Multipl skleroz ve alt üriner sistem disfonksiyonu: Ürodinamik değerlendirme

Abstract

Poser kriterlerine gore multipl skleroz tanisi almis 24 hastada hastahkla ilgili parametrelerin alt uriner sistem anormallikleri ile iliskisini saptamak igin urodinamik galisma yapildi. Hastalann 13'unde (% 54.2) detrusor hiperrefleksisi, 2'sinde (% 8.3) detrusor hiperrefleksisi ile birlikte detrusor-eksternal sfinkter dissinerjisi, 9'unda (% 37.5) ise normal urodinamik patern belirlendi. Genisletilmis sakathk durum skalasi, reziduel idrar miktan ve hastalik suresi, urodinamik degerlendirmeler sonu|unda patolojik patemler saptanan hasta grubunda anlamli olarak yuksek bulunurken, atak sayisi ve sistometrik kapasite yonunden gruplar arasinda fark saptanmadi. Kadin ve erkek hastalar arasinda urodinamik bulgular yonunden fark yoktu. Sonuc olarak, noroloji unitelerince izlenen, yuksek genisletilmis sakathk durum skala degeri ve uzun hastalik suresine sahip multipl sklerozlu hastalara alt uriner sistem disfonksiyonu agisindan urodinami yapilmah ve Cist uriner sistemin korunmasi igin uygun onlemler erken alinmalidir. Ayrica, uroloji unitelerinin urodinamik galismalan ile vezikouretral disfonksiyon saptanan geng hastalarda multipl skleroz olasiligi gozardi edilmemeli ve noroloji muayenesi istenmelidir.

Multiple Sclerosis And Lower Urinary Tract Dysfunction: Urodynantic Evaluation-Twenty-four patients with multiple sclerosis according to the Poser criteria underwent urodynamic evaluation to determine the relationship between the disease-related parameters and lower urinary tract dysfunction. Urodynamic evaluation revealed detrusor hyperreflexia in 13 patients (54.2 %), detrusor hyperreflexia with detrusor-sphincter dyssynergia in 2 patients (8.3 %) and normal urodynamic findings in 9 patients (37.5 %). Significantly higher expanded dysability status scala and longer duration of disease were evident in groups with abnormal urodynamic findings whereas the attack frequencies and cystometric capacities were similar in both groups. Urodynamic findings were similar in both sexes. In conclusion, multiple sclerosis patients with high disability status scala and longer duration of disease should be urodynamically evaluated to determine a possible lower urinary tract dysfunction and to establish suitable precautions to prevent upper urinary tract deterioration. In addition, young patients with urodynamically abnormal vesico-urethral function must also be evaluated by neurologists for a possible diagnosis of multiple sclerosis.