Yıl: 2017 Cilt: 43 Sayı: 1 Sayfa Aralığı: 68 - 74 Metin Dili: İngilizce DOI: 10.5152/tud.2016.93467 İndeks Tarihi: 11-01-2019

The attitudes of Urologists and Gynecologists about overactive bladder and treatment of it in Turkey: A questionnaire survey

Öz:
Objective: We aimed to review the approaches of urologist and gynecologist in the management of overactivebladder (OAB).Material and methods: A questionnaire consisting of 12 items were answered by 375 urologist and 46 gynecologist.The differences between frequency of encountering OAB, their viewpoints concerning conservativetreatment, and their experience related to anticholinergic drug use and the management of refractoryOAB were compared.Results: The majority of the urologists, and gynecologists responded to the question “How often do youencounter OAB patients in your daily practice?” as ‘in 10-25, and 50% of our patients’, respectively (<0.001).The most common complaint consulted to urologists, and gynecologists were urge incontinence (51.1% vs.64.8). The frequency of using questionnaire and voiding diary was similar in both specialties (23.9% vs.25.1%, p=0.892). It was observed that 38.6% of the urologists, and 50% of the gynecologists had recommendedconservative treatment as a first-line treatment of overactive bladder (p=0.049). The low socioculturallevel was the most important obstacle confronting application of conservative treatment methods (54.3% vs.37%, p=0.012). The survey participants indicated that the most important factor which affected their decisionto select an anticholinergic agent as the first-line treatment of overactive bladder was higher effectiveness ofthese drugs (urologists; 55.7%, and gynecologists 64%, p=0.371). The patients who started to receive anticholinergicdrugs most frequently complained both to their urologists, and/or gynecologists about dry mouth(76.3 vs. 74.5%). Based on the responses of the urologists, and gynecologists, the most frequent reason ofanticholinergic drug withdrawal was patients’ inability to tolerate side effects of these drugs (48% vs. 47.8%,p=0.697). The participants indicated that in case of unsatisfactory response to one anticholinergic agent,swithching rate to another anticholinergic drug was 56.9% among urologists vs. 59.6%, among gynecologists.In addition, 36.9% of urologists and 38.5% of gynecologists recommended another pharmaceutical form ofthe drug with a higher dose to their patients (p=0.279). Similar number of physicians indicated that the prescribedanticholinergic drug should be continued for at least 3 months and in case of unresponsiveness patientcould be considered refractory. Majority of urologists (68.8%), and gynecologists (56.5%) chose to performurodynamic tests in patients who are unresponsive to anticholinergic treatment, (p=0.093).Conclusion: The attitudes of urologist and gynecologist for diagnosis and treatment of OAB are mostlycorrelating with current guideline practices with few exceptions. Urologists tend to use bladder diaries orquestionnaires less frequently whereas, gynecologists refer to urodynamic studies in patients with refractoryOAB less than the urologists do. However, irrespective of the clinical speciality, conservative treatmentmodalities are rarely administered.
Anahtar Kelime:

Konular: Üroloji ve Nefroloji

Türkiye'deki ürolog ve jinekologların aşırı aktif mesane ve tedavisi hakkındaki yaklaşımları: anket çalışması

Öz:
Amaç: Bu çalışmada aşırı aktif mesanenin (AAM) yönetiminde ürolog ve jinekologların yaklaşımlarını gözden geçirmeyi amaçladık. Gereç ve yöntemler: On iki sorudan oluşan bir anket 375 ürolog ve 46 jinekolog tarafından cevaplandırıldı. AAM hastalarıyla karşılaşma sıklığı, konservatif tedavi hakkındaki görüşleri, antikolinerjik kullanımı ve refrakter AAM ile ilgili deneyimleri karşılaştırıldı. Bulgular: “Günlük pratiğinizde ne sıklıkla AAM hastalarıyla karşılaşıyorsunuz?” sorusuna ürologlar %10- 25 jinekologlar %50 cevabını verdi (<0,001). En sık karşılaşılan şikayet ürologlar tarafından %51,1 ve jinekologlar tarafından %64,8 oranla sıkışma hissi olarak bildirildi. Sorgulama formu ve mesane günlüğü kullanım oranları her iki bölüm arasında benzer bulundu (%23,9 ile %25,1, p=0,892). Ürologların %38,6’sı ve jinekologların %50’sinin tedavide ilk basamak olarak konservatif tedavileri önerdiği gözlendi (p=0,049). Konservatif tedavileri uygulamada en büyük güçlüğün hastaların sosyo kültürel seviyelerinin düşük olmasıolarak bildirildi (%54,3’e karşı %37, p=0,012). Ürologların %55,7’si ve jinekologların %64’ü antikolinerjik seçiminde en önemli faktörün yüksek etkinlik olduğunu belirttiler (p=0,371). Antikolinerjiklerin en sık gözlenen yan etkisinin ağız kuruluğu olduğu bildirildi (%76,3 ile %74,5). Antikolinerjiklerin en sık bırakılma nedeninin hastaların yan etkileri tolere edememeleri olduğu bildirildi (%48 ile %47,8, p=0,697). İlk antikolinerjiğe yeterli cevap alınamadığı takdirde değişik bir molekülün denenmesi ürologların %56,9’u jinekologların %59,6’sı tarafından yanıtlandı ve yüksek doz uygulaması ise ürologların %36,9’sı ve jinekologların ise %38,5’i tarafından tercih edilmekteydi (p=0,279). Refrakter AAM tanısı için en az 3 ay boyunca ilaç kullanılması gerekliliği her iki uzmanlık dalı hekimleri tarafından benzer oranda yanıtlandı. Antikolinerjik tedaviye yanıtsız olgularda ürologların %68’i ve jinekologların %56,5’i ürodinamik inceleme planlanması gerekliliğini bildirdi (p=0,093). Sonuç: Ürologların ve jinekologların AAM konusundaki yaklaşımları bir kaç istisna dışında güncel kılavuzları yansıtmaktadır. Ürologlar mesane günlüğü ve sorulama formlarını daha az uygularken, jinekologlar ise refrakter AAM de ürodinamiyi daha az tercih etmektedir. Her iki uzmanlık dalında da konservatif tedaviler hastaların düşük sosyo-kültürel seviyelerine bağlı olarak göz ardı edilmektedir
Anahtar Kelime:

