Musa SARAÇOĞLU, SACİT NURİ GÖRGEL, HAKAN ÖZTÜRK, Tarık ZENGİN, Mahmoud MUSTAFA

Üriner inkontinansın farklı tiplerinin tedavisinde manyetik sandalye tedavisi

Amaç: Üriner inkontinansın farklı tiplerinin tedavisinde vücut dışı manyetik innervasyon tedavisinin kullanılabilirliğini değerlendirmekGereç ve Yöntemler: Ortalama yaşı 59.76±14.51 olan inkontinans nedeniyle vücut dışı manyetik innervasyon tedavisi alan 88 hasta 44 erkek, 44 kadın çalışmaya dahil edildi. 53 %60 hastada stress inkontinans, 24 %27 hastada mix tip inkontinans, 9 %10 hastada gerçek inkontinans, 2 %3 hastada urge inkontinans saptandı. 31 %35 hastada radikal prostatektomi RP sonrası, 13 %15 hastada transüretral prostatektomi TURP sonrası, 8 %9 hastada doğum sonrası, 35 %40 hastada idiopatik üriner inkontinans saptandı. Hiçbir hastada inkontinans cerrahisi öyküsü yoktu. Tüm hastalar 16 seans terapiyi tamamladı. Her seans 20 dk olarak ve haftada 3 kez yapıldı. Bulgular: Yirmi iki %25 hastada kür, 32 %36 hastada iyileşme, 25 %28 hastada kısmı fayda ve 9 %10 hastada tedavide başarızlık izlendi. Her iki cinsiyet tedaviden fayda gördü. Tedavi öncesi ve sonrası semptom skoru erkeklerde 18.25±2.44 ve 11.80±5.32 p=0.001 , benzer şekilde kadınlarda 16.62±4.67 ve 7.91±5.32 p=0.001 idi. RP ve TURP öyküsü olanlarda tedavi öncesi ortalama semptom skoru 18.00± 2.52 ve 18.15±2.41, tedavi sonrası 12.44±4.82 ve 11.54±5.68 idi p=0.001, 0.001 . Stres veya miks inkontinansta tedavi sonrası anlamlı iyileşme gözlendi; tedavi öncesi semptom skoru 17.38±3.7 ve 17.00±4.38, tedavi sonrası 9.75±5.18 ve 7.83±5.28 p=0.001, p=0.001 idi. Gerçek inkonscore were 12.44±4.82 and 11.54±5.68 respectively p=0.001,0.001 . Patients with stress or mixed types of UI showed significant improvements after therapy; the symptoms scores before therapy were 17.38±3.7 and 17.00±4.38 respectively and after therapy the score became 9.75±5.18 and 7.83±5.28 respectively p=0.001, p=0.001 . Patients with true incontinence had the least benefit of therapy, the symptoms score before and after therapy were 19.33±2.17 and 16.33±4.47 respectively p=0.08 . Conclusion: ExMI therapy offers a safe and feasible treatment modality for UI. This kind of therapy is effective for different types tinans tedaviden en az yarar gördü; tedavi öncesi ve sonrası semptom skoru 19.33±2.17 ve 16.33±4.47 p=0.08 idiSonuç: Vücut dışı manyetik innervasyon tedavisi üriner inkontinans tedavisinde güvenli ve uygulanabilir bir tedavidir. Bu tedavi şekli onkolojik cerrahi dahil çeşitli etiyolojiler nedeniyle meydana gelen üriner inkontinansın farklı tiplerinde etkili bir yöntemdir. Bu yöntemde en az fayda gerçek inkontinansta gözlenmiştir. Daha fazla sayıda ve daha uzun takipli çalışmalarla bu sonuçlar konfirme edilmelidir

Anahtar Kelimeler:

İnkontinans, manyetik sandalye, pelvik taban

Extracorporeal magnetic chair in the treatment of various types of urinary incontinence

Objective: To evaluate the usefulness of extracorporeal magnetic innervations ExMI therapy in the treatment of various types of urinary incontinence UI Material and Methods: Total of 88 patients with mean age of 59.76±14.51 44 male, 44 female who underwent ExMI therapy due UI were included. The patients were diagnosed to have stress UI 53 patients, 60% , mixed UI 24 patients, 27% , true UI 9 patients, 10% and urge UI 2 patients, 3% . Thirty one patients 35% had UI after radical prostatectomy RP , 13 patients 15% had UI after transurethral prostatectomy TURP , 8 patients 9% had UI after delivery and 35 patients 40% were idiopathic. All patients were primary cases without history of anti-incontinence surgery. All patients have completed 16 sessions of therapy. Each session is 20 minutes and done three times a week. The severity of UI was evaluated using 3rd,4th, and 5thquestion from ICIQ-SF. Results: Twenty two patients 25% were cured, 32 36% were improved and 25 28% partially benefited and 9 10% patients had failure of therapy. Both sexes benefited from the therapy; the male score before and after therapy were 18.25±2.44 and 11.80±5.32 respectively p=0.001 , similarly the female scores before and after therapy were 16.62±4.67 and 7.91±5.32 respectively p=0.001 . The mean values of symptoms score before therapy for patients with history of RP and TURP were 18.00± 2.52 and 18.15±2.41 respectively and the post therapeutic score were 12.44±4.82 and 11.54±5.68 respectively p=0.001,0.001 . Patients with stress or mixed types of UI showed significant improvements after therapy; the symptoms scores before therapy were 17.38±3.7 and 17.00±4.38 respectively and after therapy the score became 9.75±5.18 and 7.83±5.28 respectively p=0.001, p=0.001 . Patients with true incontinence had the least benefit of therapy, the symptoms score before and after therapy were 19.33±2.17 and 16.33±4.47 respectively p=0.08 . Conclusion: ExMI therapy offers a safe and feasible treatment modality for UI. This kind of therapy is effective for different types of UI which occurred due to various types etiologies including oncologic surgery. The least benefit of this modality was in patients with true UI. Further studies recruiting larger number of patients with longer follow up period should be carried out to confirm these results

Keywords:

incontinence, magnetic chair, pelvic floor,

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