Yılda Arzu ABA, Deniz SARICI, Ramazan ÖZYURT, Bulat Aytek ŞIK

Üriner İnkontinans Tedavisinde Pelvik Taban Egzersizleri Nöromodülasyon-Biofeedback İçin Evde Egzersiz Eğitim Uygulaması Kısa Dönem Sonuçları

Amaç: Bu çalışmada amacımız üriner inkontinans tedavisinde FemiScan Home Trainer (Mega Electronics Ltd., Finlandiya) ile evde pelvik taban kas egzersiz tedavisinin kısa dönem değişikliklerin incelenmesi amaçlanmıştır.Materyal ve Metod: Çalışmamıza ürojinekoloji polikliniğine üriner inkontinans(Üİ) şikayetiyle başvuran ve inkontinansı objektif olarak gösterilebilen, tedavide evde egzersiz eğitimi için FemiScan biofeedback cihazı verilmiş olan 30 kadın hasta dahil edilmiş olup bu hastaların dosyaları retrospektif olarak taranmıştır. Evde egzersiz eğitimini kesintisiz olarak uygulayabilmiş olan hastalar çalışmaya dahil edilmiştir. Ayrıntılı anamnez formu, pelvik taban kuvvet muayenesi bulguları, ürodinamik inceleme kayıtları, doldurmuş oldukları inkontinans anketleri incelenmiştir. Hastaların, üçüncü ay sonundaki kas gücü sonuçları, ürodinami değerleri ve inkontinans anketleri başlangıç değerleri ile karşılaştırılmıştır.Bulgular: FemiScan ile yapılan biofeedback ile pelvik taban kas egzersizi sonuçlarını değerlendirken objeftif kriter olarak EMG amplitüd farkı, MD, VB ve MD/VB farkı dikkate alınmıştır. Bu verilerin istatistiksel analizi sonucu EMG amplitüdünde (p< 0,0001), MD değerlerinde (p< 0,0001) ve MD/ VB oranında da tedavi sonrasında istatistiksel olarak anlamlı olacak şekilde bir artış gözlenmiştir (p< 0,01). VB’da ise tedavi sonrasında anlamlı bir değişiklik izlenmemiştir. Tedavi sonrası hastaların idrara çıkma sayısında ve bir seferde kaçırılan idrar miktarında azalma, idrar akışını durdurabilme yeteneğinde istatistiksel olarak anlamlı bir iyileşme izlenmiştir. Sonuç: Çalışmamız FemiScan (Mega Electronics Ltd., Finlandiya)’ nin Üİ tedavisinde etkin bir yöntem olabileceğini göstermektedir.

Anahtar Kelimeler:

Üriner inkontinans, Overaktif Mesane, nokturi

Home pelvic floor muscle training with electromyographic biofeedback to treatment of the urinary incontinence: A prospective analysis

AbstractAim: Pelvic floor muscle training is an accepted therapy to improve or cure symptoms of urinary incontinence. In this study, examination of short term changes in home treatment of pelvic floor muscle training with FemiScan Home Trainer in treatment of urinary incontinence was aimed. Material and Method: Prospective analysis in a tertiary-level center. 30 female patients admitted to urogynecology polyclinic with complaints of urinary incontinence (UI) who were given FemiScan biofeedback device for home exercise treatment were included in our study. Patients who could apply home exercise training continuously were included in the study. Detailed anamnesis form, pelvic floor force examination findings, urodynamic examination records and incontinence forms they filled were examined. Muscle force results, urodynamic values and incontinence forms of patients at the end of third month were compared to initial values. Results: While evaluating results of pelvic floor muscle exercise with biofeedback performed using FemiScan, Electromyography (EMG) amplitude difference, Bladder fullness (BF), Vesical pressure (VP) and BF/VP difference were taken as objective criteria. In the result of statistical analysis of these data, statistically significant increase was observed in EMG amplitude (P <0.0001), BF values (P <0.0001) and BF/VP ratio after the treatment (P <0.01). No significant change was recorded in VP after the treatment. Number of urinations and amount of urine leaked decreased and statistically significant recovery in ability to stop urine flow were observed. Conclusions: Our study shows that FemiScan (Mega Electronics Ltd, Finland) might be an effective method in UI treatment.

Keywords:

Urinary incontinence; Overactive bladder; Nocturia,

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