Tolgay Tuyan İLHAN, Ayşe Gül KEBAPÇILAR, Berat Berrin GENÇOĞLU, Türkan İLHAN, Tansel ÇAKIR, Çetin ÇELİK

RADİKAL JİNEKOLOJİK CERRAHİNİN ÜRİNER İNKONTİNANS’ A ETKİSİ

Amaç: Çalışmanın amacı jinekolojik kanser tedavisinin üriner inkontinans semptomlarına olan etkisinin araştırılmasıdır. Metot: Çalışma endometrium ve over kanseri tanısıyla lenf nodu diseksiyonu geçirmiş 76 hastayı kapsamaktadır. Tedavi öncesi dönemde ürojinekolojik muayene , “ Kadınlarda Üriner İnkontinans Skoru”, Incontinence Impact Questionnaire-7 (IIQ7), Urogenital Distress Inventory-6 (UDI6) anket formları doldurulmuş ve tedavi sonrası 6. Haftada tekrarlanmıştır. Sonuçlar: Katılımcıların ortalama yaşları 57,7±10,5 ve ortalama pariteleri 2,6±1,2 dır. Toplam 44 (%57) hastada muayene ve “Kadınlarda Üriner İnkontinans Skoru” testiyle stres inkontinans, urge inkontinans veya miks inkontinans saptandı. Tedavi öncesinde stres üriner inkontinans, urge inkontinans ve miks inkontinans oranları sırasıyla %52,3, %9 ve %38,7’dir. Yirmi dört (%31) hasta over kanseri tanısıyla ve 52 (%69) hasta endometrium kanseri tanısıyla opere edilmiştir. Operasyonlar sırasında üriner sistem zedelenmesi olmamıştır. Operasyon sonrası 6. haftada üriner inkontinans oranı %71’dir ve fark istatistiksel olarak anlamlıdır (p<,05). Operasyon öncesi ve sonrası IIQ7 ve UDI6 skorları arasında istatistiksel olarak anlamlı artış vardı (p<,05). Anket formları kendi içlerinde değerlendirildiğinde IIQ7 test sonuçlarında fiziksel aktivite ve seyahat skorlarında anlamlı farklılıklar saptandı. Sonuç: Radikal jinekolojik operasyonların üriner inkontinans semptomları üzerinde ciddi olumsuz etkileri vardır. Üriner semptomların hayat kalitesinde olumsuz etkileri vardır. Önleyici yaklaşımlar jinekolojik cerrahi sonrası tüm hastalara önerilmelidir.

Anahtar Kelimeler:

Jinekolojik cerrahi, inkontinans, lenf nodu diseksiyonu

THE EFFECT OF RADİCAL GYNECOLOGİC SURGERY ON URİNARY İNCONTİNENCE

Objectives: The aim of the study was evaluate the effect of gynecologic cancer treatment on urinary incontinence symptoms. Methods: This study includes 76 patients who underwent lymhnode disection surgery for endometrial cancer and ovarian cancer. At preoperative period urogynecologic examination and “Urinary incontinence score for females” test were performed. Preoperative IIQ-7 (Incontinence Impact Questionnaire-7), UDI-6 (Urogenital Distress Inventory-6) and were performed before treatment and at the 6th week after surgery for all patients. Results: The mean age and parity of patients were 57,7 ±10,5 and 2,6 ± 1,2. Total of 44 patients (57%) who were diagnosed stress or urge incontinence by examination or “Urinary incontinence score for females” test. The percentage of stress urinary incontinence and urge incontinence were 52, 3% and 9%. The percentage of mixed incontinence was 38,7%. Twenty four (31%) of 76 procedures were performed for ovarian cancer and 52 (69%) procedures were performed for endometrial cancer. There was no urinary track injury during procedures. The percentage of urinary incontinence at 6th week after surgery was 71% and difference was significant (p<.05).The difference between preoperative IIQ- 7 and UDI-6 score and postoperative IIQ- 7 and UDİ- 6 scores were significantly different (p<.05). When compare the items of IIQ- 7 test, physical activity and travel items were significantly difference. Conclusions: Radical gynecologic surgery has serious adverse effect on urinary incontinence symptoms. Urinary symptoms could impair quality of life after surgery. Preventive approaches should suggest patient early after operation.

Keywords:

: Gynecologic surgery, incontinence, lymphnode dissection,

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