Aşırı Aktif Mesaneli Erkek Bireylerdeki Otonomik Sinir Sistemi Fonksiyon Bozukluğu

Amaç: Aşırı aktif mesane, oldukça sık görülen ve hayat kalitesini azaltan ürolojik bir hastalıktır. Bu klinik durumun altında yatan ana patofizyolojiyi açıklayan birçok hipotez öne sürülmüştür, ancak altta yatan mekanizma tam olarak açıklığa kavuşamamıştır. Ayrıca ilgili çalışmaların sayısı oldukça sınırlı, sadece bayan hastaları kapsamakta ve çelişen sonuçlar içermektedir. Biz burada, öne sürülen hipotezlerden biri olan otonomik sinir sistemi fonksiyon bozukluğunu aşırı aktif mesanesi olan erkek hastalarda araştırmayı amaçladık. Yöntem: Bu çalışmaya, 41 aşırı aktif mesanesi olan erkek hasta ile 43 sağlıklı erkek birey alınmıştır. Katılımcıların elektrokardiyografik sinyalleri işeme öncesi ve işeme sonrası dönemde kaydedilmiş ve otonomik sinir sistemi fonksiyon bozukluğunu gösterebilen kalp hızı değişkenliği parametrelerine dönüştürülmüştür. Bulgular: Kontrol grubuna kıyasla, aşırı aktif mesaneli erkek hastalarda; NN intervallerinin standart sapması, ardışık normal NN intervalleri arasındaki farkların karekökü, düşük frekans bandı, düşük frekans/yüksek frekans oranı anlamlı olarak daha düşük, yüksek frekans bandı ise anlamlı olarak daha yüksek bulundu (p<0.05) Sonuç: Aşırı aktif mesaneli erkek hastalarda kalp hızı değişkenliği azalmakta ve bayan hastalardaki sempatik hakimiyeti raporlayan önceki bazı çalışmaların aksine, hem işeme öncesi hem de işeme sonrası dönemde parasempatik hakimiyet gözlenmektedir.

Anahtar Kelimeler:

aşırı aktif mesane, , elektrokardiyografi, erkek, kalp hızı, otonomik sinir sistemi

Alteration of Autonomic Nervous System Function in Male Patients with Overactive Bladder Syndrome

Background/Aims: Overactive bladder is a frequently encountered urological disease that has debilitating effects on quality of life. Some hypotheses have been brought forward in order to explain the main pathophysiology underlying this clinical phenomenon, however the exact mechanism remains unclear and the relevant reports are limited in number, confined to female patients and have conflicting results. Therefore, we aimed to examine one of these hypotheses -autonomic nervous system dysfunction- in male patients with overactive bladder. Methods: We enrolled 41 male patients with overactive bladder and 43 healthy males in this study. Their electrocardiographic signals are recorded in the prevoiding and postvoiding periods and then converted to heart rate variability parameters which may reveal autonomic nervous system dysfunction. Results: Standard deviation of normal-to-normal interval, square root of the mean squared differences of successive normal-to-normal intervals, low frequency signal and low frequency/high frequency ratio were found to be significantly lower while high frequency signal was significantly higher in the patient group compared to healthy controls (p<0.05). Conclusions: Heart rate variability was attenuated in male patients with overactive bladder and parasympathetic predominance was observed during both prevoiding and postvoiding periods, contrary to some of the previous reports revealing sympathetic predominance in female patients.

Keywords:

autonomic nervous system, electrocardiography, heart rate, male, overactive urinary bladder,

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