Konzervativno zdravljenje urinske inkontinence pri osebah z multiplo sklerozo : pregled literature

Košir, Anja (author), Šćepanović, Darija (mentor)

Uvod: Normalna funkcija mehurja je pomembna ne samo za splošno zdravje oseb, ampak tudi za občutek ugodja in samozavesti. Čeprav obstaja veliko terapevtskih možnosti, je postopni pristop z začetnim ne-invazivnim zdravljenjem pacientov z multiplo sklerozo pomemben z upoštevanjem poteka bolezni in vrsto disfunkcije spodnjih sečil. Namen: Namen diplomskega dela je bil, na podlagi pregleda strokovne in znanstvene literature, predstaviti rezultate raziskav, katerih namen je bil ugotoviti učinkovitost zdravljenja urinske inkontinence pri pacientih z multiplo sklerozo, s poudarkom na uporabi fizioterapevtskih postopkov in raziskati vpliv teh zdravljenj na kvaliteto življenja. Metode: V pregled literature so bili zaradi majhnega števila obstoječe literature zajeti vsi viri, ne glede na časovno obdobje in velikost vzorca. Iskanje tuje in domače strokovne ter znanstvene literature je potekalo tako ročno v knjižnicah, kot s pomočjo brskalnikov ter elektronskih baz podatkov. Rezultati: Glede na vključitvene in izključitvene kriterije zdravljenja urinske inkontinence pri pacientih z multiplo sklerozo je bilo v pregled literature vključenih 12 raziskav in 4 sistematični pregledi literature. Od tega so se 3 ukvarjale izključno z vadbo mišic medeničnega dna, 2 z vadbo mišic medeničnega dna združeno z električno stimulacijo, 2 sta primerjali vadbo mišic medeničnega dna z drugimi oblikami zdravljenj – elektromiografsko biološko povratno zvezo, nevromuskularno električno stimulacijo, trankutano nevrostimulacijo posteriornega tibialnega živca, 4 raziskave so preučevale učinek električnih stimulacij – interferenčne, vaginalne, transkutane električne nevrostimulacije, transkutane stimulacije posteriornega tibialnega živca – in ena raziskava učinek treninga mehurja. Rezultati so pokazali pozitivne učinke na simptome spodnjih sečil, saj sta tako vadba mišic medeničnega dna kot nevromuskularna električna stimulacija pozitivno vplivala na zmanjšanje simptomov spodnjih sečil, transkutana stimulacija posteriornega tibialnega živca pa pri lajšanju simptomov prekomerno aktivnega sečnega mehurja in vse vrste zdravljenja so pokazale izboljšanja subjektivne ocene kvalitete življenja pacientov z multiplo sklerozo. Razprava in sklep: Po pregledu dostopne literature, so trenutni dokazi o učinkovitosti posameznih fizioterapevtskih postopkov za preprečevanje in zdravljenje različnih simptomov disfunkcije spodnjih sečil še vedno malenkost pomanjkljivi, a zelo spodbudni.

• Language: Slovenian
• Keywords: multipla skleroza, urinska inkontinenca, simptomi spodnjih sečil, konzervativno zdravljenje
• Work type: Bachelor thesis/paper
• Organization: ZF - Faculty of Health Sciences
• Year: 2017
• PID: 20.500.12556/RUL-88686
• COBISS.SI-ID: 5216619
• Publication date in RUL: 21.01.2017

Secondary language

• Language: English
• Title: Conservative treatment of urinary incontinence in patients with multiple sclerosis : literature review

Abstract

Introduction: Normal bladder function is important not only for the general health of people, but also for the feeling of comfort and confidence. Although there are many of potential therapeutic interventions available, graduate approach with non-invasive treatment of patients with multiple sclerosis is important with compliance progress of illness and type of dysfunction of lower urinary tract. Purpose: The purpose of the thesis is based on a review of domestic and foreign professional and scientific literature to determine effectiveness of treatments of urinary incontinence in patients with multiple sclerosis, with focus on use of physical therapy and impact of these treatments on quality of life. Methods: In literature review, there were included all sources, regardless of time period or sample size, because of small amount of avaible literature. Search for domestic and foreign scientific and professional literature was conducted with web browsers and electronic databases as well by hand searching in different libraries. Results: Regardless the entry criteria of urinary incontinence treatments in patients with multiple sclerosis corresponded 12 studies and 4 systematic reviews. Three of them examined the impact of only pelvic floor muscles training, 2 pelvic floor muscles training combined with electrical stimulation, 2 were comparing pelvic floor muscle training with other types of treatments – EMG biofeedback, neuromuscular electrical stimulation, transcutaneous posterior tibial nerve stimulation, 4 studies examined the impact of single use of different electrical stimulations – interferential electrical stimulation, transcutaneous nerve stimulation, transcutaneous posterior tibial nerve stimulation – and one study examined effectiveness of bladder training. Results showed positive effects on lower urinary tract symptoms, both pelvic floor muscle training and neuromuscular electrical stimulation had positive effect on reduction of lower urinary tract symptoms, and transcutaneous posterior tibial nerve stimulation on reduction of overactive bladder symptoms and all kind of treatments showed improvements of subjective scores on quality of life MS patients. Discussion and conclusion: After review of available literature, current evidences on effectiveness of each physiotherapy interventions for preventing and treatment different symptoms of dysfunction of lower urinary tract are still a little unclear, but very promising.

• Keywords: multiple sclerosis, urinary incontinence, lower urinary tract symptoms, conservative treatment