Journal of Reconstructive Urology

.: ORIGINAL RESEARCH
Acil Hekimlerinin Üriner Sistem Taş Hastalığında Medikal Ekspulsif Tedavi Konusunda Farkındalık ve Davranışlarının Araştırılması: Anket Çalışması
Investigation of Emergency Physicians' Awareness and Behaviors Related to Medical Expulsion Therapy for Urinary Tract Stone Disease: A Survey Study
Burhan COŞKUNa , Vahide Aslıhan DURAKb , Murat ÇETİNc
aBursa Uludağ Üniversitesi Tıp Fakültesi, Üroloji ABD, Bursa, Türkiye
bBursa Uludağ Üniversitesi Tıp Fakültesi, Acil Tıp ABD, Bursa, Türkiye
cManisa Merkezefendi Devlet Hastanesi, Acil Tıp Kliniği, Manisa, Türkiye
J Reconstr Urol. 2023;13(1):10-5
doi: 10.5336/urology.2022-93804
Article Language: TR
Full Text
ÖZET
 Amaç: Üreter taşı, acil servislerde sıklıkla karşılaşılan bir problem olup, medikal ekspulsif tedavi (MET), belirli boyut ve lokalizasyonda taş düşürmeyi kolaylaştırabilen bir tedavi yöntemi olarak ortaya çıkmıştır. Genellikle alfa blokerler bu amaçla kullanılırken, bu ilaçların taş düşürme tedavisinde kullanım endikasyonları bulunmamaktadır. MET, ürologlar arasında genellikle tercih edilen bir tedavi olmakla birlikte, üreter taşları ile sıklıkla karşılaşan hekimler olan acil servis hekimlerinin görüşleri de ilgi çekicidir. Çalışmamızda, acil servis hekimlerinin üriner sistem taş hastalığında MET kullanımı konusunda farkındalıklarını, tutumlarını ve bunlara etki eden faktörleri bir anket düzenleyerek araştırmayı hedefledik. Gereç ve Yöntemler: On dört sorudan oluşan bir anket ''Google Forms'' üzerinden hazırlanan bir anket formu ile 183 acil hekimi tarafından yanıtlandı. MET farkındalık düzeyleri, hangi endikasyonlarda tercih ettikleri ve tedaviye ait çekincelerine ait sorulara yanıtları gruplar arasında karşılaştırıldı. Bulgular: MET farkındalık oranı %49,7 olarak bulundu. Acil tıp uzmanlarının, araştırma görevlileri ve pratisyen hekimlere farkındalıklarının daha fazla olduğu izlendi. Alfa blokerlerin MET kapsamında kullanılabilir olduğunu belirten hekimlerin sadece %25,3'ünün günlük pratikte bu ilaçları tercih ettikleri ve kullanmayı tercih etmeyen hekimlerin ise %77,9'unun ise bu tercihi üroloğa bırakmak istedikleri saptandı. Sonuç: Ülkemizde MET'in acil hekimlerince farkındalığı hâlen yeterli düzeyde değildir ve az sayıda acil hekimi tarafından tercih edilmektedir. Bu konuda yapılacak düzenli eğitim programları ile farkındalığın artırılması hedeflenmektedir.

Anahtar Kelimeler: Ürolitiyazis; renal kolik; adrenerjik alfa-1 reseptör antagonistleri
ABSTRACT
 Objective: Ureteral stones are a common problem in the emergency department and medical expulsive therapy (MET) has emerged as a treatment modality that can facilitate spontaneous stone passage for certain sizes and locations. While alpha blockers are generally used for this purpose, these medications do not have such an indication. Although MET is generally the preferred treatment among urologists, the views of emergency department physicians who frequently encounter ureteral stones are also of interest. In this study, we aimed to investigate the awareness and attitudes of emergency physicians toward medical expulsion therapy for urinary tract stone disease and the factors that influence them using a questionnaire. Material and Methods: A questionnaire consisting of 14 questions was answered by 183 emergency physicians using ''Google Forms''. Awareness of MET, their preferred indications, and responses to questions about treatment concerns were compared between groups. Results: The level of awareness of MET was reported to be 49.7%. It was found that the awareness level of emergency medicine specialists was higher compared to residents and general practitioners. It was found that only 25.3% of physicians who indicated that alpha blockers could be used on MET preferred these molecules in daily practice and 77.9% of physicians who did not prefer it stated that they wanted to leave this decision to the urologist. Conclusion: In our country, the awareness of MET among emergency physicians is insufficient, and only a small number of emergency physicians prefer it. It is aimed to raise awareness with regular training programs on this subject.

Keywords: Urolithiasis; renal colic; adrenergic alpha-1 receptor antagonists
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