Yakup BAYKUŞ, Rulin DENİZ, Ebru ÇELİK KAVAK

Pelvik Organ Prolapsuslu Olgularda Semptomatoloji

Amaç: Pelvik organ prolapsusu nedeniyle vajinal histerektomi yapılan olguların başvuru sırasındaki semptom ve şikayetlerinin incelenmesi. Materyal ve Metot: Ocak 2010-Aralık 2015 tarihleri arasında vajinal histerektomi yapılan pelvik organ prolapsuslu hastaların dosya kayıtlarından semptom ve şikayetleri araştırıldı. Bulgular: Toplam 127 olgunun %22’sinde üriner (n: 28), %8,6’sında seksüel (n: 11), %6,3’ünde defekasyonla ilgili problemler, %15,7’sinde ağrı (n: 20), %36,2’sinde anatomik problemler (n: 46), %10,2’sinde vajende dolgunluk hissi (n: 13) ve bir olguda (%0,8) tekrarlayan tedaviye dirençli vajinal akıntı semptom ve şikayetleri mevcuttu. Sonuç: Pelvik organ prolapsuslu olgular başta anatomik problemler olmak üzere, üriner, seksüel, defekasyonla ilgili problemler ve ağrı şikayetleriyle başvurabilmektedir. Olguların bu şikayetleri açısından sorgulanmaları ve bir bütün halinde değerlendirilmeleri gerekmektedir.

Anahtar Kelimeler:

pelvik organ prolapsusu; semptomatoloji; vajinal histerektomi

Symptomatology in Cases with Pelvic Organ Prolapse

Aim: To investigate the complaints and symptoms of the cases who undergone vaginal hysterectomy because of pelvic organ prolapsus at the administration to the hospital. Material and Method: The symptoms and complaints of the patients who undergone vaginal hysterectomy because of pelvic organ prolapsus between January 2010 and December 2015 were evaluated from file records. Results: 22% of totally 127 case had urinary tract (n: 28), 8.6% sexually (n: 11), % 6.3 defecation problems, % 15.7 had pain (n: 20), 36.2% had anatomical problems (n: 46), 10.2% feeling of fullness in the vagina (n: 13) and in one case (0.8%) recurrent treatment-resistant vaginal discharge was present. Conclusion: The cases with pelvic organ prolapsus had problems and complaints including pain, urinary, sexual, defecation and anatomical problems at the administration. Cases that should be asked for the complaints and the asses as a whole.

Keywords:

pelvic organ prolapsus; symptomatology; vaginal hysterectomy,

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1. Jelovsek J, Maher C, Barber MD. Pelvic organ prolapse. Lancet 2007;369:1027–38.
2. Swift SE, Pound T, Dias JK. Case-control study of etiologic factors in the development of severe pelvic organ prolapse. Int Urogynecol J Pelvic Floor Dysfunct 2001;12:187–92.
3. Gerten KA, Markland AD, Lloyd LK, Richter HE. Prolapse and incontinence surgery in older women. J Urol 2008;179:2111–8.
4. Samuelsson EC, Victor FTA, Tibblin G, Svärdsudd KF. Signs of genital prolapse in a Swedish population of women 20 to 59 of age and possible related factors. Am J Obstetrics Gynecol 1999;180:299–305.
5. Handa VL, Garret E, Hendrix SDO, Gold E, Robbins J. Progression and remission of pelvic organ prolapse: a longitudinal study of menopausal women. Am J Obstetrics Gynecol 2004;190:27–32.
6. Hunskaar S, Burgio K, Clark A. Epidemiology of urinary and fecal incontinence and pelvic organ prolapse. In: Abrams P, Cordozo L, Koury S, Wein A.(Eds). Third international consultation on incontinence, 1st ed. Paris: Health Publication, 2005. p.105–124.
7. Swift S, Woodman P, O’Boyle A, Kahn M, Valley M, Bland D et al. Pelvic Organ Support Study (POSST): the distribution, clinical definition, and epidemiologic condition of pelvic organ support defects. Am J Obstet Gynecol 2005;192:795–806.
8. Samuelsson EC, Victor FT, Tibblin G, Svärdsudd KF. Signs of genital prolapse in a Swedish population of women 20 to 59 years of age and possible related factors. Am J Obstet Gynecol 1999;180:299–305.
9. Swift SE, Tate SB, Nicholas J. Correlation of symptoms with degree of pelvic organ support in a general population of women: what is pelvic organ prolapse? Am J Obstet Gynecol 2003;189:372–7.
10. Olsen AL, Smith VJ, Bergstrom JO, Colling JC, Clark AL. Epidemiology of surgically managed pelvic organ prolapse and urinary incontinence. Obstet Gynecol 1997;89:501–6.
11. Clark AL, Gregory T, Smith VJ, Edwards R. Epidemiologic evaluation of reoperation for surgically treated pelvic organ prolapse and urinary incontinence. Am J Obstet Gynecol 2003;189:1261–7.
12. Ellerkmann RM, Cundiff GW, Melick CF, Nihira MA, Leffler K, Bent AE. Correlation of symptoms with location and severity of pelvic organ prolapse. Am J Obstet Gynecol 2001;185:1332–7. 13. Romanzi LJ. Management of the urethral outlet in patients with severe prolapse. Curr Opin Urol 2002;12:339–44.
14. Bai SW, Jeon MJ, Kim JY, Chung KA, Kim SK, Park KH. Relationship between stress urinary incontinence and pelvic organ prolapse. Int Urogynecol J Pelvic Flor Dysfunct 2002;13:256–60.
15. Handa VL, Harris TA, Ostergard DR. Protecting the pelvic floor: obstetric management to prevent incontinence and pelvic organ prolapse. Obstet Gynecol 1996;88:470–8.
16. Barber M, Walters MB, Bump R. Association of the magnitude of pelvic organ prolapse and presence and severity of symptoms. J Pelvic Med Surg 2003;9:208.
17. Kenton K, Shott S, Brubaker L. The anatomic and functional variability of rectoceles in women. Int Urogynecol J Pelvic Floor Dysfunct 1999;10:96–9.
18. Meschia M, Buonaguidi A, Pifarotti P, Somigliana E, Spennacchio M, Amicarelli F. Prevalence of anal incontinence in women with symptoms of urinary incontinence and genital prolapse. Obstet Gynecol 2002;100:719–23.
19. Handa VL, Harvey L, Cundiff GW, Siddique SA, Kjerulff KH. Sexual function among women with urinary incontinence and pelvic organ prolapse. Am J Obstet Gynecol 2004;191:751–6.
20. Rogers RG, Coates KW, Kammerer-Doak D, Khalsa S, Qualls C. A short form of the pelvic organ prolapse/urinary incontinence sexual questionnaire (PISQ-12). Int Urogynecol J Pelvic Floor Dysfunct 2003;14:164–8.
21. Ozel B, White T, Urwitz-Lane R, Savas A, Durukan H, Kanik A. The impact of pelvic organ prolapse on sexual function in women with urinary incontinence. Int Urogynecol J Pelvic Floor Dysfunct 2006;17:14–7.