Publication: Postmenopozal kadınlarda anal inkontinans görülme sıklığı, etiyolojisi ve tedavisinde pelvik taban egzersizlerinin uygulanması
Abstract
Postmenopozal Kadınlarda Anal İnkontinans Görülme Sıklığı, Etiyolojisi ve Tedavisinde Pelvik Taban Egzersizlerinin Uygulanması ÖZET Yaşamı tehdit edici bir durum olmamasına karşın anal inkontinans birey üzerinde sosyal, ekonomik, hijyenik ve duygusal baskı yaratmakta, yaşam kalitesini azaltmaktadır. Bu araştırma, postmenopozal kadınlarda anal inkontinans görülme sıklığını, oluşumundaki etiyolojik faktörleri ve tedavisinde pelvik taban kas egzersizlerinin etkinliğini belirlemek amacıyla yapıldı. Araştırmanın evrenini, 2005-2010 yılları arasında İstanbul ilinde bir üniversite hastanesi menopoz polikliniğine başvuran postmenopozal hastalardan ulaşılabilen 555 kadın oluşturdu. Araştırmanın örneklemi, retrospektif olarak taranan dosyalardan telefon ile ulaşılan 555 kadının istemsiz gaz ya da gaita kaçırma durumu sorgulanarak, anal inkontinans olduğu belirlenen ve çalışmaya katılmayı kabul eden 26 deney ve 26 kontrol olmak üzere toplam 52 postmenopozal kadından oluştu. Veriler yüzyüze görüşme yoluyla araştırmacı tarafından geliştirilen anket formu, fekal inkontinans ciddiyet indeksi (FİCİ), fekal inkontinans yaşam kalitesi ölçeği (FİYKÖ) doldurularak ve anal manometre ölçümü yapılarak toplandı. Deney grubunu oluşturan 26 olgu üç ay süreyle pelvik taban kas egzersizleri uyguladı, kontrol grubu ise inkontinans için herhangi bir tedavi almadı. Üçüncü ayın sonunda tüm ölçümler tekrarlandı. Verilerin analizinde; ortalama, yüzdelik, ki-kare, t-testi, Mann Whitney U, Wilcoxon, lojistik regresyon, korelasyon ve varyans analizi testleri kullanıldı. Araştırma sonucunda postmenopozal kadınlarda anal inkontinans görülme sıklığı % 9.4 olarak belirlendi. Anal inkontinans ile doğum şekli (p=0.00) ve üriner inkontinans (p=0.00) arasında anlamlı bir ilişki olduğu saptandı. 12 hafta boyunca pelvik taban kas egzersizi uygulayan grupta FİCİ skorunda azalma (p=0.00) ve FİYKÖ puan ortalamasında artma (p=0.00) olduğu belirlendi. Çalışma verilerine göre, postmenopozal dönemde anal inkontinans varlığında yapılacak pelvik taban kas egzersizleri inkontinansın ciddiyetinde azalma ve yaşam kalitesinde artma sağlayabilir. ANAHTAR SÖZCÜKLER: anal inkontinans, cidiyet indeksi, pelvik taban egzersizleri, yaşam kalitesi
Prevalence of Anal Incontinence in Postmenopausal Women, Etiology and Performance of Pelvic Floor Exercises in Treatment Though it is not a life threatening condition anal incontinence results in social, economical, hygenic and emotional distress in elderly people as well as decreased quality of life. This study was performed to investigate the prevalance and etiological factors of anal incontinence in postmenopausal women and the effectiveness of pelvic floor exercises in the treatment. The universe of study was 555 postmenopausal women who admitted to the menopause clinic of a university hospital in Istanbul between the years 2005-2010. Patient files were analyzed retrospectively and 555 women who were contacted by phone surveyed for gas or fecal incontinence. The study group was composed of 52 women who gave consent to enter the study and were assigned to experiment and control groups as 26 women in each group. Data were collected by personal interview by filling a questionare, fecal incontinace severity index form (FISI) and fecal incontinance quality of life scale (FIQL) forms and performing anal manometric measurements. All measurements were repeated at the end of three months. In the analysis of data; mean, percentage, ki-square, Mann Whitney U, Wilcoxon, logistic regression, correlation and varience analysis tests were used. Results of the study revealed 9.4 % anal incontinence prevelance in postmenapausal women. Statistically significant relation with anal incontinence and type of delivery (p=0.00) and urinary incontinence (p=0.00) was determined. In the group performing pelvic floor exercises for 12 weeks FISI score was decreased (p=0.00) and FIQL mean score was increased (p=0.00). According to the results of this study it can be stated that pelvic floor exercises decrease the severity of incontinence and improve quality of life in the post menopausal period. KEY WORDS: anal incontinence, severity index, pelvic muscle exercises, quality of life
Prevalence of Anal Incontinence in Postmenopausal Women, Etiology and Performance of Pelvic Floor Exercises in Treatment Though it is not a life threatening condition anal incontinence results in social, economical, hygenic and emotional distress in elderly people as well as decreased quality of life. This study was performed to investigate the prevalance and etiological factors of anal incontinence in postmenopausal women and the effectiveness of pelvic floor exercises in the treatment. The universe of study was 555 postmenopausal women who admitted to the menopause clinic of a university hospital in Istanbul between the years 2005-2010. Patient files were analyzed retrospectively and 555 women who were contacted by phone surveyed for gas or fecal incontinence. The study group was composed of 52 women who gave consent to enter the study and were assigned to experiment and control groups as 26 women in each group. Data were collected by personal interview by filling a questionare, fecal incontinace severity index form (FISI) and fecal incontinance quality of life scale (FIQL) forms and performing anal manometric measurements. All measurements were repeated at the end of three months. In the analysis of data; mean, percentage, ki-square, Mann Whitney U, Wilcoxon, logistic regression, correlation and varience analysis tests were used. Results of the study revealed 9.4 % anal incontinence prevelance in postmenapausal women. Statistically significant relation with anal incontinence and type of delivery (p=0.00) and urinary incontinence (p=0.00) was determined. In the group performing pelvic floor exercises for 12 weeks FISI score was decreased (p=0.00) and FIQL mean score was increased (p=0.00). According to the results of this study it can be stated that pelvic floor exercises decrease the severity of incontinence and improve quality of life in the post menopausal period. KEY WORDS: anal incontinence, severity index, pelvic muscle exercises, quality of life