Hasan S SAĞLAM

Multiple system atrophy and lower urinary system

Multi sistem atrofisi MSA Parkinson hastalığına benzeyen fakat klinik olarak daha ağır, erken başlayan, morbidite ve mortalitesi daha yüksek bir nörodejeneratif hastalıktır. Hastalığın alt üriner sistem semptomları tüm klinik belirtilerden önce başlayabilir. Hastalık alt üriner sistemi etkileyerek noktüri, pollaküri ve mesanenin inkomplet boşalmasının da aralarında bulunduğu bir çok şikayete neden olduğundan ürolojik açıdan ayrıca önem taşımaktadır. Benign prostat hastalığı BPH ile benzer yaşlarda başladığı için yanlışlıkla şikayetler BPH’ya bağlı zannedilip medikal tedaviye cevap vermeyen obstrüktif bulguları için hasta cerrahiye gidebilir. Bu durum hastaların şikayetlerinin kötüleşmesine, hasta ve hekimin memnuniyetsizliğine neden olabilmektedir. O nedenle ürolog, bazen ilk ve en belirgin şikayetler olan obstrüktif alt üriner sistem şikayetlerinin MSA’ya bağlı olmadığından veya hastada MSA olmadığından emin olmalıdır

Anahtar Kelimeler:

Benign prostat hiperplazisi, multisistem atrofisi, Parkinson hastalığı

Multi sistem atrofisi ve alt üriner sistem

Multiple system atrophy MSA is similar to Parkinson’s disease but it is more severe, early onset neurodegenerative disease and has a higher morbidity and mortality. The symptoms of the disease for lower urinary system may be seen before symptoms of other systems develope. Because the disease causes a lot of complaints including nocturia, frequency and incomplete emptying of the bladder by means of its degenerative effect on lower urinary system, it has a particular importance for urology. Due to similarities in respect of symptoms and findings to prostatic obstruction, some times the patients may be misdiagnosed as having benign prostatic hyperplasia BPH and consequently undergo prostatic surgery when medical treatment suggested to be inadequate. This event may cause the patients’ complaints worsen and result in distressing outcomes for both patients and urologists. Therefore urologist should be sure if obstructive symptoms that sometimes are the only and preceding symptoms of MSA, resulted from BPH or be sure the patient has no MSA actually

Keywords:

Benign prostate hyperplasia, multiple system atrophy, Parkinson’s disease,

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