Yeni Açılan Enürezis Polikliniğinden Ön Çalışma Sonuçları
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Tarih
2014
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info:eu-repo/semantics/openAccess
Özet
Amaç: Enürezis (EN) polikliniğinde son bir yılda izleme alınan ve Türkiye Enürezis Kılavuzu (TEK) rehberliğinde tedavisi yapılan hastaların sonuçlarını değerlendirmek amacıyla ileriye dönük bir çalışma planlanmıştır. Gereç ve Yöntemler: EN polikliniğimize başvuran hastaların demogra? k özellikleri, şikayetleri, ? zik inceleme-laboratu- var tetkik sonuçları, uygulanan tedaviler ve takip sonuçları ileri dönük olarak kaydedilmiştir. Bulgular: Olguların yaş ortalaması 8.592.53dır (N59). Erkek/kız oranı 2,9/1dir. Tüm olgular primer ENdir. 38 olguda yalnız gece altını ıslatma şikayeti varken, 21 olguda (%35.6) gündüz semptomu da vardır. Haftada ortalama altını ıslatma sıklığı 5.541.7 gündür. Olguların 21i (%35.6) günde 8den fazla, 7si (%11.9) 3den az idrar yapıyorlardı. Olguların %57.6sında (n34) yetişememe, %49.2sinde (n29) idrar tutma manevrası, %6.8sinde (n4) zorlanma, %18.6sında (n11) idrar yolu enfeksiyonu (İYE) öyküsü, %32.2inde (n19) kabızlık vardı. Fizik inceleme bir olgu dışında normaldi. Tümünde idrar tetkiki normaldi. USG istenen 20 olgunun hiçbirinde patolojik bulgu saptanmadı. Ürodinami yapılan 9 olgunun 4inde aşırı aktif detrusör, 5inde düşük kapasite, 2inde artmış kapasite, 4ünde artmış detrüsör aktivitesi vardı. Üro? ovmetre yapılan 12 olgunun birinde kesintili işeme, birinde Crede manevrası ile işeyebilme vardı. Tüm olgularda davranış düzenlenmesi yapılmış; olguların 20ine desmopressin, 4üne oksibutinin, 1ine alarm, 1ine temiz aralıklı kate- terizasyon, 14üne kombine tedavi başlanmıştır. Tedavinin 15. gününde yapılan ilk kontrolde 18 olgu görülmüş, tedavi cevabı %6625.3 bulunmuştur. Bunların yarısında tedaviye devam edilirken, yarısında desmopressin dozu arttırılmıştır. Birinci ayda kontrolüne gelen 16 olgunun 12sinde tedaviye devam edilmiş, 2inde desmopressin dozu arttırılmış, 2inde tedaviye oksibutinin eklenmiştir. Üç ay tedavisi tamamlanan 7 olgunun 1inde nüks nedeniyle kombine tedaviye yeniden başlanmıştır. Sonuç: Enürezis tedavisi, aile uyumunun önemli rol oynadığı zahmetli bir süreç gerektirmektedir. Çalışmamızdaki olgu- ların yalnız %30.5i takiplere gelebilmiştir. Tedavi etkinliğini değerlendirmek için randomize-kontrollü çalışmalar gerek- mektedir.
