EYÜP BURAK SANCAK, Alpaslan AKBAŞ, Cabir ALAN, AHMET REŞİT ERSAY

Enurezisli erişkin hastalarda biofeedback tedavisinin etkinliği

Amaç: Çalışmanın amacı; primer monosemptomatik enurezisli MsE erişkinlerde, biofeedback tedavisinin etkinliğini araştırmaktır. Gereç ve Yöntemler: Prospektif dizaynlı bu çalışmada, primer MsE’li erişkin hastalar çalışmaya dahil edildi. Nörojen mesaneli, gündüz işeme problemi olan, anatomik anomalisi olan ve enurezisle ilişkili başka hastalığı olan hastalar çalışmaya alınmadı. Kriterlere uyan 13 hastanın demografik verileri kaydedildi. Biofeedback öncesinde ve tedavinin bitiminden sonra 3. ayda, hastaların enurezis sıklıkları, üroflovmetri değerleri, rezidüel idrar miktarları PVR ve total mesane hacmi TMH işeme hacmi + PVR değerlendirildi. Biofeedback tedavinin başarısı, ayda bir kez veya daha az gece ıslatması olarak tanımlandı. Bulgular: Altı erkek ve yedi kadını içeren toplam 13 hastanın yaş ortalaması 29.2 ± 8.2 idi. Biofeedback tedavisi öncesinde aylık enurezis sıklığı 23.4 ± 5.9 iken, tedavi sonrasında 5.2 ± 8.9 olarak hesaplandı p=0.002 . Biofeedback tedavisi öncesi ve sonrasında; PVR, maksimum idrar akım hızı Qm ve ortalama akım hızı Qa açısından fark saptanmadı. Biofeedback tedavisi sonrası, TMH’nin 277.8 ml’den 329.9 ml’ye yükseldiği belirlendi p=0.001 . Sonuç: Primer MsE olan erişkin hastalarda biofeedback tedavisi, güvenli basit ve kolay uygulanabilen bir tedavi seçeneğidir. Mesane kapasitesini artırdığı saptanan bu tedavi, bu özel hasta grubu için önerilebilir.

Anahtar Kelimeler:

Biofeedback, erişkin treatment, which was found to increase TBV, may be recommended for this special patient enurezis, mesane kapasitesi, monosemptomatik enurezis, üroflovmetri

Effectiveness of biofeedback therapy in adult patients with enuresis

Objectives: To investigate the effectiveness of biofeedback therapy for adult patients with primary monosymptomatic enuresis MsE . Material and Methods: In this prospective design study, the adult patients with primary MsE were included in the study. Patients with neuropathic bladder, daytime voiding problems, anatomical pathology and enuresis-related other diseases were excluded from the study. The demographic data of 13 adult patients who meeting the criteria were recorded. The outcomes of enuresis frequency, uroflowmetry parameters, post-void residual urine PVR and total bladder volume TBV voided volume + PVR were evaluated before and at the end of the three month after biofeedback treatment. One or less enuretic night in a month was defined as the success of the biofeedback therapy. Results: Including 6 men and 7 women, the mean age of 13 patients was 29.2 ± 8.2 years. Before biofeedback therapy the incidence of enuresis was 23.4 ± 5.9 monthly , while after treatment this was calculated as 5.2 ± 8.9 p=0.002 . There was no significant difference found between before and after biofeedback therapy in terms of PVR, maximum flow rate Qm and average flow rate Qa . The mean TBV of patients increased from 277.8 ml to 329.9 ml after biofeedback treatment p=0.001 . Conclusion: Biofeedback therapy is a safe, simple and minimally invasive treatment modality in adult patients with primary MsE. This treatment, which was found to increase TBV, may be recommended for this special patient group

Keywords:

adult enuresis, biofeedback, bladder capacity, monosymptomatic enuresis, uroflowmetry,

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