Dergiler / Türk Üroloji Dergisi/Turkish Journal of Urology / 2007 / Cilt: 33 - Sayı: 2
Multipl sklerozlu hastalarda uluslararası prostat semptom skoru ve aşırı aktif mesane sorgulaması ile hastalıkla ilgili ölçütler ve yaşam kalitesi arasındaki ilişki
- Sayfa
- 218–222
- DOI
- —
Özet
Bu çalışmada, amacımız Multipl Sklerozlu (MS) hastalarda uluslararası prostat semptom skoru (IPSS) ve aşırı aktif mesane sorgulaması (OAB) ile hastalıkla ilgili ölçütler ve yaşam kalitesi arasındaki ilişkiyi araştırmaktır. MS’li 56 hasta (27 erkek, 29 kadın) ve 40 sağlıklı kontrol (20 erkek, 20 kadın) çalışmaya alındı. Tüm hastalardan ayrıntılı tıbbi öykü alınarak fiziksel inceleme yapıldı. Her hastanın belirtileri, sakatlığı, nörolojik bozukluğu ve genitoüriner yakınmaları ve süreleri kaydedildi. Bu hastalara MS’nin klinik seyrine dayanan detaylı görüşmeyi de içeren tam nörolojik muayene yapıldı. Genişletilmiş özürlülük durum ölçeği (EDSS) ve günlük yaşam aktiviteleri (Barthel) indeksleri, MS yaşam kalitesi sorgulaması (MSQOL-54), IPSS ve OAB-V8 dolduruldu. MS’li hastaların ve kontrollerin ortalama yaşı sırasıyla 35.02±1.38 ve 34.25±1.64 idi. (p>0.05). Ortalama IPSS, MS’lularda 8.42±1.21 ve kontrollerde 2.70±0.50 idi (p 0.05). EDSS skoru düşük ve yüksek olan hasta grupları arasında OAB ve IPSS skorları bakımlarından istatistiksel olarak anlamlı fark saptandı (p<0.05). Üriner semptom skorları, özelikle IPSS hastalığın durumunu yansıtabilir ve nedenle nörolojik durumun değerlendirilmesinde yardımcı olabilir.
Abstract
Introduction: Multiple Sclerosis (MS) is a chronic inflammatory disease of the central nervous system causing great disability. Voiding dysfunction often occurs in patients with MS and severely disturbs the quality of the patient’s life. We aimed to investigate the relationships between international prostate symptom score (IPSS), overactive bladder questionnaire (OAB-V8) and the disease-related parameters in MS patients and life quality of patients. Materials and Methods: In a prospective study, we included 56 consecutive patients (27 male, 29 women) with MS and 40 healthy control patients (20 male, 20 women). Thirty-six patients (64%) was classified as relapsing remittent form, 13 patients (23%) as secondary progressive form, and 7 patients (13%) as primary progressive form of MS. A detailed medical history was taken and detailed neuro-urological examination, urine biochemical studies, and culture, ultrasonography were performed for all patients. Patients’ symptoms, disability, neurologic illness, urinary compliants, and duration of MS were recorded. Expanded disability status scale (EDSS) and Barthel index, multiple sclerosis quality of life questionnaire (MSQOL-54) and IPSS, OAB questionnaires have been assessed. The relation between the IPSS, OAB, and MSQOL-54, EDDS, Barthel scores were investigated. Results: Mean age of patients with MS and controls were 35.02±1.38 and 34.25±1.64, respectively (p>0.05). Mean duration of MS was 5.86±0.69 years. Mean MSQOL-54 physical health score and mental health Score were 60.23±3.11 and 60.80±2.82 in patients with MS, respectively. Mean EDSS score was 3.18±0.25 and Barthel index was 89.71±2.19 in patients with MS. Mean IPSS was 8.42±1.21 in MS patients and was 2.70±0.50 in controls (p<0.05). Mean OAB of MS patients and controls were 11.38±1.43 and 5.78±0.66, respectively (p<0.05). OAB scores were exceed over cut-off values in 25 patients (45%) and IPSS scores were exceed over cut-off values in 24 patients (43%). There was significant correlation between disease related parameters and IPSS, OAB, (p<0.05). MS duration was correlated with only IPSS (p<0.05). OAB and IPSS were correlated with MSQOL-54(p<0.05). Between “relapsing remittent” and “secondary progressive” patients groups, the difference of OAB and IPSS scores were not statistically significant (p>0.05). However, difference of OAB and IPSS scores were statistically significant in between the higher EDSS group and the lower EDDS group (p<0.05). Conclusion: The IPSS and OAB have provided information about voiding dysfunction in MS patients. Duration and disabilities of the disease have deleterious effect on voiding function. Urinary symptom scores, especially IPSS, reflect the condition of the disease. Thus, the quantified urinary symptoms may help to evaluate neurological status.