Kadınlarda görülen anal fissürün medikal tedavi başarısında obstetrik faktörlerin etkisi var mıdır?

Amaç: Bu çalışmanın amacı, kadınlarda görülen anal fissürün medical tedavi başarısında obstetrik faktörlerin etkisinin incelenmesidir. Gereç ve yöntemler: Çalışmaya2015-2020 yılları arasında Genel Cerrahi polilliniğine anal bölge rahatsızlığı nedeni ile başvurup anal fissür tanısı almış 324 kadın dahil edildi. Hastalar iki gruba ayırıldı; grup I (medikal tedavi başarılı) ve grup II (medikal tedavi başarısız - cerrahi yapılan). Her iki grup yaş, vücut kitle indeksi (VKİ), doğum sayısı, doğum şekli, bebek doğum ağırlığı, emzirme oranı, kabızlık, ishal, sigara içme ve anal fissür semptomları açısından karşılaştırıldı. Bulgular: Çalışmamıza aldığımız 324 hastanın tümüne medikal tedavi uygulanmış olup bunlardan %45,7’sinde medikal tedavi başarılıyken, %54,3’ünde ise medikal tedavi başarısız olduğundan dolayı cerrahi tedavi (lateral internal sfinkterotomi) uygulandığı gözlendi. Medikal tedavi başarısız olanlarda yaş, VKİ, doğum sayısı, vajinal doğum sayısı, emzirme oranı, kabızlık oranlarının daha fazla olduğu tespit edildi (p0,05). Cerrahi tedavi uygulananlarda %44,1 gaz inkontinansı görülürken medikal tedaviden yarar görenlerde bu oran %1,4 saptandı. Sonuç: Çalışmamızda gebelik sürecinde oluşan anal fissure medikal tedavi başarısında obstetrik etkenlerden maternal yaş, doğum sayısı, vajinal doğum ve emzirmenin olumsuz yönde etki ettiği görülürken sezaryenle doğum ve bebek doğum kilosunun etkili olmadığı saptandı.

Anahtar Kelimeler:

Anal fissür, gebelik, doğum, obstetrik, medical tedavi

Do obstetric factors have an effect on success of medical treatment of anal fissure seen in women?

Objective: The aim of this study is to examine the effect of obstetric factors on the medical treatment success of anal fissure in women. Material and methods: A total of 324 women, who were diagnosed with anal fissure, who applied to the General Surgery outpatient clinic between 2015 and 2020, were included in the study. The patients were divided into two groups; group I (medical treatment was successful) and group II (medical treatment failed - surgery performed). Both groups were compared in terms of age, body mass index (BMI), number of births, delivery type, birth weight, breastfeeding rate, constipation, diarrhea, smoking and anal fissure symptoms. Results: Medical treatment was applied to all of the 324 patients we included in our study, and it was observed that 45.7% of them had successful medical treatment and 54.3% had undergone surgical treatment (lateral internal sphincterotomy) because of unsuccessful medical treatment. It was found that age, BMI, number of births, number of vaginal births, breastfeeding rate, constipation rates were higher in those who failed medical treatment (p 0.05). While gas incontinence was observed in 44.1% of those who underwent surgical treatment, this rate was found to be 1.4% in those who benefited from medical treatment. Conclusion: In our study, it was found that while maternal age, number of births, vaginal delivery and breastfeeding rates had a negative effect on the success of anal fissure medical treatment, cesarean delivery and baby birth weight were not effective.

Keywords:

Anal fissure, pregnancy, delivery, obstetrics, medical therapy,

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