Memorial Dicle Hastanesi \u00c7ocuk Cerrahisi B\u00f6l\u00fcm\u00fc\u2019nden Op. Dr. Taner Kamac\u0131, mesane refl\u00fcs\u00fc ve tedavi se\u00e7enekleri hakk\u0131nda bilgi verdi.<\/p>\n
Hastal\u0131\u011f\u0131n toplumda g\u00f6r\u00fclme s\u0131kl\u0131\u011f\u0131n\u0131n ortalama y\u00fczde 1 iken bu oran\u0131n s\u0131k idrar yolu enfeksiyonu ge\u00e7iren \u00e7ocuklarda y\u00fczde 50\u2019lere kadar \u00e7\u0131kt\u0131\u011f\u0131n\u0131 kaydeden Op. Dr. Kamac\u0131, do\u011fu\u015ftan b\u00f6breklerinde \u015fi\u015fme olan hastalar\u0131n ortalama y\u00fczde 30\u2019unun sebebinin mesane refl\u00fcs\u00fc oldu\u011funu s\u00f6yledi. Op. Dr. Kamac\u0131, \u201c1 ya\u015f\u0131ndan \u00f6nce erkek \u00e7ocuklar\u0131nda daha s\u0131k g\u00f6r\u00fcl\u00fcr, ancak ya\u015f b\u00fcy\u00fcd\u00fck\u00e7e k\u0131z \u00e7ocuklar\u0131nda da g\u00f6r\u00fclebilme oran\u0131 artmaktad\u0131r. Mesane refl\u00fcs\u00fcnde genetik fakt\u00f6rler \u00f6n plandad\u0131r. Dolay\u0131s\u0131yla mesane refl\u00fc hastas\u0131 olan \u00e7ocuklar\u0131n karde\u015flerinin de kontrolden ge\u00e7mesi \u00f6nerilmektedir. Erken te\u015fhis ve m\u00fcdahale hastal\u0131\u011f\u0131n seyri a\u00e7\u0131s\u0131ndan \u00e7ok \u00f6nemlidir. \u0130hmal edildi\u011fi takdirde hastal\u0131k b\u00f6brek hasar\u0131na hatta b\u00f6brek yetmezliklerine neden olabilir. \u00c7ocu\u011funuzda bu belirtiler varsa, tekrarlayan idrar yolu enfeksiyonu, s\u0131k s\u0131k ancak az miktarda idrar yapma, idrar ka\u00e7\u0131rma, k\u00f6t\u00fc kokulu idrar, bel ve kar\u0131n b\u00f6lgesinde a\u011fr\u0131, inat\u00e7\u0131 kab\u0131zl\u0131k belirtilerini dikkate alarak bir \u00e7ocuk cerrahisi uzman g\u00f6r\u00fc\u015f\u00fc almak, erken tan\u0131 ve tedavi ba\u015far\u0131s\u0131 i\u00e7in \u00e7ok \u00f6nemlidir\u201d dedi.<\/p>\n
\u00d6zel g\u00f6r\u00fcnt\u00fcleme y\u00f6ntemleri ile tan\u0131 konulabiliyor<\/p>\n
Voiding sisto\u00fcretrogram ad\u0131 verilen g\u00f6r\u00fcnt\u00fcleme y\u00f6nteminin tan\u0131 i\u00e7in \u00e7ok \u00f6nemli oldu\u011funu aktaran Op. Dr. Kamac\u0131, \u201cVoiding filmi, skopi denilen \u00f6zel r\u00f6ntgen cihaz\u0131 alt\u0131nda, idrar yoluna yerle\u015ftirilen steril bir kateter ile kontrast madde verilerek \u00e7ekilir. A\u011fr\u0131l\u0131 olmayan bu i\u015flem ile mesane refl\u00fcs\u00fcn\u00fcn olup olmad\u0131\u011f\u0131 ve varsa e\u011fer birden be\u015fe kadar evrelemesi yap\u0131labilir. Ayr\u0131ca voiding filmi ile mesane duvar\u0131 incelenebilir, mesanede divertik\u00fcl denilen balonla\u015fma, mesane \u00e7\u0131k\u0131\u015f\u0131nda darl\u0131k olup olmad\u0131\u011f\u0131 g\u00f6zlemlenebilir. Mesane refl\u00fcs\u00fc tespit edilen hastalarda refl\u00fcn\u00fcn derecesine, hastan\u0131n ya\u015f\u0131na, b\u00f6breklerinde hasar ve e\u015flik eden ba\u015fka \u00fcriner sistem hastal\u0131\u011f\u0131n olup olmad\u0131\u011f\u0131na g\u00f6re ila\u00e7 tedavisi veya ameliyat planlanabilir. Hafif d\u00fczeydeki refl\u00fclerin zamanla kendi kendine iyile\u015fmesi m\u00fcmk\u00fcnd\u00fcr. Ancak refl\u00fcn\u00fcn derecesi artt\u0131k\u00e7a kendili\u011finde iyile\u015fme \u015fans\u0131 azal\u0131r. Bu durumda hafif d\u00fczeydeki refl\u00fc, koruyucu antibiyotik tedavisi ile takip edilirken, derecesi artm\u0131\u015f y\u00fcksek riskli refl\u00fc \u00e7o\u011funlukla cerrahi m\u00fcdahale gerektirir. Koruyucu antibiyotik tedavisi almas\u0131na ra\u011fmen 2 den fazla idrar yolu enfeksiyonu ge\u00e7iren \u00e7ocuklarda da cerrahi m\u00fcdahale d\u00fc\u015f\u00fcn\u00fclebilir. Tedavide, halk aras\u0131nda kapal\u0131 denilen sistoskopik ve a\u00e7\u0131k cerrahi se\u00e7enekleri bulunmaktad\u0131r. Hastan\u0131n durumuna, ya\u015f\u0131na, refl\u00fcs\u00fcn\u00fcn tek veya iki tarafl\u0131 olmas\u0131na, refl\u00fcn\u00fcn derecesine, \u00fcreterin ve