Saliha SAĞNIÇ, Mahmut Kuntay KOKANALI, Sabri CAVKAYTAR, Melike DOĞANAY

Doğum şekli ve paritenin pelvik organ prolapsusu ve üriner inkontinans gelişimi üzerine etkisi

Amaç: Doğum şekli ve parite sayısının pelvik organ prolapsusu (POP) ve üriner inkontinans (UI) gelişimine etkisini araştırmak. Gereç ve yöntem: 2007-2012 yılları arasında POP ve UI ameliyatı geçiren 1500 kadın geriye dönük olarak değerlendirildi. Dışlama kriterlerinden sonra 875 kadın dahil edildi. POP ameliyatı öyküsü olan 353 kadın, POP ameliyatı olmayan 129 kontrol ile karşılaştırıldı ve anti-inkontinans ameliyatı öyküsü olan 201 hasta, böyle bir ameliyatı olmayan 192 kontrol ile karşılaştırıldı. Olası faktörlerin POP ve UI gelişimi üzerindeki çoklu etkisi lojistik regresyon ile belirlendi. Bulgular: POP grubu ve kontroller ile anti inkontinans cerrahisi grubu ve kontrollerin özellikleri parite sayısı dışında benzerdi. Parite sayısı arttıkça POP ameliyatı olma riski daha yüksekti. En yüksek risk, 5 ve daha fazla doğum öyküsü olan kadınlarda bulundu. UI için multiparite bir risk faktörü olarak göründü, ancak inkontinans cerrahisine girme riski artan parite sayısı ile artmadı. Doğum şekli, hem POP hem de anti-inkontinans grubu için bir risk faktörü değildi. Sonuç: Parite sayısı arttıkça POP riski artar ve multiparite de UI için bir risk faktörüdür. Birden fazla doğum planlayan kadınlar bu durumdan haberdar edilmelidir. Doğum modunun etkisi net olarak gösterilmediğinden, pelvik taban disfonksiyon insidansının uygun obstetrik bakım ile azaltılabileceğine inanıyoruz.

Anahtar Kelimeler:

doğum, parite, prolaps, inkontinans

The impact of delivery mode and parity on development of pelvic organ prolapse and urinary incontinence

Aim: To investigate the effect of delivery mode and parity number on development of pelvic organ prolapse (POP) and urinary incontinence (UI). Materials and methods: 1500 women who had undergone surgery for POP and UI between 2007-2012 were retrospectively evaluated. After exclusion criteria, 875 women were included. 353 women with history of POP surgery were compared with 129 controls who had no POP and 201 patients with history of anti-incontinence surgery were compared with 192 controls who had no such surgery. Multiple effect of possible factors on the development of POP and UI was determined by logistic regression. Results: The characteristics of POP group and the controls, as well as anti incontinence surgery group and controls were similar, except parity number. The risk of having a POP surgery was higher with increasing number of parity. The highest risk was found in women with a history of 5 and more deliveries. For UI, multiparity seemed as a risk factor, however the risk of undergoing incontinence surgery did not increase with increasing number of parity. Delivery mode was not a risk factor for either POP or anti-incontinence group. Conclusion: The risk of POP increases with increasing number of parity, and also multiparity is a risk factor for UI. Women planning more than one delivery should be informed about this concern. Since the impact of delivery mode has not been shown clearly, we believe the incidence of pelvic floor dysfunction can be decreased with proper obstetric

Keywords:

delivery, parity, prolapse, inkontinence,

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