Stres üriner inkontinansı olan kadınların tedavisinde lokal otolog trombositten zengin plazma (PRP) enjeksiyonunun etkinliği
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Tarih
2022
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Hatay Mustafa Kemal Üniversitesi
Erişim Hakkı
info:eu-repo/semantics/openAccess
Özet
Amaç: Calışmamızda 20 yaş üstü SÜİ olan kadınlarda cerrahi tedaviye alternatif olarak periüretral otolog PRP etkinliğini görmeyi amaçladık. Gereç ve Yöntem: Çalışmaya Ürodinami ile belirlenen SUİ ve Stres ağırlıklı Mikst İnkontinans tanısı alan 36 hasta katıldı. Hastalara başlangıçta ve 1. ay sonunda Cence marka PRP için özel üretilen tüp ile implacer yardımıyla periüretral enjeksiyonu uygulandı. Hastalara başlangıç, 1. ay uygulama ve 3. ay kontrol sonrası Üİ değerlendirme ve yaşam kalite anketleri ( ICIQ-SF , UDİ-6 , IIQ-7) ve Öksürük Stres testi (ÖST) uygulanarak tedavinin etkinliği kontrol edildi. Bulgular: Çalışmaya katılan hastalara uygulanan yaşam kalite anketlerinden ICIQ-SF anketinde 0 dan 21 e doğru semptomların etkilerinin artışını gösteren puanlamada preop ortalama puan 15.36±3.53 ten 3. ay sonunda 10.53±3.52 ye gerilemiştir (p<0,001). İrritatif semptomlar, stres semptomlar, obstrüktif / rahatsız edici ya da işeme güçlüğü oluşturan semptomları gösteren 0-18 arası puanlamanın olduğu UDİ-6 anketinin başlangıç değerinin 11,33±3,64 ten 3. ay sonunda 8.25±3.34 düştüğü gözlenmiştir (p<0,001). Fiziksel ve sosyal olarak 0 dan 21 e doğru kötüleşme etkilerinin gösterildiği IIQ-7 testinde preop 12.50±4.95 ten 8.94±4.34 e azalma izlenerek tüm anketlerde işlem öncesine göre anlamlı düzelme tespit edilmiştir.(p< 0,001). ÖST başlangıçta pozitif olan 35 hastanın 3. ay kontrol sonunda 14 tanesi negatif (%40) olup anlamlı farklılık tespit edildi.(p< 0,001). Sonuç: SÜİ inkontinans tedavisinde PRP uygulamasının invaziv cerrahiye alternatif olabileceği görülmüştür. PRP uygun maliyeti, kısa uygulama süresi, az yan etki profiliyle uygun bir tedavi gibi görünmekle beraber daha fazla hasta ve daha uzun süreli çalışma gereksinimi bulunmaktadır
Objective: We aimed to see the efficacy of periurethral autolog (PRP) as an alternative to surgical treatment in women over 20 years of age with stress urinary incontinence. Materials and Methods Thirty-six patients diagnosed with SUI and Stress-weighted Mixed Incontinence, determined by Urodynamics, participated in the study. PRP was applied to the patients at the beginning and at the end of the first month. The efficacy of the treatment was checked by applying the UI assessment and quality of life questionnaires (ICIQ-SF, UDI-6, IIQ-7) and the Cough Stress test (OST) to the patients at the beginning, the 1st month of application and the 3rd month after the control. Results In the ICIQ-SF questionnaire, one of the quality of life questionnaires used for the individuals participating in the study, the preoperative mean score decreased from 15.36± 3.53 to 10.53±3.52 at the end of the 3rd month, in the scoring that shows the increase in the effects of symptoms from 0 to 21(p<0,001). It was observed that the initial value of the UDI-6 questionnaire, which had a score between 0-18 showing irritative symptoms, stress symptoms, obstructive / disturbing or voiding difficulties, decreased from 11.33±3.64 to 8.25±3.34 at the end of the 3rd month(p<0,001). In the IIQ-7 test, which shows the effects of physical and social deterioration from 0 to 21, a decrease was observed from preop 12.50±4.95 to 8.94±4.34, and a significant improvement was detected in all questionnaires compared to pre-procedure (p< 0.001). Of 35 patients with positive OST at the beginning, 14 of them were negative (40%) at the end of the 3rd month, and a significant difference was detected. (p< 0.001). Conclusıon: It has been observed that PRP application can be an alternative to invasive surgery in the treatment of SUI incontinence. Although PRP seems to be an appropriate treatment with its cost-effective, short application time, and less side-effect profile, more patients and longer-term studies are needed.
Objective: We aimed to see the efficacy of periurethral autolog (PRP) as an alternative to surgical treatment in women over 20 years of age with stress urinary incontinence. Materials and Methods Thirty-six patients diagnosed with SUI and Stress-weighted Mixed Incontinence, determined by Urodynamics, participated in the study. PRP was applied to the patients at the beginning and at the end of the first month. The efficacy of the treatment was checked by applying the UI assessment and quality of life questionnaires (ICIQ-SF, UDI-6, IIQ-7) and the Cough Stress test (OST) to the patients at the beginning, the 1st month of application and the 3rd month after the control. Results In the ICIQ-SF questionnaire, one of the quality of life questionnaires used for the individuals participating in the study, the preoperative mean score decreased from 15.36± 3.53 to 10.53±3.52 at the end of the 3rd month, in the scoring that shows the increase in the effects of symptoms from 0 to 21(p<0,001). It was observed that the initial value of the UDI-6 questionnaire, which had a score between 0-18 showing irritative symptoms, stress symptoms, obstructive / disturbing or voiding difficulties, decreased from 11.33±3.64 to 8.25±3.34 at the end of the 3rd month(p<0,001). In the IIQ-7 test, which shows the effects of physical and social deterioration from 0 to 21, a decrease was observed from preop 12.50±4.95 to 8.94±4.34, and a significant improvement was detected in all questionnaires compared to pre-procedure (p< 0.001). Of 35 patients with positive OST at the beginning, 14 of them were negative (40%) at the end of the 3rd month, and a significant difference was detected. (p< 0.001). Conclusıon: It has been observed that PRP application can be an alternative to invasive surgery in the treatment of SUI incontinence. Although PRP seems to be an appropriate treatment with its cost-effective, short application time, and less side-effect profile, more patients and longer-term studies are needed.
Açıklama
Anahtar Kelimeler
Kadın Hastalıkları ve Doğum, Obstetrics and Gynecology, Stres Üriner İnkontinans, PRP, periüretral enjeksiyon, Stres Ürinary İncontinance, PRP, Periüretral İnjectıon
