Orhan ALTINBOĞA, Cüneyt Eftal TANER, İsmail Burak GULTEKIN

SON ÜÇ YIL İÇİNDE DOĞUM YAPMIŞ KADINLARDA STRES İNKONTİNANS: PARİTE VE DOĞUM ŞEKLİNİN ETKİSİ

Amaç: Bu çalışma, stres üriner inkontinansla; parite, fetüsün doğum ağırlığı, hastanın doğumdaki yaşı, boyu, kilosu ve doğum şekli (sezaryen/vajinal doğum) arasındaki ilişkiyi incelemek amacıyla yapılmıştır.Gereç ve yöntemler: Son 3 yıl içinde doğum yapmış, 15-49 yaş aralığında toplam 522 hasta, demografik özelliklerini inceleyen anket formu uygulandıktan sonra Ürogenital Distress Envanteri formu ile değerlendirilerek stres üriner inkontinans açısından sorgulandı. Olgular jinekolojik muayene ve üro-jinekolojik klinik testlerle değerlendirildi. Hastaların paritesi, doğum şekli, hastanın boyu ve kilosu, yaşı, fetüsün doğum ağırlığı gibi faktörlerin üriner inkontinans ile olası ilişkisi incelendi.Bulgular: Sezaryen doğum yapmış olan hastalarda, parite ile inkontinans arasında istatistiksel olarak anlamlı fark bulunmadı (p>0.05). Vajinal doğum yapmış olan hastalar parite inkontinans ilişkisi açısından değerlendirildiğinde, inkontinans ile parite arasında istatistiksel olarak anlamlı fark bulunmadı (p>0.05). İnkontinansı olup, sadece sezaryen doğum ve sadece vajinal doğum yapmış olan hastalar yaş gruplarına göre (15-30 ve 31-49 yaş) hem kendi aralarında hem de çapraz olarak birbirleriyle karşılaştırıldı. Her iki yaş grubu sezaryen ve vajinal doğum açısından değerlendirildiğinde erken yaşta doğum yapan hastalarda her iki grupta da inkontinans sıklığı istatistiksel olarak anlamlı şekilde daha fazla bulundu (p0.05).Sonuç: Doğum şekline göre (sezaryen/normal vajinal doğum) değerlendirdiğimizde parite ile inkontinans arasında anlamlı bir ilişki saptanmamıştır. Genç yaşta doğum yapmış olan kadınlarda ise stres inkontinans yakınmasının daha ileri yaştaki grubun semptomlarına göre daha belirgin olduğu görülmüştür.

Stress Incontinence in Women who Delivered Within Past Three Years: İmpact of Parity and Route of Delivery

Objective:The aim of this study was to analyse the relation of stres urinary incontinence with parity, birth weight, maternal age, weight, height and route of delivery.Material and methods: 522 women of ages 15-49 who delivered within past 3 years were evaluated with UDI-6 and demographic variables in regard to urinary incontinance. All cases were evaluated with gynecological examination and urogynecological tests (Marshall, Bonney, Q-tip test). The impact of variables such as parity, route of delivery, women's height and weight, age at delivery, fetal birth weight on urinary incontinance were analysed.Results:There was no significant difference in parity and urinary incontinance in women delivered with cesarean section (p>0.05). There was no significant difference in parity and urinary incontinance in women delivered vaginally (p>0.05).The only-Cesarean section group and the only-vaginal delivery group, both having incontinence, were compared according to age specified subgroups (15-30 and 31-49 years of age) both between the groups and within the groups. The difference was significant with higher frequency of urinary incontinance in younger age group independent of the route of delivery and parity (p0.05).Conclusion: The difference was insignificant for route of delivery and parity in regard to urinary incontinance. However, younger age at delivery was found to be statistically significant for development of incontinence regardless of the other variables including the route of delivery and parity.

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