Promjene urogenitalnog sustava tijekom starenja i urinarna inkontinencija

master's thesis

• Title (english): Changes in the urogenital system during aging and urinary incontinence
• Author: Antonia Alfirević
• Mentor: Mato Pavić (mentor)
• Committee member: Držislav Kalafatić (predsjednik povjerenstva)
• Committee member: Dinka Pavičić Baldani (član povjerenstva)
• Committee member: Mato Pavić (član povjerenstva)
• Granter: University of Zagreb; School of Medicine; (Department of Gynecology and Obstetrics); Zagreb
• Defense date and country: 2024-07-12, Croatia
• Scientific / art field, discipline and subdiscipline: BIOMEDICINE AND HEALTHCARE; Clinical Medical Sciences; Gynecology and Obstetrics

Abstract

Tijekom starenja dolazi do anatomskih i fizioloških promjena koje utječu na funkciju mokraćnog mjehura, uretre i reproduktivnih organa. Menopauza i smanjena razina estrogena značajno doprinose razvoju genitourinarnog sindroma menopauze i urinarne inkontinencije. Urinarna inkontinencija definirana je kao nevoljno otjecanje mokraće, a može se pojaviti u različitim oblicima poput stresne, urgentne i miješane inkontinencije. Stresna urinarna inkontinencija se također može klasificirati prema etiološkim faktorima, uključujući uretralnu hipermobilnost i intrinzičnu insuficijenciju sfinktera. Gubitak potpore uretre i gubitak funkcije sfinktera rezultira neadekvatnim zatvaranjem uretre tijekom porasta intraabdominalnog tlaka, što dovodi do smanjenja tlaka zatvaranja uretre i inkontinencije. Dijagnostika stresne urinarne inkontinencije uključuje nekoliko ključnih koraka kako bi se precizno utvrdilo stanje i odredio optimalan plan liječenja. Osnovne dijagnostičke metode obuhvaćaju anamnezu, klinički/ginekološki pregled, dnevnik mokrenja, urodinamičke pretrage te upitnike za samoprocjenu. Konzervativno liječenje stresne urinarne inkontinencije uključuje promjene životnog stila, fizikalne terapije, mehanička sredstva, hormonalnu terapiju i farmakoterapiju. Hormonska terapija koristi topički estrogen za poboljšanje zdravlja urogenitalnih tkiva kod postmenopauzalnih žena, dok farmakoterapija uključuje lijekove koji povećavaju tonus mišića u vratu mjehura i uretralnom sfinkteru. Sling operacije zlatni su standard u kirurškom liječenju stresne urinarne inkontinencije. Individualizacija terapije i kontinuirana edukacija pacijentica od ključne su važnosti u prevenciji i liječenju urinarnih inkontinencija.

Abstract (english)

During aging, anatomical and physiological changes affect the function of the bladder, urethra, and reproductive organs. Menopause and reduced estrogen levels significantly contribute to the development of genitourinary syndrome of menopause and urinary incontinence. Urinary incontinence is defined as the involuntary leakage of urine and can manifest in various forms such as stress, urge, and mixed incontinence. Stress urinary incontinence can also be classified according to etiological factors, including urethral hypermobility and intrinsic sphincter deficiency. Loss of urethral support and sphincter function results in inadequate urethral closure during increased intra-abdominal pressure, leading to decreased urethral closure pressure and incontinence. The diagnosis of stress urinary incontinence involves several key steps to determine the condition and establish an optimal treatment plan accurately.. Basic diagnostic methods include medical history, clinical/gynecological examination, bladder diary, urodynamic tests, and self-assessment questionnaires. Conservative treatment of stress urinary incontinence includes lifestyle changes, physical therapies, mechanical devices, hormonal therapy, and pharmacotherapy. Hormonal therapy uses topical estrogen to improve the health of urogenital tissues in postmenopausal women, while pharmacotherapy includes medications that increase muscle tone in the bladder neck and urethral sphincter. Sling surgery is the gold standard in treatmeninh stress urinary incontinence. Individualization of therapy and continuous patient education are of crucial importance in the prevention and treatment of urinary incontinence.

• Keywords: postmenopauza; starenje; stresna urinarna inkontinencija
• Keywords (english): aging; postmenopause; stress urinary incontinence
• Language: croatian
• URN:NBN: urn:nbn:hr:105:950084
• 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: 2024-06-27 14:11:41