Konular: Üroloji ve Nefroloji
Belge Türü: Makale Makale Türü: Araştırma Makalesi Erişim Türü: Erişime Açık
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APA COŞKUN B, BAYRAK O, DİNÇER M, ÖNEM K, gurbuz c, ONUR A (2017). The attitudes of Urologists and Gynecologists about overactive bladder and treatment of it in Turkey: A questionnaire survey. , 68 - 74. 10.5152/tud.2016.93467
Chicago COŞKUN BURHAN,BAYRAK OMER,DİNÇER Muhammet Murat,ÖNEM KADİR,gurbuz cenk,ONUR AHMET RAHMİ The attitudes of Urologists and Gynecologists about overactive bladder and treatment of it in Turkey: A questionnaire survey. (2017): 68 - 74. 10.5152/tud.2016.93467
MLA COŞKUN BURHAN,BAYRAK OMER,DİNÇER Muhammet Murat,ÖNEM KADİR,gurbuz cenk,ONUR AHMET RAHMİ The attitudes of Urologists and Gynecologists about overactive bladder and treatment of it in Turkey: A questionnaire survey. , 2017, ss.68 - 74. 10.5152/tud.2016.93467
AMA COŞKUN B,BAYRAK O,DİNÇER M,ÖNEM K,gurbuz c,ONUR A The attitudes of Urologists and Gynecologists about overactive bladder and treatment of it in Turkey: A questionnaire survey. . 2017; 68 - 74. 10.5152/tud.2016.93467
Vancouver COŞKUN B,BAYRAK O,DİNÇER M,ÖNEM K,gurbuz c,ONUR A The attitudes of Urologists and Gynecologists about overactive bladder and treatment of it in Turkey: A questionnaire survey. . 2017; 68 - 74. 10.5152/tud.2016.93467
IEEE COŞKUN B,BAYRAK O,DİNÇER M,ÖNEM K,gurbuz c,ONUR A "The attitudes of Urologists and Gynecologists about overactive bladder and treatment of it in Turkey: A questionnaire survey." , ss.68 - 74, 2017. 10.5152/tud.2016.93467
ISNAD COŞKUN, BURHAN vd. "The attitudes of Urologists and Gynecologists about overactive bladder and treatment of it in Turkey: A questionnaire survey". (2017), 68-74. https://doi.org/10.5152/tud.2016.93467
APA COŞKUN B, BAYRAK O, DİNÇER M, ÖNEM K, gurbuz c, ONUR A (2017). The attitudes of Urologists and Gynecologists about overactive bladder and treatment of it in Turkey: A questionnaire survey. Turkish Journal of Urology, 43(1), 68 - 74. 10.5152/tud.2016.93467
Chicago COŞKUN BURHAN,BAYRAK OMER,DİNÇER Muhammet Murat,ÖNEM KADİR,gurbuz cenk,ONUR AHMET RAHMİ The attitudes of Urologists and Gynecologists about overactive bladder and treatment of it in Turkey: A questionnaire survey. Turkish Journal of Urology 43, no.1 (2017): 68 - 74. 10.5152/tud.2016.93467
MLA COŞKUN BURHAN,BAYRAK OMER,DİNÇER Muhammet Murat,ÖNEM KADİR,gurbuz cenk,ONUR AHMET RAHMİ The attitudes of Urologists and Gynecologists about overactive bladder and treatment of it in Turkey: A questionnaire survey. Turkish Journal of Urology, vol.43, no.1, 2017, ss.68 - 74. 10.5152/tud.2016.93467
AMA COŞKUN B,BAYRAK O,DİNÇER M,ÖNEM K,gurbuz c,ONUR A The attitudes of Urologists and Gynecologists about overactive bladder and treatment of it in Turkey: A questionnaire survey. Turkish Journal of Urology. 2017; 43(1): 68 - 74. 10.5152/tud.2016.93467
Vancouver COŞKUN B,BAYRAK O,DİNÇER M,ÖNEM K,gurbuz c,ONUR A The attitudes of Urologists and Gynecologists about overactive bladder and treatment of it in Turkey: A questionnaire survey. Turkish Journal of Urology. 2017; 43(1): 68 - 74. 10.5152/tud.2016.93467
IEEE COŞKUN B,BAYRAK O,DİNÇER M,ÖNEM K,gurbuz c,ONUR A "The attitudes of Urologists and Gynecologists about overactive bladder and treatment of it in Turkey: A questionnaire survey." Turkish Journal of Urology, 43, ss.68 - 74, 2017. 10.5152/tud.2016.93467
ISNAD COŞKUN, BURHAN vd. "The attitudes of Urologists and Gynecologists about overactive bladder and treatment of it in Turkey: A questionnaire survey". Turkish Journal of Urology 43/1 (2017), 68-74. https://doi.org/10.5152/tud.2016.93467