turkish version of Bristol Female Lower Urinary Tract Symptom Index. J Clin Anal Med 2012;3(4):415-8.
- Brookes ST, Donovan JL, Wright M, Jackson S, Abrams P. A scored form of the Bristol Female Lower Urinary Tract Symptoms questionnaire: Data from a randomized controlled trial of surgery for women with stress incontinence. Am J Obstet Gynecol 2004;191(1):73-82.
- Jackson S, Donovan J, Brookes S, Eckford S, Swithinbank L, Abrams P. The Bristol Female Lower Urinary Tract Symptoms questionnaire: Development and psychometric testing. Br J Urol 1996;77(6):805-12.
- Aboseif S, Tamaddon K, Chalfin S, et al. Sacral neuromodulation in functional urinary retention: An effective way to restore voiding. BJU Int 2002;90(7):662-5.
- Kessler TM, La Framboise D, Trelle S, et al. Sacral neuromodulation for neurogenic lower urinary tract dysfunction: Systematic review and meta-analysis. Eur Urol 2010;58(6):865-74.
- Wollner J, Krebs J, Pannek J. Sacral neuromodulation in patients with neurogenic lower urinary tract dysfunction. Spinal Cord 2016;54(2):137-40.
- Engeler DS, Meyer D, Abt D, Muller S, Schmid HP. Sacral neuromodulation for the treatment of neurogenic lower urinary tract dysfunction caused by multiple sclerosis: A single-centre prospective series. BMC Urol 2015;15(2):105.
- Lombardi G, Musco S, Celso M, Del Corso F, Del Popolo G. Sacral neuromodulation for neurogenic non-obstructive urinary retention in incomplete spinal cord patients: A ten-year follow-up single-centre experience. Spinal Cord 2014;52(3):241-5.
- Cappellano F, Bertapelle P, Spinelli M, et al. Quality of life assessment in patients who undergo sacral neuromodulation implantation for urge incontinence: An additional tool for evaluating outcome. J Urol 2001;166(6):2277-80.
- Das AK, Carlson AM, Hull M, Group USM-S. Improvement in depression and health-related quality of life after sacral nerve stimulation therapy for treatment of voiding dysfunction. Urology 2004;64(1):62-8.
- Foster RT Sr, Anoia EJ, Webster GD, Amundsen CL. In patients undergoing neuromodulation for intractable urge incontinence a reduction in 24-hr pad weight after the initial test stimulation best predicts long-term patient satisfaction. Neurourol Urodyn 2007;26(2):213-7.
Ayrıntılar
| Birincil Dil | Türkçe |
|---|---|
| Konular | Sağlık Kurumları Yönetimi |
| Bölüm | Araştırma Makaleleri |
| Yazarlar | |
| Yayımlanma Tarihi | 3 Aralık 2018 |
| Gönderilme Tarihi | 9 Kasım 2017 |
| Yayımlandığı Sayı | Yıl 2018 |