mesanenin durumuna ve e\u015flik eden di\u011fer durumlara g\u00f6re a\u00e7\u0131k veya kapal\u0131 ameliyat y\u00f6ntemlerine karar verilir. Kapal\u0131 ameliyatta sistoskopi denilen i\u015flemle idrar yollar\u0131ndan kamera ile mesaneye girilir ve idrar ka\u00e7a\u011f\u0131 olan \u00fcreter a\u011fz\u0131n\u0131n hemen alt\u0131na, o b\u00f6lgeyi \u015fi\u015firerek refl\u00fcy\u00fc \u00f6nleyecek bir madde enjeksiyonu yap\u0131l\u0131r. \u0130\u015flem yakla\u015f\u0131k yar\u0131m saat s\u00fcrer ve a\u011fr\u0131s\u0131zd\u0131r. Ba\u015far\u0131 oran\u0131 olduk\u00e7a y\u00fcksektir, a\u00e7\u0131k ameliyata g\u00f6re de bir\u00e7ok avantaj\u0131 vard\u0131r. A\u00e7\u0131k ameliyatta ise mesane i\u00e7inden veya d\u0131\u015f\u0131ndan yap\u0131lan farkl\u0131 i\u015flemler ile idrar yolunun mesane i\u00e7indeki yeri uzat\u0131larak de\u011fi\u015ftirilir ve ka\u00e7ak \u00f6nlenir. \u00c7ocuklarda son d\u00f6nem b\u00f6brek yetmezli\u011finin ve b\u00f6brek nakli gereksiniminin en s\u0131k sebeplerinden birisi olmas\u0131 nedeniyle s\u0131k idrar yolu enfeksiyonu ge\u00e7iren \u00e7ocuklar mutlaka mesane refl\u00fcs\u00fc a\u00e7\u0131s\u0131ndan de\u011ferlendirilmelidir\u201d diye konu\u015ftu.<\/p>\n","protected":false},"excerpt":{"rendered":"
MEMOR\u0130AL D\u0130CLE HASTANES\u0130 \u00c7OCUK CERRAH\u0130S\u0130 B\u00d6L\u00dcM\u00dc\u2019NDEN OP. DR. TANER KAMACI, MESANE REFL\u00dcS\u00dc VE TEDAV\u0130 SE\u00c7ENEKLER\u0130 HAKKINDA B\u0130LG\u0130 VERD\u0130.<\/p>\n","protected":false},"author":1,"featured_media":227367,"comment_status":"closed","ping_status":"open","sticky":false,"template":"","format":"standard","meta":{"_jetpack_newsletter_access":"","_jetpack_dont_email_post_to_subs":false,"_jetpack_newsletter_tier_id":0,"_jetpack_memberships_contains_paywalled_content":false,"_jetpack_memberships_contains_paid_content":false,"footnotes":"","jetpack_publicize_message":"","jetpack_publicize_feature_enabled":true,"jetpack_social_post_already_shared":true,"jetpack_social_options":{"image_generator_settings":{"template":"highway","default_image_id":0,"font":"","enabled":false},"version":2},"jetpack_post_was_ever_published":false},"categories":[1],"tags":[7305,1440,29633,57286],"class_list":["post-227366","post","type-post","status-publish","format-standard","has-post-thumbnail","hentry","category-genel","tag-cocuklarda","tag-dikkat","tag-mesane","tag-reflusune"],"jetpack_publicize_connections":[],"jetpack_featured_media_url":"https:\/\/i0.wp.com\/www.tvturk.com\/wp-content\/uploads\/2019\/11\/cocuklarda-mesane-reflusune-dikkat_71f0806.jpg?fit=1000%2C923","jetpack_sharing_enabled":true,"jetpack_shortlink":"https:\/\/wp.me\/paKIfm-X9c","_links":{"self":[{"href":"http:\/\/www.tvturk.com\/index.php\/wp-json\/wp\/v2\/posts\/227366","targetHints":{"allow":["GET"]}}],"collection":[{"href":"http:\/\/www.tvturk.com\/index.php\/wp-json\/wp\/v2\/posts"}],"about":[{"href":"http:\/\/www.tvturk.com\/index.php\/wp-json\/wp\/v2\/types\/post"}],"author":[{"embeddable":true,"href":"http:\/\/www.tvturk.com\/index.php\/wp-json\/wp\/v2\/users\/1"}],"replies":[{"embeddable":true,"href":"http:\/\/www.tvturk.com\/index.php\/wp-json\/wp\/v2\/comments?post=227366"}],"version-history":[{"count":0,"href":"http:\/\/www.tvturk.com\/index.php\/wp-json\/wp\/v2\/posts\/227366\/revisions"}],"wp:featuredmedia":[{"embeddable":true,"href":"http:\/\/www.tvturk.com\/index.php\/wp-json\/wp\/v2\/media\/227367"}],"wp:attachment":[{"href":"http:\/\/www.tvturk.com\/index.php\/wp-json\/wp\/v2\/media?parent=227366"}],"wp:term":[{"taxonomy":"category","embeddable":true,"href":"http:\/\/www.tvturk.com\/index.php\/wp-json\/wp\/v2\/categories?post=227366"},{"taxonomy":"post_tag","embeddable":true,"href":"http:\/\/www.tvturk.com\/index.php\/wp-json\/wp\/v2\/tags?post=227366"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}