Urinary incontinence and risk factors

Amaç: Üriner inkontinanslı hastalarda vücut kitle indeksi, parite, doğum şekli, pelvik tabandefektleri ve gizli veya aşikar diabetin inkontinans tiplerinin dağılımı üzerindeki etkisininaraştırılması.Yöntem: Toplam 230 üriner inkontinans olgusu değerlendirildi. Olgulara; yaş, gebelik, parite,Diabetes Mellitus(DM), gestasyonel diabet ve inkontinans tipini saptamaya yönelik soru formlarıdolduruldu. Ayrıca boy, kilo, jinekolojik muayene bulguları, açlık-tokluk kan şekeri (AKŞ-TKŞ)ve hemoglobin A1c(HbA1c) ölçümleri değerlendirildi.Bulgular: Olgularda ortalama yaş 49,63 ± 10,68; gravida 4,21 ± 2,68; parite 3,59 ± 2,51; vücutkitle indeksi (VKİ) ortalaması 29,86 ± 4,25 saptanmıştır. Olguların %40,9unda (94) stres,%30,4ünde (70) urge, %28,7sinde (66) mikst inkontinans saptanmıştır. Pelvik taban bozukluğu94 (%40,86) olguda tespit edildi. Pelvik anatomik bozuklukların eşlik ettiği, genç yaş, düşük pariteve doğumda stres üriner inkontinans (SUİ) baskınlığı ön plandayken; pelvik taban defektiolmayan, daha ileri yaş, 5 ve üzeri gebelik ve doğum yapanlarda bu fark ortadan kalkmaktadır; 114(%49,56) olguda obezite + morbid obezite mevcuttu. 68 (%29,56) olguda BAG, 49 (%21,30) olguda BGT ve 35 (%15,21) olguda DM tespit edildi. Bozulmuş glukoz toleransı (BGT) saptananolgularda (SÜİ) daha yüksek orandaydı. Diabet saptanan olgularda urge üriner inkontinans (UÜİ);mikst (MÜİ) ve SÜİa göre daha fazla saptanmış olmakla birlikte her iki durumda da farklaristatistiksel önemde değildi (p>0,05).Sonuç: Düşük parite ve doğum, travmatik doğuma bağlı olabilecek anatomik bozukluk, bozulmuşaçlık ve tokluk kan şekeri ve genç yaş SÜİ ile ilişkilidir. Daha ileri yaş, yüksek parite ve doğumdagruplar arasında bu fark ortadan kalkmaktadır. İleri yaşla birlikte MÜİ daha sık izlenir. UUİ ileriyaştaki diabetes mellituslu hastalarda sıktır.

Üriner inkontinans ve risk faktörleri

Objective: Examining the effects of body mass index (BMI), parity, method of delivery, defects inpelvic floor, diabetes mellitus on the types of incontinence in Urinary incontinence (UI) cases.Method: 230 UI cases were evaluated in this study. Questions asked to the cases to determine theage, parity and the type of incontinence. Incontinence was diagnosed with history. Additionally,gynecological examination findings, fasting and postprandial blood glucose (FBG-PPG) andhemoglobin A1c(HbA1c) levels were recorded.Results: The average age was 49.63 ± 10.68; gravida 4.21 ± 2.68; parity 3.59 ± 2.51. The averageBMI was determined as 29.86 ± 4.25. In 94 (40.86%) of the patients had stress incontinence(SUI),70 (30.43%) urge incontinence(UUI) and 66 (28.69%) mixed incontinence. Pelvic floor defectswas detected at 94(40.86%) of the cases. Whereas SUI was observed more prominently in juvenilecases with low parity accompanied by anatomic pelvic deformity; the divergence disappears withthe introduction of no pelvic floor defect and with 5 or more instances of gestation and delivery. In114 (49.56%) cases obesity + morbid obesity was existent. In this group, the types of incontinencewere similar; in 116 (51.44%) of the cases with normal weight, SUI was more prevalent. It wasobserved that there was impaired fasting glucose(IFG) in 68 (29.56%) of cases impaired glucosetolerance(IGT) in 49 (21.30%) of cases and diabetes mellitus in 35 (15.21%) of cases. In IGTcases, SUI was more prevalent. UUI was observed more frequently than MUI and SUI in diabetescases; however the divergence didn t bear any statistical significance (p>0.05).Conclusion: SUI is prevalent in juvenile cases with IFG and IGT, low parity and delivery,anatomic defects due to traumatic birth. The divergence disappears with advanced age, high parityand delivery. MUI is observed with advanced age more frequently. UUI is observed morefrequently in advanced age patient with DM.

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