Journal of Reconstructive Urology

.: ORIGINAL RESEARCH
Diyabetik Kadın Hastalarda Retina Sinir Lifi Tabakasındaki İncelme ile Aşırı Aktif Mesane Sendromu Arasındaki İlişki: Kesitsel Çalışma
The Relationship Between Thinning of the Retinal Nerve Fiber Layer and Overactive Bladder Syndrome in Diabetic Female Patients: A Cross Sectional Study
Berna ŞAHANa, Murat ŞAHANb
aMedicana International İzmir Hastanesi, Göz Hastalıkları Kliniği, İzmir, Türkiye
bİzmir Bozyaka Eğitim ve Araştırma Hastanesi, Üroloji Kliniği, İzmir, Türkiye
J Reconstr Urol. 2022;12(2):77-83
doi: 10.5336/urology.2022-91296
Article Language: TR
Full Text
ÖZET
 Amaç: Çalışmamızda, aşırı aktif mesanesi (AAM) olan ve olmayan diabetes mellituslu (DM) kadın hastalarda retinada ortaya çıkan nörodejeneratif tutulumun seviyesini karşılaştırmayı amaçladık. Gereç ve Yöntemler: Haziran 2021-Nisan 2022 tarihleri arasında kliniğimize başvuran Tip 2 DM tanısı konulmuş 30 yaş üstü kadın hastaların verileri prospektif olarak toplandı. Tüm hastalarda diyabetik retinopati (DR) varlığı araştırıldı ve optik koherens tomografi cihazı ile retina sinir lifi tabakası (RSLT) kalınlığı ölçüldü. Ayrıca çalışmaya tüm hastaların alt üriner sistem semptomları değerlendirildi ve her hasta için Aşırı Aktif Mesane-V8 [Over Active Bladder-V8 (OAB-V8)] anketi dolduruldu. OAB skoru 8 ve üzerinde olanlar AAM sendromu olarak kabul edildi. Bulgular: Çalışmaya 48 kadın hasta dâhil edildi. Bu hastaların 31'inde OAB skoru 8'in üzerindeydi ve Grup 1 olarak adlandırıldı. AAM saptanmayanlar da Grup 2'yi oluşturdu. Hastaların yaş ortalaması ve beden kitle indeksleri her iki grupta benzerdi. HbA1c düzeyleri ise Grup 1'de Grup 2'ye göre istatistiksel olarak anlamlı şekilde yüksek saptandı (p=0,023). Sağ ve sol göz nazal kadranda RSLT kalınlığı anlamlı olarak Grup 1'de daha azalmış bulundu (sırasıyla p=0,001 p=0,018). Retinopati şiddeti karşılaştırıldığında Grup 1 de istatistiksel olarak anlamlı şekilde retinopati evresi daha yüksek bulundu (p=0,01). AAM gelişimi üzerine en etkili risk faktörleri HbA1c düzeyi ve sağ göz nazal RSLT kalınlığı olarak saptandı (sırasıyla p=0,038 ve p=0,024). Sonuç: Bu çalışmada, şiddetli DR'si olan diyabetik hastalarda AAM insidansının daha yüksek olduğu gösterilmiştir. Ek olarak serum HbA1c düzeyi ve sağ göz nazal RSLT kalınlığı AAM sendromu gelişimi için birer risk faktörü olduğu saptanmıştır.

Anahtar Kelimeler: Retina sinir lifi tabakası; aşırı aktif mesane; diabetes mellitus; diyabetik retinopati
ABSTRACT
 Objective: To compare the level of neurodegenerative involvement in the retina in female patients with diabetes mellitus (DM) with and without overactive bladder (OAB). Material and Methods: The data of female patients over the age of 30 and diagnosed with Type 2 DM who applied to the our clinic between June 2021 and April 2022 were prospectively collected. Presence of diabetic retinopathy (DR) was investigated in all patients and retinal nerve fiber layer (RNFL) thickness was measured with optical coherence tomography. In addition, all study participants were evaluated about the lower urinary systems symptoms and filled the OAB-V8 questionnaire. Patients with OAB score 8 or more were considered to have OAB syndrome. Results: Fortyeight female patients were included in the study. In 31 of these patients, the OAB score was above 8 and was named Group 1. Those without OAB also formed Group 2. The mean age and body mass index of the patients were similar in both groups. Serum HbA1c levels were found significantly higher in Group 1 compared to Group 2 (p=0.023). RNFL thickness in the nasal quadrant of the right and left eyes was significantly decreased in Group 1 (respectively, p=0.001 p=0.018). Retinopathy stage was found significantly higher in Group 1 (p=0.01). The most effective risk factors for the development of OAB were HbA1c level and right eye nasal RNFL thickness (p=0.038 and p=0.024, respectively). Conclusion: In present study, it was shown that the incidence of OAB is higher in diabetic patients with severe DR. In addition, serum HbA1c level and right eye nasal RNFL thickness were found risk factors for the development of OAB syndrome.

Keywords: Retinal nerve fiber layer; overactive bladder; diabetes mellitus; diabetic retinopathy
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