Covid19 pandemisinin gölgesinde inkontinans ve enürezis hakkında retrospektif bir çalışma

Yıl 2022, Cilt: 5 Sayı: 3, 351 - 360, 31.12.2022

Özlem Yüksel Aksoy , Funda Baştuğ

https://doi.org/10.36516/jocass.1175355

Öz

Amaçlar: Üriner inkontinans idrarın istemsiz kaçışıyken enürezis ise uykuda idrar kaçırma anlamına gelmektedir. Enürezis ve/veya inkontinans, ailelerin bir hekimin yardımına ihtiyaç duydukları yaygın sorunlardan biridir. Bu çalışmada, Covid19 pandemisinin başlangıcından itibaren peditrik nefroloji polikliniğine enürezis ve/veya inkontinans nedeniyle başvuran hastaları değerlendirmeyi amaçladık.
Yöntemler: “Organik olmayan enürezis” ve “Üriner inkontinans” ICD kodlarına sahip hastaları retrospektif olarak değerlendirdik. Hastanemizin tıbbi kayıt sisteminde kayıtlı detaylı anamnezi bulunan 204 hasta çalışma grubu olarak seçildi. Hastaların klinik verilerini, laboratuvar ve görüntüleme testlerini hastaları Grup A (primer enürezis nokturna) ve Grup B (disfonksiyonel işeme, sekonder enürezis, mesane ve barsak disfonksiyonu vb diğer enürezis ve inkontinans tipleri) olarak iki gruba ayırarak karşılaştırdık.
Bulgular: 204 hastanın 97’si erkek(%47.5), 107’si kızdı (52.5%). Hastaların ortalama yaşı 9.1 (±3.05) idi. Ortalama tuvalet eğitimi yaşı 2.5 (±0.8) (min-max: 1,5-5) idi. 104 hasta primer enürezis nokturna (%51), 37 hasta (%18.1) disfonksiyonel işeme, 22 hasta (%10.8) sekonder enürezis, 14 hasta (%6.9) enürezis diürna, 12 hasta (5.9%) aşırı aktif mesane olarak tanı aldı. Hastaları Grup A (primer enürezis nokturna) ve Grup B (disfonksiyonel işeme, sekonder enürezis, mesane ve barsak disfonksiyonu vb diğer enürezis ve inkontinans tipleri) olarak iki gruba ayırdık. Grup A’nın ortalama yaşı Grup B ile karşılaştırıldığında anlamlı olarak daha yüksekti (9.57 (± 2.78) vs. 8.67 (±3.27), p=0.036). Grup A’da erkek/kız oranı 61/43 iken Grup B’de erkek/kız oranı 36/64 idi (p<0.001). Aile öyküsü Grup A’da daha belirgindi (%72 vs %31) ( p<0.001). Grup B’de hastaların %25’inde en az bir semptomatik idrar yolu enfeksiyonu öyküsü vardı ve bu oran Grup A’dan anlamlı olarak daha yüksekti (p=0.012).
204 hastanın 109’u kontrole geldi (%53). En az bir kontrol viziti olan hastalar arasında tedavi başarısı oranı Grup A ve B’de sırasıyla %82 ve %72 idi.
Sonuç: İnkontinans ve enürezis çocuklarda yaygın görülen sorunlardandır. Nokturnal enürezis ve gündüz inkontinansı arasında özellikleri ve tedavileri açısından belirgin farklılıklar vardır. Enürezis ve inkontinans tedavisi yakın takip gerektirdiğinden genellikle kontrol vizitine ihtiyaç duyarız, ancak hastaların yalnızca %53’ü kontrole geldi. Hastaların ve ailelerinin önemli bir bulaşıcı hastalık ile karşılaştırıldığnda “daha az önemli” görünen bu şikayetler için hastaneye başvurmaktan çekinmiş olabileceği gerekçesiyle bu düşük kontrol oranının, Covid19 pandemisiyle ilişkili olabileceği düşünüldü.

Anahtar Kelimeler

Covid19, inkontinans, enürezis, alt ıslatma

A retrospective study about incontinence and enuresis in the shadow of Covid19 pandemic

Öz

Aim: Enuresis and/or incontinence are one of the most common problems that families seek professional help. In this study we wanted to evaluate the patients who applied to pediatric nephrology outpatient clinics with enuresis and/or urinary incontinence during Covid19 pandemic.
Methods: We retrospectively evaluated the patients with the ICD diagnoses of “Non-organic enuresis” and “Urinary incontinence”. The data regarding two hundred and four patients were analyzed and compared via dividing them into two groups as Group A (Primary enuresis nocturna) and Group B (other enuresis and incontinence types such as dysfunctional voiding, secondary enuresis, bladder and bowel dysfunction etc.).
Results: Mean age was significantly higher in Group A when compared with Group B (9.57 (± 2.78) vs. 8.67 (±3.27), p=0.036). In Group A male/female ratio was 61/43, in Group B male/female ratio was 36/64 (p<0.001). Family history was more prevalent in Group A (72% vs 31%) (p<0.001). In Group B, 25% of the patients had a history of at least one symptomatic urinary tract infection, and it is significantly higher than Group A (p=0.012). One-hundred and nine over 204 patients had applied for a control visit (53%). Overall treatment success rate in patients having at least one control visit was 82% and 72% in Group A and B respectively.
Conclusions: Urinary incontinence and enuresis are common problems in children. There are certain differences between nocturnal enuresis and day time incontinence in terms of their characteristics and the treatments as well. We usually demand a control visit since the treatment of enuresis and incontinence requires close follow-up, however only 53% of the patients applied for a control visit. This low rate of control visit might be attributed to the Covid19 pandemic since patients and families might have avoided to apply to hospitals with this “less serious” complaints when compared with an important contagious disease.

Anahtar Kelimeler

Covid19, enuresis, incontinence, bed-wetting

Kaynakça

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