Pelvik Organ Prolapsusu Olan Hastaların Konuma Özgün Prolapsus Redüksiyonu Yapılarak Ürodinami Sonuçlarının Karşılaştırılması

Amaç: Evre 2 ve üzerinde prolapsusu olan hastaların prolabe olan kompartmanın lokal redüksiyonu ile okült inkontinans oranını saptamak. Gereçler ve Yöntem: Eylül 2014 ve Şubat 2015 tarihleri arasında pelvik organ prolapsusu tanısı konan 65 hasta çalışmaya alındı. .Hastalara ürodinami yapıldı ve aynı zamanda hayat kalitesi sorgu formlarından UDI-6, IIQ-7, PISQ-12 ve PQoL anketleri doldurtuldu. Anket sonuçları prolapsus hastaları arasında değerlendirildi. Bulgular: Hastaların %55.4 ‘ü( n: 36) evre 2, %29.2’si (n : 19) evre 3 ve %15.4 ‘ü (n: 10) evre 4 prolapsusu vardı.Prolapsusu olan hastaların 4 tanesinde ( % 6.2) aşikar üriner inkontinans saptandı. İnkontinansı olmayan hastalarda ise spekulum ve ring forceps ile yapılan lokal redüksiyon sonrası okült inkontinans oranı %18.5, peser ile redüksiyon sonrası ise okült inkontinans oranı % 24.6 olarak saptandı.Ürodinamik parametrelerden ise her iki grup Pdet Qmax, Qmax, Qave, Qmax (liverpol), Qave ( liverpol),PVR açısından değerlendirildi, İstatistksel olarak her iki grup arasında anlamlı bir fark saptanmadı.( p>0.05). Prolapsus lokalizasyonu açısından da her iki grup arasında istatistiksel olarak anlamlı fark saptanmadı. Hayat kalitesi değerlendirme formları yapılmış olan diğer çalışmalar ile tutarlılık göstermesine rağmen her iki grup arasında İstatistiksel olarak anlamlı bir fark saptanmadı. Sonuç: Üriner inkontinans ile pelvik organ prolapsusu sıklıkla bir arada bulunabilir. Ciddi prolapsusu olan hastalarda okült inkontinans bulunabilir. Bu nedenle pelvik organ prolapsusu nedeni ile cerrahi tedavi planlanan hastaların preoperatif dönemde ürodinamik olarak ayrıntılı şekilde değerlendirilmesi gerekmektedir.

Comparision of Urodynamic Results of Patients Who Had Reduced Pelvic Organ Prolapse According to Position

Objective: Detection of occult incontinence proportion inpatients who have pelvic organ prolapse quantitation system [POP-Q] stage II to IV with reducting of prolapse compartment. Material and Methods: 2015.A total of 65 cases who had stage II to IV pelvic organ prolapse, patients with stage I prolapse were excluded. Occult incontinence rates was detected and urodynamic parameters were compared. Before the urodynamic study patients were answered the questionnaire about quality of life such as UDI-6, IIQ-7, PISQ-12 ve PQoL. Results: %55.4 ( n:36) of the patients had stage II, %29.2 ( n:19) of them hade stage III and %15.4 ( n: 10) of them had stage IV pelvic organ prolapsus. Four of women who had prolapse (%6.2) were also having evidant urinary incontinece.% 18.5 of patients had occult incontinence after reduction with speculum,and % 24.6 of patients had also occult urinary incontinence after passary reduction among the patients who hadn’t incontinece. But between this two group, there was not anystatistically significant difference in term of urodynamic parameters such as grup Pdet Qmax, Qmax, Qave, Qmax (liverpol), Qave ( liverpol),PVR ( p>0.05).And also between two groups there was not any statistically significant difference in terms of prolapse localization. Results of this questionnaire were similar with previous study,but there were not any statistically significant difference between reduction with speculum and pessary. Conclusion: Pelvic organ prolapse (POP) and urinary incontinence (UI) are common conditions.But patients who had serious prolapse have occult incontinence also. So Urodynamic testing is helpful when the diagnosis of urinary occult incontinence is unclea. Before prolapse surgery treatment patients should be evaluated in detail.

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