Suvremeni pristup u liječenju bolesnica s inkontinencijom urina

master's thesis

• Title (english): A novel approach in the treatment of patients with urinary incontinence
• Author: Lucija Cvetković
• Mentor: Ivana Maurac (mentor)
• Committee member: Slavko Orešković (predsjednik povjerenstva)
• Committee member: Željko Duić (član povjerenstva)
• Committee member: Ivana Maurac (član povjerenstva)
• Granter: University of Zagreb; School of Medicine; (Department of Gynecology and Obstetrics); Zagreb
• Defense date and country: 2020-07-17, Croatia
• Scientific / art field, discipline and subdiscipline: BIOMEDICINE AND HEALTHCARE; Clinical Medical Sciences; Gynecology and Obstetrics

Abstract

Inkontinencija urina predstavlja globalni zdravstveni problem s češćom pojavnosti u žena. Gotovo 60% žena starijih od 70 godina prezentira se poremećajima mokrenja koji značajno umanjuju kvalitetu života. Inkontinencija nastupa izostankom međusobne koordinacije normalnih anatomskih i fizioloških osobina mokraćnog mjehura, mokraćne cijevi i sfinktera, zdjeličnog dna i intaktnog živčanog sustava koji inervira te organe. Upravo zato je za uspješno liječenje potrebno dobro poznavanje svih navedenih struktura i patofiziologije IU. Najčešća IU je stresna inkontinencija urina (SIU). Inicijalna obrada bolesnice uključuje detaljno uzetu anamnezu, klinički pregled s ginekološkim pregledom, procjena kvalitete života putem upitnika, vođenje dnevnika mokrenja te isključenje infekcije urotrakta. Kvalitetna inicijalna obrada je preduvjet za pravilno usmjeravanje daljnjeg liječenja koje može biti konzervativno
nefarmakološko, farmakološko i kirurško. Prvu liniju liječenja uglavnom čine promjena načina života te vježbe za jačanje mišića dna zdjelice, koje su ujedno pristupačne i učinkovite metode. Primjena lijekova označava sekundarnu liniju liječenja, a najprimjenjivaniji su antimuskarinici i ß3-agonisti. Ovisno o vrsti inkontinencije, ukoliko navedene metode se pokažu bezuspješnima, zadnja opcija je kirurško liječenje. Sling metode su zlatni standard u liječenju SIU.

Abstract (english)

Urinary incontinence is a global health problem with a higher incidence in women. Almost 60% of women over the age of 70 present with urinary disorders that significantly reduce the quality of life. Incontinence occurs by the lack of mutual coordination of normal anatomical and physiological features of the bladder, urethra and sphincter, pelvic floor and intact nervous system that innervates these organs. That is why successful treatment requires a good knowledge of all these structures and pathophysiology of UI. The most common UI is stress urinary incontinence (SIU). Initial treatment of the patient includes a detailed history, clinical examination with gynecological examination, assessment of QoL through a questionnaire, keeping a diary of urine, exclusion of urinary tract infection. Quality initial treatment is a prerequisite for the proper direction of further treatment, which can be conservative non-pharmacological, pharmacological and surgical. The first line of treatment mainly consists of lifestyle changes and exercises to strengthen the pelvic floor muscles, which are both affordable and effective methods. Drug administration presents a secondary line of treatment, and the most widely used are antimuscarinics and ß3-agonists. Depending on the type of incontinence, if these methods prove unsuccessful, the last option is surgical treatment. Sling methods are the gold standard in the treatment of SIU.

• Keywords: inkontinencija urina; konzervativne metode; sekundarna linija liječenja; sling metode
• Keywords (english): urinary incontinence; conservative methods; secondary line of treatment; sling methods
• Language: croatian
• URN:NBN: urn:nbn:hr:105:527402
• Study programme: Title: Medicine; Study programme type: university; Study level: integrated undergraduate and graduate; Academic / professional title: doktor/doktorica medicine (doktor/doktorica medicine)
• Type of resource: Text
• File origin: Born digital
• Access conditions: Open access
• Created on: 2021-03-19 08:51:31