İNTRAVEZİKAL ONABOTULİNUM TOKSİN A TEDAVİSİNİN AŞIRI AKTİF MESANE HASTALARINDA YAŞAM KALİTESİ ÜZERİNE ETKİSİ

Year 2023, Volume: 86 Issue: 2, 109 - 116, 30.03.2023

Tuğçe Arslanoğlu , Cenk Yaşa , Funda Güngör Uğurlucan

https://doi.org/10.26650/IUITFD.1218714

Abstract

Amaç: Aşırı aktif mesane (AAM), kadınlarda oldukça sık görülen ve hayat kalitesini olumsuz etkileyen bir sendromdur. Çalışmamızın amacı; tedaviye dirençli AAM sendromu olan hastalarda intravezikal onabotulinum toksin A enjeksiyonunun hastaların hayat kalitesine ve üriner semptomlarına olan etkisini değerlendirmektir. Gereç ve Yöntem: Çalışmaya medikal tedaviye dirençli toplam 20 hasta dahil edildi. Hastalara 1:1 oranda salin ile sulandırılıp 100 Ünite onabotulinum toksin A kullanılarak 20 farklı noktaya, mesane trigonundan kaçınılarak enjeksiyon yapılmıştır. Hastaların yaşam kalitelerini belirlemek için kullanılan “King Sağlık Anketi (KHQ), Ürogenital Distres Envanteri kısa formu (UDI 6), İnkontinans Etki Anketi kısa formu (IIQ 7), ICIQ-FLUTS, Kadın Cinsel Fonksiyon Endeksi formu (FSFI), Pelvik Organ Prolapsusu/ Üriner İnkontinans Sorgulama formu (PISQ-12)” anketlerin tedavi öncesi ve tedavi sonrası sonuçları değerlendirilmiştir. Bulgular: Tedavi öncesi ve sonrası üroflowmetri parametrelerinden maksimum idrar akım hızında anlamlı azalma izlendi. Tedavi öncesi ve sonrası yapılan KHQ skorlarının değerlendirilmesinde kişiler arası ilişkiler dışında tüm skorlarda anlamlı azalma izlendi. Tedavi öncesi ve sonrası FSFI skorları değerlendirildiğinde anlamlı bir değişiklik olmadığı izlendi. Ancak, diğer yaşam kalite anketleri olan UDI-6, IIQ-7, ICIQ-FLUTS ve PISQ-12’de anlamlı bir azalma olduğu ve yaşam kalitesinde olumlu değişim olduğu izlendi. Sonuç: Medikal tedaviye dirençli aşırı aktif mesane sendromu olan hastalarda; intravezikal onabotulinum toksin A enjeksiyonunun kısa dönem sonuçları değerlendirildiğinde hastaların semptom, şikayetlerini azaltmış ve hastaların hayat kalitelerini olumlu yönde arttırmıştır. Bizim hasta grubumuzda komplikasyon gelişmemiş olsa da enfeksiyon ve rezidü idrar artışına bağlı kateterizasyon görülebilmektedir. Medikal tedaviye yanıt alınmayan AAM tedavisinde intravezikal onabotulinum toksin A enjeksiyonu ucuz, kolay uygulanabilir ve ciddi yan etkisi olmayan bir tedavi seçeneği olduğu düşünmekteyiz.

Keywords

Aşırı aktif mesane, onabotulinum toksin A, üriner retansiyon, aciliyet hissi

Supporting Institution

Yok

Project Number

Yok

THE EFFECT OF INTRAVESICAL ONABOTULINUM TOXIN A TREATMENT ON QUALITY OF LIFE IN PATIENTS WITH OVERACTIVE BLADDER

Abstract

Objective: Overactive bladder (OAB) syndrome is common in women and negatively affects their quality of life. Our study aimed to evaluate the effect of intravesical onabotulinum toxin A injection on quality of life and urinary symptoms in patients with treatment resistant OAB syndrome. Material and Method: The treatment records of 20 patients with treatment-resistant OAB were reviewed. The patients were injected with a 1:1 solution of saline and 100 units of onabotulinum toxin A at 20 different points on the body, avoiding the bladder trigon. The following survey instruments were used to determine the patient’s quality of life before and after treatment: the King’s Health Questionnaire (KHQ), the short-form Urodistress Inventory (UDI 6), the short-form Incontinence Impact Questionnaire (IIQ 7), the International Consultation on Incontinence Questionnaire Female Lower Urinary Tract Symptoms Modules (ICIQ FLUTS), the Female Sexual Function Index (FSFI), and the Pelvic Organ Prolapse/Urinary Incontinence Inquiry form (PISQ-12). The pre-and post-treatment results of the questionnaires were then evaluated. Result: The uroflowmetry parameters indicated that the patients’ maximum urine flow rate decreased significantly after treatment, as did their KHQ scores on all but one item. Evaluation of their FSFI scores indicated no significant change after treatment; however, the other quality of life questionnaires used (UDI-6, IIQ-7, ICIQ-FLUTS, and PISQ-12) revealed significant decreases, indicating an improvement in quality of life. Conclusion: When the patients’ short-term results were evaluated, it was found that this therapy reduced their symptoms and complaints, thus improving their quality of life. Although none of the patients in the sample group experienced complications, in some cases catheterization is necessary due to infection and increased residual urine. Intravesical onabotulinum toxin A injection is a cheap and easy-to-administer treatment for OAB that has not responded to other treatments and does not cause serious side effects.

Keywords

Overactive bladder, Onabotulinumtoxin A, Urinary Retention, Urgency

Project Number

Yok

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