Furkan ŞENDOĞAN, Turgay TURAN, Rasim GÜZEL, Özgür EFİLOĞLU, Yavuz Onur DANACIOĞLU, Ramazan Gökhan ATIŞ, Turhan ÇAŞKURLU, Asıf YILDIRIM

Türkiye’deki Ürologların Benign Prostat Hiperplazisi Tedavisindeki Güncel Yaklaşımları

Giriş: Benign prostat hiperplazisi (BPH) hayatı tehdit edici bir hastalık olmasa da uyku kalitesini, psikolojik durumu, günlük aktiviteleri ve seksüel durumu etkileyerek depresyon ve düşük yaşam kalitesi gibi önemli morbiditelere neden olmaktadır. Bu çalışmada ülkemizde aktif çalışan Üroloji hekimlerinin BPH tanı ve tedavisindeki eğilimlerinin incelenmesi amaçlanmıştır. Gereç ve Yöntemler: Güncel Üroloji kılavuzları temel alınarak BPH tanı ve tedavisini kapsayan online web tabanlı 33 soruluk anket oluşturuldu. Türk Üroloji Derneği’ne üye olan ve aktif çalışmaya devam eden hekimlere Ekim 2016 ve Ocak 2017 tarihleri arasında e-mail yoluyla ankete katılım daveti gönderildi. Çalışmaya üroloji asistanları ve emekli ürologlar dahil edilmedi. Bulgular: Çalışmamızda 200 Ürolog 33 sorudan oluşan çoktan seçmeli anketi tamamlamıştır. Katılımcıların %60,5’i uzman, %14’ü yardımcı doçent, %12,5’i doçent ve %13’ü profesör statüsündeydi. Katılımcılar alt üriner sistem semptomları (AÜSS) ile başvuran hastaların %19,5’ine International Prostate Symptom Score (IPSS) sorgulama formunu her zaman uygularken, digital rektal muayeneyi (DRM) her zaman uygulayanların sayısı ise %39’du. Katılımcılara BPH tedavisinde en çok tercih ettikleri alfa bloker sorgulandığında, %33’ü tamsulosin cevabını verirken en çok yan etkinin silodosin ile görüldüğünü belirtti. Katılımcıların %65,5’i BPH’nın endoskopik cerrahi tedavisinde en çok monopolar sistemleri uyguladıklarını belirtirken %62,2’si ise en çok bipolar sistemi tercih ettiklerini belirtti. En az uygulanan ve tercih edilen endoskopik yöntemin ise Diod lazer sistemi olduğu saptandı. Sonuç: Günümüzde endoskopik BPH tedavisinde lazer yöntemler popülerliğini kaybetmiş ve bipolar teknolojiler ise en çok tercih edilen yöntemler haline gelmiştir. Alfa bloker ise BPH’nın medikal tedavisinde hala ilk seçenek olarak tercih edilmektedir.

The Current Approaches of Urologist in Treatment of Benign Prostate Hyperplasia in Turkey

Objective: Although benign prostatic hyperplasia (BPH) is not a life threatening disease, it affects sleep quality, psychological state, daily activities and sexuality, leading to significant morbidities such as depression and low quality of life. In this study, we aimed to investigate the tendency of urologists in our country in the diagnosis and treatment of BPH. Material and Methods: Based on current Urology guidelines, a web-based 33-items questionnaire including BPH diagnosis and treatment was created. Between October 2016 and January 2017, Urologists who are members of the Turkish Urological Association and working actively have been invited to participate by e-mail. Urology residents and retired urologists were not included in the study. Results: In our study, 200 Urologists completed a multiple-choice questionnaire consisting of 33 questions. The participants; 60.5% were specialist, 14% were assistant professors, 12.5% were associate professors and 13% were professors. International Prostate Symptom Score (IPSS) was always performed by %19.5 of participants and digital rectal examination(DRE) was performed by %39 of participants for all the admissions with LUTS. Tamsulasin was the most preferred alfa blocker with the rate of %33 and silodosin was the most accused alfa blocker for side effects by the participants. Monopolar systems were the most used method for surgeries with the rate of %65,5 but bipolar systems were the most preferred method for endoscopic BPH surgical treatments with the rate of %62,2. Diod laser was the least used and preferred method for endoscopic BPH treatment. Conclusion: Laser technology has lost its popularity in recent years and bipolar technologies has become the most preferred method for the endoscopic BPH treatments. Alfa blockers are still used as a first choice for BPH medical treatment.

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