Fekal inkontinansı olan erkek hastada pelvik taban kas eğitimi ile ekstrakorporeal manyetik stimülasyonun etkisi: vaka raporu

Emine Baran; Ceren Orhan; Esra Uzelpasacı; Serap Özgül; Gülbala Nakip; Türkan Akbayrak

Case Report

Fekal inkontinansı olan erkek hastada pelvik taban kas eğitimi ile ekstrakorporeal manyetik stimülasyonun etkisi: vaka raporu

Year 2018, Volume: 5 Issue: 1, 59 - 64, 04.06.2018

Emine Baran Ceren Orhan Esra Uzelpasacı Serap Özgül Gülbala Nakip Türkan Akbayrak

Abstract

Çalışmanın amacı, internal anal sfinkter yetmezliğine bağlı fekal inkontinansı (Fİ) olan erkek hastada Pelvik Taban Kas Eğitimi (PTKE) ile kombine Ekstrakorporeal Manyetik Stimülasyonnun (ExMS) Fİ semptomları üzerine etkilerini araştırmaktı. Fİ’si olan 26 yaşında erkek hasta çalışmaya dâhil edildi. Subjektif iyileşme algısı Likert-tip skala ile, inkontinans şiddeti Wexner İnkontinans Derecelendirme Skalası ile; yaşam kalitesi Görsel Analog Skalası (VAS) ile değerlendirildi. Pelvik taban kas kuvveti ve enduransının değerlendirilmesi için anal perineometrik ölçüm yapıldı. Tüm sonuç ölçümleri başlangıç, 8 haftalık tedavi sonrası ve 6. ayda değerlendirildi. PTKE, ilk hafta günde 5 set egzersiz ile başladı. Her hafta 5 set artırılarak 4. haftada 20 sete çıkarıldı ve 6 ay boyunca günde 20 set ev programı şeklinde uygulandı. ExMS ise, her bir seans 20 dk (10dk 10Hz, 10dk 50Hz) olmak üzere haftada 3 seans, 8 hafta süresince uygulandı. 8. hafta ve 6. ayda subjektif iyileşme algısı, başlangıçtaki durum ile karşılaştırıldığında “daha iyi” olarak bildirildi. Pelvik taban kas kuvveti ve enduransı, başlangıç, tedaviden hemen sonra ve 6. ay takipte sırasıyla; 2,06-4,2-4,1 kPa ve 1-3,7-3.5 sn olarak bulundu. Wexner ve VAS skorları sırasıyla 7-3-3 ve 3,7-0,5-0,6 olacak şekilde iyileşti. Hastanın 8. hafta ve 6. aydaki egzersiz uyumu VAS ile değerlendirildiğinde 5,9-4,7 cm olarak bulundu. Bu vaka raporu, PTKE ve ExMS’nin Fİ’si olan bu hastada etkin bir tedavi olduğunu göstermiştir. Daha büyük örneklemli ve uzun dönem takipli ileri rastgele kontrollü çalışmalara ihtiyaç vardır.

Keywords

Fekal inkontinans, Ekstrakorporeal manyetik stimülasyon, Pelvik taban kas eğitimi

