Orhan Seyfi AKSAKAL, Özlem EVLİYAOĞLU, Hatice KANSU ÇELİK, Burcu KISA KARAKAYA

Kadınlarda Stres Üriner İnkontinansın Farmakolojik Tedavisi

Üriner inkontinans kadınları zayıflatan ve sıkıntıya sokan yaygın bir durumdur ve genellikle rapor edilmez ve tedavi edilmezler. Stres üriner inkontinans SÜİ en yaygın inkontinans tipini oluşturmaktadır. SÜİ yüksek prevalansı ve yaşam kalitesine olumsuz etkileri nedeniyle önemini korumakta olan bir hastalıktır. Bu durum sosyal izolasyon, psikolojik rahatsızlık, fiziksel aktivitelerden kaçınma ve seksüel disfonksiyonla ilişkilidir. SÜİ’nin tedavisinde konservatif, medikal tedavi ve cerrahi yer almaktadır. Stres üriner inkontinansın tedavisi bireyselleştirilmelidir. Medikal tedavi, cerrahi olmak istemeyen ya da cerrahinin kontraendike olduğu kadınlarda alternatif bir seçenek olabilir. Ameliyat olamayan ya da ameliyatı istemeyen hastalar için de cerrahi dışı yöntemler bir seçenek olabilmektedir. Cerrahi dışı tedavi seçeneklerinden birisi de farmakoterapidir. Alfa reseptör agonitleri, beta reseptör agonistleri, beta reseptör antagonistleri, trisiklik antidepresanlar, antikolinerjikler, serotonin-adrenalin geri alım inhibitörleri ve östrojenleri içeren çeşitli ilaçlar kullanılmaktadır. Bu ilaçlar içerisinde SÜİ tedavisi için onay alan tek ilaç duloksetindir. Bu derlemede diğer ajanlarla birlikte duloksetin tedavisinin özellikleri ve dikkat edilmesi gereken noktalar ele alınmıştır.

Anahtar Kelimeler:

Stres üriner inkontinans, farmakoterapi, duloksetin

Pharmacotherapy For Stress Urinary Incontinence In Women

Urinary incontinence is a widespread debilitating and distressing condition in women and generally under-reported and undertreated. Stress urinary incontinence SUI is the most common type of incontinence.This condition is associated with social isolation, psychological impairement, restriction of physical activities and sexual dysfunction. Treatment options for SUI include conservative, medical treatment and surgery.Treatment of SUI should be individualized.Pharmacotherapy may be alternative options in womenwho do not wish to undergo a surgery or whose the surgery is contraindicated. Various drugs, including alpha receptor agonists, beta receptor antagonists, serotonin-adrenaline re-uptake inhibitors, and estrogen have been used. Among these agents, duloxetine is the only drug that has obtained approval for the treatment of SUI. In this review, the features of duloxetine therapy together with the other agents and the important aspect to be considered are discussed.

Keywords:

Stress urinary incontinence, pharmacotherapy, duloxetine,

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