Objective: The aim of the study is to evaluate the results and prognosis of the patients admitted to our new enuresis clinic in the last year and managed according to the Turkish Enuresis Guide. Material and Methods: The demographic features, symptoms, physical examination and laboratory fi ndings, treatment modalities, and treatment results of the patients were recorded prospectively. Results: The mean age (N59) of the patients was 8.59±2.53 years. The male/female ratio was 2,9/1. Twenty-one cases (35.6%) had daytime symptoms. Enuresis frequency per week was 5.54±1.7 days. Voiding frequency per day was more than 8 times in 21 cases (35.6%), and less than 3 times in 7 cases (11.9%). There was urgency in 34 (57.6%) patients, holding maneuvers were used in 29 (49.2%), straining was observed in 4 (6.8%) cases, urinary tract infection (UTI) was present in 11 (18.6%) cases, and there was constipation in 19 (32.2%) cases. Physical examination fi ndings were normal in all except one patient. Urinalysis and ultrasonography was normal in all patients. Urodynamic study was performed in 9 cases, revealing over-active detrusor in 4 cases, low capacity in 5 patients, increased capacity in 2 cases and hyperactive detrusor in 4 patients. Urofl owmeter measurements were performed in 12 cases showing 1 staccato voiding, and 1 voiding with Crede maneuver case. Behavioral modifi cations were used in all cases, and desmopressin therapy was initiated in 20 cases, oxybutynin therapy in 4 patients, alarm therapy in one case, clean intermittent catheterization in 1 patient, and combined therapy in 14 patients. Treatment effectiveness was 66±25.3% in 18 cases on the 15th day and desmopressin dosage was increased in half of this group. Treatment was continued in 12 cases, the desmopressin dosage was increased in 2 patients, and oxybutynin was added in 2 of 16 cases at the 1st month. Only 1 of 7 cases at the 3rd month had recurrence and was prescribed combined therapy. Conclusion: The management of enuresis is a diffi cult process in which compliance of the families plays a major role. Only 30.5% of cases came for follow-up in the present study. Randomized controlled studies are needed to evaluate the effectiveness of enuresis treatment.
Objective: The aim of the study is to evaluate the results and prognosis of the patients admitted to our new enuresis clinic in the last year and managed according to the Turkish Enuresis Guide. Material and Methods: The demographic features, symptoms, physical examination and laboratory fi ndings, treatment modalities, and treatment results of the patients were recorded prospectively. Results: The mean age (N59) of the patients was 8.59±2.53 years. The male/female ratio was 2,9/1. Twenty-one cases (35.6%) had daytime symptoms. Enuresis frequency per week was 5.54±1.7 days. Voiding frequency per day was more than 8 times in 21 cases (35.6%), and less than 3 times in 7 cases (11.9%). There was urgency in 34 (57.6%) patients, holding maneuvers were used in 29 (49.2%), straining was observed in 4 (6.8%) cases, urinary tract infection (UTI) was present in 11 (18.6%) cases, and there was constipation in 19 (32.2%) cases. Physical examination fi ndings were normal in all except one patient. Urinalysis and ultrasonography was normal in all patients. Urodynamic study was performed in 9 cases, revealing over-active detrusor in 4 cases, low capacity in 5 patients, increased capacity in 2 cases and hyperactive detrusor in 4 patients. Urofl owmeter measurements were performed in 12 cases showing 1 staccato voiding, and 1 voiding with Crede maneuver case. Behavioral modifi cations were used in all cases, and desmopressin therapy was initiated in 20 cases, oxybutynin therapy in 4 patients, alarm therapy in one case, clean intermittent catheterization in 1 patient, and combined therapy in 14 patients. Treatment effectiveness was 66±25.3% in 18 cases on the 15th day and desmopressin dosage was increased in half of this group. Treatment was continued in 12 cases, the desmopressin dosage was increased in 2 patients, and oxybutynin was added in 2 of 16 cases at the 1st month. Only 1 of 7 cases at the 3rd month had recurrence and was prescribed combined therapy. Conclusion: The management of enuresis is a diffi cult process in which compliance of the families plays a major role. Only 30.5% of cases came for follow-up in the present study. Randomized controlled studies are needed to evaluate the effectiveness of enuresis treatment.
Açıklama
Anahtar Kelimeler
Pediatri
Kaynak
Türkiye Çocuk Hastalıkları Dergisi
WoS Q Değeri
Scopus Q Değeri
Cilt
8
Sayı
1
Künye
Türer, Ö. B., Soyer, T., Özmen, İ., Günal, Y. D., Aslan, M. K. (2014). Yeni Açılan Enürezis Polikliniğinden Ön Çalışma Sonuçları. Türkiye Çocuk Hastalıkları Dergisi, 8(1), 7 - 11.