References

1. Kalantar JS, Howell S, Talley NJ. Prevalence of faecal incontinence and associated risk factors; an underdiagnosed problem in the Australian community? Med J Aust. 2002;176:54-57.
2. Norton C, Kamm MA. Anal sphincter biofeedback and pelvic floor exercises for faecal incontinence in adults--a systematic review. Aliment Pharm Ther. 2001;15:1147-1154.
3. Dumoulin C, Hay-Smith J, Habee-Seguin GM, et al. Pelvic floor muscle training versus no treatment, or inactive control treatments, for urinary incontinence in women: a short version Cochrane systematic review with metaanalysis. Neurourol Urodynam. 2015;34:300-308.
4. Scott KM. Pelvic floor rehabilitation in the treatment of fecal incontinence. Clin Colon Rect Surg. 2014;27:99-105.
5. Fujishiro T, Enomoto H, Ugawa Y, et al. Magnetic stimulation of the sacral roots for the treatment of stress incontinence: an investigational study and placebo controlled trial. J Urol. 2000;164:1277-1279.
6. Thornton MJ, Kennedy ML, Lubowski DZ. Extracorporeal magnetic stimulation of the pelvic floor: impact on anorectal function and physiology. A pilot study. Dis Colon Rectum. 2005;48:1945-1950.
7. Lagro-Janssen A, Debruyne F, Smits A, et al. The effects of treatment of urinary incontinence in general practice. Fam Pract. 1992;9:284-289.
8. Jorge JMN, Wexner SD. Etiology and management of fecal incontinence. Dis Colon Rectum. 1993;36:77-97.
9. Kaya S, Akbayrak T, Gursen C, et al. Short-term effect of adding pelvic floor muscle training to bladder training for female urinary incontinence: a randomized controlled trial. Int Urogynecol J. 2015;26:285-293.
10. Bo K, Berghmans B, Morkved S, et al. Evidence-Based Physical Therapy For The Pelvic Floor: Bridging Science And Clinical Practice. 2nd ed. Churchill Livingstone Elsevier. Edinburgh; 2015.
11. Kaya S, Akbayrak T, Gursen C, et al. Short-term effect of adding pelvic floor muscle training to bladder training for female urinary incontinence: a randomized controlled trial. Int Urogynecol J. 2015;26:285-293.
12. Fitz FF, Stupp L, da Costa TF, et al. Outpatient biofeedback in addition to home pelvic floor muscle training for stress urinary incontinence: a randomized controlled trial. Neurourol Urodyn. 2017;36:2034-2043.
13. Sander P, Bjarnesen J, Mouritsen L, et al. Anal incontinence after obstetric third- /fourth degree laceration. One-year follow-up after pelvic floor exercises. Int Urogynecol J Pelvic Floor Dysfunct. 1999;10:177-181.
14. Norton C, Chelvanayagam S, Wilson-Barnett J, et al. Randomized controlled trial of biofeedback for fecal incontinence. Gastroenterology. 2003;125:1320-1329.
15. Bakar Y, Cinar Ozdemir O, Ozengin N, et al. The use of extracorporeal magnetic innervation for the treatment of stress urinary incontinence in older women: a pilot study. Arch Gynecol Obstet. 2011;284:1163-1168.
16. Shobeiri SA, Chesson RR, West EC, et al. A pilot study of extracorporeal magnetic stimulation of the pelvic floor for the treatment of women with fecal incontinence and underactive pelvic floor muscles. Female Pelvic Med Re. 2007;13:19-26.
17. Chandi D, Groenendijk P, Venema P. Functional extracorporeal magnetic stimulation as a treatment for female urinary incontinence: ‘the chair’. BJU Inter. 2004;93:539-542.
18. Yamanishi T, Yasuda K, Suda S, et al. Effect of functional continuous magnetic stimulation for urinary incontinence. J Urol. 2000;163:456-459.
19. Kemeny MM. Coloproctology and the pelvic floor: pathophysiology and management. JAMA. 1986;256:410.

Year 2018, Volume: 5 Issue: 1, 59 - 64, 04.06.2018

Emine Baran Ceren Orhan Esra Uzelpasacı Serap Özgül Gülbala Nakip Türkan Akbayrak

