Ispitivanja urodinamskih disfunkcija kod bolesnika sa multiplom sklerozom

  • Rade Babović Clinic for Rehabilitation “Dr Miroslav Zotović”, Belgrade, Serbia
  • Saša Milićević Clinic for Rehabilitation “Dr Miroslav Zotović”, Belgrade, Serbia
  • Saša Radovanović Institute for Medical Research, University of Belgrade, Belgrade, Serbia
  • Jasna Jančić Clinic of Neurology and Psychiatry for Children and Youth, Faculty of Medicine, University of Belgrade, Belgrade, Serbia
DOI: https://doi.org/10.2298/2161
Ključne reči: multiple sclerosis||, ||multipla skleroza, urination disorders||, ||mokrenje, poremećaji, urodynamics||, ||urodinamika, electromyography||, ||elektromiografija,

Sažetak


 

Uvod/Cilj. Multipla skleroza (MS) je hronično zapaljensko autoimuno oboljenje nepoznate etiologije koje dovodi do multifokalne demijelinizacije, oštećenja aksona i gubitka nervnog tkiva u različitim delovima centralnog nervnog sistema. Većina bolesnika sa multiplom sklerozom ima i poremećenu funkciju mokraćne bešike koja dovodi do različitih dizuričnih smetnji tokom trajanja bolesti. Samo kod 2% bolesnika ove smetnje su prvi simptom bolesti. Urodinamsko ispitivanje omogućava nam da postavimo dijagnozu funkcionalnih poremećaja donjeg urinarnog trakta, što uobičajenim invazivnim procedurama ili neinvazivnim snimanjima (ultrazvuk, kompjuterizovana tomografija ili funkcionalna magnetna rezonanca) često nije moguće ustanoviti. Metode. Urodinamsko ispitivanje – cistometrija i registrovanje elektromiografskih (EMG) potencijala sa spoljašnjeg analnog sfinktera (SAS) urađeno je kod 34 bolesnika (25 žena i 9 muškaraca), koji ispunjavaju Mc Donaldove dijagnostičke kriterijume za multiplu sklerozu. Dobijene vrednosti su upoređivane sa neurološkom simptomatologijom i znacima bolesti. Rezultati. Ispitivani su bolesnici sa (n = 27) i bez (n = 7) mikcionih tegoba. Hiperrefleksija detrusor bila je najčešći nalaz, prisutan čak kod 58,8% bolesnika. Više od polovine ovih bolesnika imalo je detrusor-sfinkter disinergiju. Zaključak. Urodinamsko ispitivanje može pomoći da se utvrde postojeći neurourološki poremećaji i na osnovu njih planira sprovođenje odgovarajućeg terapijskog plana. Tokom trajanja bolesti mogu se ustanoviti različiti oblici urodinamskih nalaza disfunkcije, kao i promena funkcije mokrenja. Razlog za sprovođenje urodinamskog ispitivanja kod bolesnika sa MS pre svake terapije bio bi postavljanje jasne dijagnoze dizuričnih poremećaja koja bliže određuje pravilnu i adekvatnu terapiju.

 

 

Biografija autora

Rade Babović, Clinic for Rehabilitation “Dr Miroslav Zotović”, Belgrade, Serbia
Fizikalna medicina i rehabilitacija. Prim dr sc. med.

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Objavljeno
2015/04/23
Broj časopisa
Vol. 71 Br. 5 (2014)
Rubrika
Originalni članak