Urodynamic findings in stroke patients with overactive bladder symptoms/Asiri aktif mesane belirtileri olan inme hastalarinda urodinamik bulgular

• Published in: Türkiye fiziksel tip ve rehabilitasyon dergisi Vol. 62; no. 1; p. 51
• Main Authors: Aydemir, Koray, Adiguzel, Emre, Yilmaz, Bilge
• Format: Journal Article
• Language: English
• Published: Galenos Yayinevi Tic. Ltd 01-03-2016
• Subjects: Brain damage; Complications and side effects; Risk factors; Stroke (Disease); Turkey
• ISSN: 1302-0234
• DOI: 10.5606/tftrd.2016.84479

Objectives: This study aims to determine the effect of the localization of the brain lesion on bladder functions in patients with stroke. Patients and methods: We retrospectively reviewed the medical records and urodynamic charts of a total of 51 ischemic and hemorrhagic stroke patients (34 males, 17 females; mean age 65.8 [+ or -] 16.2 years; range 13 to 88 years) with overactive bladder. Stroke localization was classified according to the Oxfordshire Community Stroke Project stroke subtypes. Urodynamic parameters included the first sensation of bladder filling, maximum vesical volume, maximum detrusor pressure, detrusor compliance, residual volume, mean flow rate, voided volume, voiding time, desire to void and strong desire to void. The patients were also classified according to sex and compared in terms of brain lesion laterality. Results: Thirty six patients had ischemic and 15 had hemorrhagic stroke. The mean time from stroke to the urodynamic studies was 396.9 [+ or -] 713.8 days. Maximum detrusor pressure was associated with sex, resulting in a significantly higher rates in males (p=0.028). Residual volume was significantly higher in the right hemiplegic group than the left hemiplegic group (p=0.007). The voided volume was significantly lower in the right hemiplegic group than the left hemiplegic group (p=0.007). In the right hemiplegic male group, the first sensation of bladder filling was delayed, residual volume was higher and the voided volume was lower (p=0.045, p=0.01, and p=0.043, respectively). In the right hemiplegic female group, the voided volume was lower than the left hemiplegic female group (p=0.024). Conclusion: Our study results show that there are significant differences in urodynamic variables between the right and left hemispheric cerebral infarctions. These findings suggest that urodynamic findings can be characterized by the laterality of the unilateral hemispheric stroke. However, further large-scale studies are required to confirm these findings. Keywords: Stroke; urinary incontinence; urodynamic study. Amac: Bu calismada inme hastalarinda beyindeki lezyon yerinin mesane fonksiyonlari uzerine olan etkisi belirlendi. Hastalar ve yontemler: Bu calismada asiri aktif mesanesi olan, iskemik ve hemorajik inmeli toplam 51 hastanin (34 erkek, 17 kadin; ort. yas 65.8 [+ or -] 16.2 yil; dagilim: 13-88 yil) tibbi kayitlari ve urodinamik verileri retrospektif olarak incelendi. Inme yerleri, Oxfordshire Toplulugu Inme Projesi inme alt tiplerine gore siniflandirildi. Urodinamik parametreler arasinda ilk mesane doluluk hissi, maksimum mesane hacmi, maksimum detrusor basinci, detrusor kompliyansi, reziduel hacim, ortalama akis hizi, iseme hacmi, iseme zamani, normal sikisma ve cok sikisma hacimleri yer almaktaydi. Hastalar cinsiyete gore de siniflandirildi ve beyin lezyon lateralitesi acisindan karsilastirildi. Bulgular: Otuz alti hasta iskemik, 15 hasta hemorajik inme gecirmisti. Inmeden urodinamik calismalara kadar gecen ortalama sure, 396.9 [+ or -] 713.8 gundu. Maksimum detrusor basinci, erkeklerde anlamli duzeyde yuksek oranlar ile cinsiyet ile iliskilendirildi (p=0.028). Reziduel hacim, sol hemiplejik gruba kiyasla, sag hemiplejik grupta anlamli duzeyde daha yuksekti (p=0.007). Iseme hacmi, sol hemiplejik gruba kiyasla, sag hemiplejik grupta anlamli duzeyde daha dusuktu (p=0.007). Sag hemiplejik erkek grubunda, ilk mesane doluluk hissinde gecikme vardi, reziduel hacim daha yuksekti ve iseme hacmi daha dusuktu (sirasiyla p=0.045, p=0.01 ve p=0.043). Sag hemiplejik kadin grubunda, iseme hacmi, sol hemiplejik kadin grubuna kiyasla, daha dusuktu (p=0.024). Sonuc: Calisma bulgularimiz, sag ve sol serebral hemisferik infarkti arasinda urodinamik parametreleri acisindan anlamli farkliliklar oldugunu gostermektedir. Bu bulgular, tek tarafli hemisferik inmeli hastalarda urodinamik bulgularin lezyon lateralitesine gore karakterize olduguna isaret etmektedir. Ancak, bu bulgulari dogrulamak icin genis olcekli baska calismalara ihtiyac vardir. Anahtar sozcukler: Inme; uriner inkontinans; urodinamik calisma.