Abstract

References

1. Kalantar JS, Howell S, Talley NJ. Prevalence of faecal incontinence and associated risk factors; an underdiagnosed problem in the Australian community? Med J Aust. 2002;176:54-57.
2. Norton C, Kamm MA. Anal sphincter biofeedback and pelvic floor exercises for faecal incontinence in adults--a systematic review. Aliment Pharm Ther. 2001;15:1147-1154.
3. Dumoulin C, Hay-Smith J, Habee-Seguin GM, et al. Pelvic floor muscle training versus no treatment, or inactive control treatments, for urinary incontinence in women: a short version Cochrane systematic review with metaanalysis. Neurourol Urodynam. 2015;34:300-308.
4. Scott KM. Pelvic floor rehabilitation in the treatment of fecal incontinence. Clin Colon Rect Surg. 2014;27:99-105.
5. Fujishiro T, Enomoto H, Ugawa Y, et al. Magnetic stimulation of the sacral roots for the treatment of stress incontinence: an investigational study and placebo controlled trial. J Urol. 2000;164:1277-1279.
6. Thornton MJ, Kennedy ML, Lubowski DZ. Extracorporeal magnetic stimulation of the pelvic floor: impact on anorectal function and physiology. A pilot study. Dis Colon Rectum. 2005;48:1945-1950.
7. Lagro-Janssen A, Debruyne F, Smits A, et al. The effects of treatment of urinary incontinence in general practice. Fam Pract. 1992;9:284-289.
8. Jorge JMN, Wexner SD. Etiology and management of fecal incontinence. Dis Colon Rectum. 1993;36:77-97.
9. Kaya S, Akbayrak T, Gursen C, et al. Short-term effect of adding pelvic floor muscle training to bladder training for female urinary incontinence: a randomized controlled trial. Int Urogynecol J. 2015;26:285-293.
10. Bo K, Berghmans B, Morkved S, et al. Evidence-Based Physical Therapy For The Pelvic Floor: Bridging Science And Clinical Practice. 2nd ed. Churchill Livingstone Elsevier. Edinburgh; 2015.
11. Kaya S, Akbayrak T, Gursen C, et al. Short-term effect of adding pelvic floor muscle training to bladder training for female urinary incontinence: a randomized controlled trial. Int Urogynecol J. 2015;26:285-293.
12. Fitz FF, Stupp L, da Costa TF, et al. Outpatient biofeedback in addition to home pelvic floor muscle training for stress urinary incontinence: a randomized controlled trial. Neurourol Urodyn. 2017;36:2034-2043.
13. Sander P, Bjarnesen J, Mouritsen L, et al. Anal incontinence after obstetric third- /fourth degree laceration. One-year follow-up after pelvic floor exercises. Int Urogynecol J Pelvic Floor Dysfunct. 1999;10:177-181.
14. Norton C, Chelvanayagam S, Wilson-Barnett J, et al. Randomized controlled trial of biofeedback for fecal incontinence. Gastroenterology. 2003;125:1320-1329.
15. Bakar Y, Cinar Ozdemir O, Ozengin N, et al. The use of extracorporeal magnetic innervation for the treatment of stress urinary incontinence in older women: a pilot study. Arch Gynecol Obstet. 2011;284:1163-1168.
16. Shobeiri SA, Chesson RR, West EC, et al. A pilot study of extracorporeal magnetic stimulation of the pelvic floor for the treatment of women with fecal incontinence and underactive pelvic floor muscles. Female Pelvic Med Re. 2007;13:19-26.
17. Chandi D, Groenendijk P, Venema P. Functional extracorporeal magnetic stimulation as a treatment for female urinary incontinence: ‘the chair’. BJU Inter. 2004;93:539-542.
18. Yamanishi T, Yasuda K, Suda S, et al. Effect of functional continuous magnetic stimulation for urinary incontinence. J Urol. 2000;163:456-459.
19. Kemeny MM. Coloproctology and the pelvic floor: pathophysiology and management. JAMA. 1986;256:410.

There are 19 citations in total.

Details

Primary Language	Turkish
Journal Section	Case Reports
Authors	Emine Baran 0000-0003-4974-6543 Ceren Orhan This is me Esra Uzelpasacı This is me Serap Özgül Gülbala Nakip Türkan Akbayrak
Publication Date	June 4, 2018
Submission Date	November 14, 2017
Published in Issue	Year 2018 Volume: 5 Issue: 1

Cite

Vancouver	Baran E, Orhan C, Uzelpasacı E, Özgül S, Nakip G, Akbayrak T. Fekal inkontinansı olan erkek hastada pelvik taban kas eğitimi ile ekstrakorporeal manyetik stimülasyonun etkisi: vaka raporu. JETR. 2018;5(1):59-64.

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