Ümmü Serpil SARI, Ayşin KISABAY, Deniz SELÇUKİ

Micturition syncope: Report of two cases

Toplumda sık görülen ve acil servise başvurunun önemli nedenlerinden olan senkop, kısa süreli geçici bilinç kaybı ile karakterizedir. Miksiyon senkobu (MS), nöral kökenli refleks sendromlarından birisidir. MS ve defekasyon senkobu, vazodilatasyon ve bradikardi ile sonuçlanan refleks nedeniyle ortaya çıkmaktadır. Klasik olarak MS sağlıklı insanlarda, uykudan uyanıp idrar yapma sonrası gelişen senkop şeklinde tarif edilmektedir. Halen MS hakkındaki bilgiler çok sınırlıdır. MS tüm senkopların %2-8ini oluşturmaktadır. MSnin tedavi ve sonuçları konusunda halen görüş birliği yoktur. Sunacağımız iki olgu ile nadir görülen bir senkop çeşidi olan miksiyon senkobuna ait ayrıntılı bir değerlendirme yapılması amaçlanmıştır.

Miksiyon senkobu: İki olgu sunumu

Syncope is a symptom which is a transient loss of consciousness and very common in society and is one of the most important referral causes to emergency services. Micturition syncope (MS) appears as a rare cause of neurally-mediated syncope. MS is caused by reflex which results with vasodilatation and bradycardia, like defecation syncope. In the clinical setting, the MS is presented with transient loss of consciousness during supine position or micturition following after a sleep period mostly in otherwise healthy men. It is a reflex state in which standing triggers vasodilatation and bradicardia. MS covers 2-8% of all syncopes. There is still no consensus about treatment and outcome of MS. In this article two male patients with MS are presented. With these two cases, we aimed to give detailed information about micturition syncope which is a rare type of syncope.

PDF

___

1. Rugg-Gunn MA. Fits, faints and blackouts; a review of the causes of syncope and allied states in naval personnel. J R Nav Med Serv 1946; 32:232-256.
2. Gastaut H. La syncope nocturne des hypervagotoniques; sa différenciation davec lépilepsie morphéique. Rev Neurol (Paris) 1956; 95:420-421.
3. Chakravarty A. Why women do not get micturition syncope? A hypothesis. Medical Hypotheses 2003; 61:463-464.
4. Kenny RA, OShea D, Walker HF. Impact of a dedicated syncope and falls facility for older adults on emergency beds. Age Ageing 2002; 31:272-275.
5. Benditt DG. Neurally mediated syncopal syndrome: pathophysiological concepts and clinical evaluation. Pacing Clin Electrophysiol 1997; 20:572-584.
6. Brignole M, Alboni P, Benditt DG, Bergfeldt L, Blanc JJ, Thomsen PE, Gert van Dijk J, Fitzpatrick A, Hohnloser S, Janousek J, Kapoor W, Kenny RA, Kulakowski P, Masotti G, Moya A, Raviele A, Sutton R, Theodorakis G, Ungar A, Wieling W, Priori SG, Garcia MA, Budaj A, Cowie M, Deckers J, Burgos EF, Lekakis J, Lindhal B, Mazzotta G, Morais J, Oto A, Smiseth O, Menozzi C, Ector H, Vardas P, Task Force on Syncope, European Society of Cardiology. Guidelines on management (diagnosis and treatment) of syncope Update 2004 Executive Summary. Eur Heart J 2004; 25:2054-2072.
7. Lyle CB Jr, Monroe JT Jr, Flinn DE, Lamb LE. Micturition syncope: report of 24 cases. N Engl J Med 1961; 265:982-986.
8. Proudfit WL, Forteza ME. Micturition syncope. N Engl J Med 1959; 260:328-331.
9. Kapoor WN, Peterson JR, Karpf M. Micturition syncope: a reappraisal. JAMA 1985; 253:796-798.
10. Sumiyoshi M, Abe H, Kohno R, Sekita G, Tokano T, Nakazato Y,Daida H. Age dependent clinical characteristics of micturition syncope. Circ J 2009; 73:1651-1654.
11. Komatsu K, Sumiyoshi M, Abe H , Kohno R, Hayashi H, Sekita G, Tokano T, Nakazato Y, Daida H. Clinical characteristics of defecation syncope compared with micturition syncope. Circ J 2010; 74:2:307-311.