Ürodinamik incelemelerinde dolum fazında detrüsör aşırı aktivitesi ve boşaltım fazında işeyememe saptanan hastaların etyolojilerinin retrospektif incelenmesi
Küçük Resim Yok
Tarih
2025
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Yayıncı
Tekirdağ Namık Kemal Üniversitesi
Erişim Hakkı
info:eu-repo/semantics/openAccess
Özet
AMAÇ: Ürodinamik inceleme sırasında dolum fazında DAA ve boşaltım fazında işeyememe saptanması paradoksal bir durum olarak gözüküp nörojenik veya non-nörojenik etyolojik sebeplerden dolayı olabilir. Bizim çalışmamızda amaç bu duruma neden olabilecek patolojileri irdelemek ve özellikle nörolojik tanıları bulunan hastalarda bu duruma neden olabilecek faktörleri araştırmaktır. YÖNTEM: Çalışmamız için TNKÜ Üroloji ABD'ye başvuran ve 2010-2024 yılları arasında ürodinamik inceleme yapılan 4317 hastanın ürodinami verileri retrospektif olarak değerlendirildi. DAA + işeyememe saptanan 324 hasta dahil edildi. Bu hastaların nörolojik tanıları incelendi ve en sık görülen 5 nörolojik tanı belirlendi. Ardından bu tanılara sahip 1131 hastanın ürodinamik inceleme verileri incelendi. Hasta gruplarının demografik verileri ve ürodinamik inceleme verileri değerlendirildi. BULGULAR: DAA + işeyememe saptanan 324 hastanın verileri incelendiğinde, 234 hastanın nörojenik bir tanısının mevcut olduğu tespit edildi. Bu grupta en sık tanı SKH daha sonra sırasıyla SVO, MS, PH ve SB tespit edildi. SKH grubunda travmadan etkilenen spinal kord segmentine göre ürodinamik bulguların değiştiği tespit edilmiş, DAA + arefleksi birlikteliği daha sık olarak T6 vertebra seviyesinin altındaki yaralanmalarda tespit edilmiştir. SVO'nun hemorajik veya iskemik olmasının ürodinamik inceleme bulgularını etkilemediği tespit edilmiştir, ancak SVO'dan etkilenen lokasyon ile ürodinami bulgularının değişebileceği tespit edilmiştir. MS hastalarında ürodinamik inceleme bulguları oldukça değişken tespit edilmiştir. PH hastalarında DAA en sık rastlanan ürodinamik bulgu olarak tespit edilmiştir. SB hastalarında arefleksif detrüsör doğuştan itibaren görülmekte olup bu hastalarda erken dönemden itibaren TAK kullanımı ile üst üriner sistemin korunması sağlanabilir. SONUÇ: Nörojenik tanısı olan hasta gruplarının takibinde ürodinamik inceleme bulgularının zamanla değişebileceği gösterilmiştir. Hastaların etkilenen santral sinir sistemi lokasyonuna göre ürodinami bulguları değişkenlik gösterebilir.
OBJECTİVE: Detection of DO in the filling phase and inability to void in the voiding phase during urodynamic study may seem like a paradoxical situation and may be due to various neurogenic or non-neurogenic reasons. The aim of our study is to examine the pathologies that may cause this situation and to investigate the factors that may cause this situation, especially in patients with neurological diagnoses. METHODS: For our study, urodynamic study data of 4317 patients who applied to TNKU Urology Department and underwent urodynamic study between 2010-2024 were evaluated retrospectively. 324 patients with DO + inability to urinate were included. The neurological diagnoses of these patients were examined and the 5 most common neurological diagnoses were determined. Then, urodynamic examination data of 1131 patients with these diagnoses were examined. Demographic data and urodynamic examination data of the patient groups were evaluated. RESULTS: When the data of 324 patients with DO + inability to urinate were examined, it was determined that 234 patients had a neurogenic diagnosis. The most common diagnosis in this group was SCI, followed by CVO, MS, PD and SB. It was determined that urodynamic study findings varied according to the spinal cord segment affected by the trauma in the SCI group, and the association of DO + areflexia was more frequently detected in injuries below the T6 vertebral level. It was determined that whether the CVO was hemorrhagic or ischemic did not affect the urodynamic examination findings, but it was determined that urodynamic findings could change with the location affected by the CVO. Urodynamic study findings were found to be quite variable in MS patients. DO was found to be the most common urodynamic finding in PD patients. Areflexive detrusor is seen from birth in SB patients, and in these patients, protection of the upper urinary system can be achieved with the use of CIC from the early period. CONCLUSION: It has been shown that urodynamic examination findings may change over time in the follow-up of patient groups with a neurogenic diagnosis. Urodynamic findings may vary depending on the affected central nervous system location of the patients. Key words: Urodynamics, detrusor overactivity, areflexive detrusor, neurogenic bladder
OBJECTİVE: Detection of DO in the filling phase and inability to void in the voiding phase during urodynamic study may seem like a paradoxical situation and may be due to various neurogenic or non-neurogenic reasons. The aim of our study is to examine the pathologies that may cause this situation and to investigate the factors that may cause this situation, especially in patients with neurological diagnoses. METHODS: For our study, urodynamic study data of 4317 patients who applied to TNKU Urology Department and underwent urodynamic study between 2010-2024 were evaluated retrospectively. 324 patients with DO + inability to urinate were included. The neurological diagnoses of these patients were examined and the 5 most common neurological diagnoses were determined. Then, urodynamic examination data of 1131 patients with these diagnoses were examined. Demographic data and urodynamic examination data of the patient groups were evaluated. RESULTS: When the data of 324 patients with DO + inability to urinate were examined, it was determined that 234 patients had a neurogenic diagnosis. The most common diagnosis in this group was SCI, followed by CVO, MS, PD and SB. It was determined that urodynamic study findings varied according to the spinal cord segment affected by the trauma in the SCI group, and the association of DO + areflexia was more frequently detected in injuries below the T6 vertebral level. It was determined that whether the CVO was hemorrhagic or ischemic did not affect the urodynamic examination findings, but it was determined that urodynamic findings could change with the location affected by the CVO. Urodynamic study findings were found to be quite variable in MS patients. DO was found to be the most common urodynamic finding in PD patients. Areflexive detrusor is seen from birth in SB patients, and in these patients, protection of the upper urinary system can be achieved with the use of CIC from the early period. CONCLUSION: It has been shown that urodynamic examination findings may change over time in the follow-up of patient groups with a neurogenic diagnosis. Urodynamic findings may vary depending on the affected central nervous system location of the patients. Key words: Urodynamics, detrusor overactivity, areflexive detrusor, neurogenic bladder
Açıklama
Anahtar Kelimeler
Üroloji, Urology, Ürodinami, detrüsör aşırı aktivitesi, arefleksif detrüsör, nörojen mesane
