Medicana Sa\u011fl\u0131k Grubu Kad\u0131n Hastal\u0131klar\u0131 ve Do\u011fum B\u00f6l\u00fcm\u00fc\u2019nden Op. Dr. G\u00fcltekin Ko\u00e7un, kad\u0131nlar\u0131n korkulu r\u00fcyas\u0131 olan rahim sarkmas\u0131n\u0131n \u00f6nlenebilece\u011fini vurgulayarak, pelvik taban\u0131 g\u00fc\u00e7lendiren egzersizlerin korunmada kritik rol oynad\u0131\u011f\u0131n\u0131 ifade etti. Op. Dr. G\u00fcltekin Ko\u00e7un, “G\u00fcnde yaln\u0131zca 5 dakika ayr\u0131larak yap\u0131lacak Kegel egzersizleri sarkma riskini azaltabilir. Ayr\u0131ca d\u00fczenli egzersiz ve do\u011fru ya\u015fam al\u0131\u015fkanl\u0131klar\u0131yla s\u00fcre\u00e7 kontrol alt\u0131na al\u0131nabilir” dedi.
\n
Rahim sarkmas\u0131, kad\u0131nlar\u0131n \u00f6zellikle ilerleyen ya\u015flarda kar\u015f\u0131la\u015ft\u0131\u011f\u0131 ancak \u00e7o\u011fu zaman dile getirmekte zorland\u0131\u011f\u0131 \u00f6nemli sa\u011fl\u0131k sorunlar\u0131ndan biri olarak \u00f6ne \u00e7\u0131k\u0131yor. G\u00fcnl\u00fck ya\u015fam\u0131, sosyal hayat\u0131 ve organ fonksiyonlar\u0131n\u0131 etkileyebilen bu durum, erken d\u00f6nemde fark edildi\u011finde ameliyats\u0131z y\u00f6ntemlerle dahi y\u00f6netilebiliyor. Medicana International \u0130zmir Hastanesi Kad\u0131n Hastal\u0131klar\u0131 ve Do\u011fum Uzman\u0131 Op. Dr. G\u00fcltekin Ko\u00e7un, rahim sarkmas\u0131n\u0131n temelinde pelvik taban kaslar\u0131 ve ba\u011f dokular\u0131n zay\u0131flamas\u0131n\u0131n yatt\u0131\u011f\u0131n\u0131 belirterek, “Rahim sarkmas\u0131 (uterus prolapsusu), rahmi yerinde tutan kaslar\u0131n ve ba\u011f dokular\u0131n zay\u0131flamas\u0131 sonucu rahmin vajina i\u00e7ine ya da d\u0131\u015f\u0131na do\u011fru kaymas\u0131 durumudur. Bu tablo \u00e7o\u011funlukla pelvik taban dedi\u011fimiz destek yap\u0131n\u0131n hasar g\u00f6rmesiyle ortaya \u00e7\u0131kar. \u00d6zellikle \u00e7ok say\u0131da ve zor vajinal do\u011fumlar, menopoz sonras\u0131 \u00f6strojen azalmas\u0131, kronik kab\u0131zl\u0131k, a\u011f\u0131r y\u00fck kald\u0131rma, kronik \u00f6ks\u00fcr\u00fck ve obezite gibi fakt\u00f6rler pelvik dokular \u00fczerinde s\u00fcrekli bask\u0131 olu\u015fturarak sarkmaya zemin haz\u0131rlar” diye konu\u015ftu.<\/p>\n
50 ya\u015f sonras\u0131 \u00e7ok s\u0131k g\u00f6r\u00fcl\u00fcyor
\n
Rahim sarkmas\u0131n\u0131n her ya\u015fta g\u00f6r\u00fclebilece\u011fini ancak \u00f6zellikle menopoz sonras\u0131 d\u00f6nemde belirgin \u015fekilde artt\u0131\u011f\u0131n\u0131 ifade eden Op. Dr. G\u00fcltekin Ko\u00e7un, “Rahim sarkmas\u0131 \u00f6zellikle 50 ya\u015f \u00fczerindeki kad\u0131nlarda daha s\u0131k g\u00f6r\u00fcl\u00fcr. En yo\u011fun g\u00f6r\u00fcld\u00fc\u011f\u00fc d\u00f6nem 50-60 ya\u015f aral\u0131\u011f\u0131d\u0131r. Klinik verilere g\u00f6re 60 ya\u015f\u0131n \u00fczerindeki her \u00fc\u00e7 kad\u0131ndan birinde farkl\u0131 derecelerde sarkma g\u00f6r\u00fclebilir. Menopozla birlikte \u00f6strojen hormonunun azalmas\u0131, pelvik taban dokular\u0131n\u0131n zay\u0131flamas\u0131na neden olur ve risk belirgin \u015fekilde artar. Bununla birlikte \u00e7ok say\u0131da do\u011fum yapm\u0131\u015f ya da ba\u011f dokusu zay\u0131f olan kad\u0131nlarda daha gen\u00e7 ya\u015flarda da g\u00f6r\u00fclebilir” dedi. Her rahim sarkmas\u0131n\u0131n ameliyat gerektirmedi\u011finin alt\u0131n\u0131 \u00e7izen Op. Dr. G\u00fcltekin Ko\u00e7un, tedavi karar\u0131n\u0131n hastaya \u00f6zel verilmesi gerekti\u011fini belirterek, “Tedavi plan\u0131 sarkman\u0131n derecesine ve hastan\u0131n ya\u015fam kalitesini ne \u00f6l\u00e7\u00fcde etkiledi\u011fine g\u00f6re \u015fekillenir. \u00d6zellikle erken ve orta evrelerde ameliyats\u0131z y\u00f6ntemlerle olduk\u00e7a ba\u015far\u0131l\u0131 sonu\u00e7lar elde edilebilir” ifadelerini kulland\u0131.<\/p>\n
Cerrahi hangi durumlarda ka\u00e7\u0131n\u0131lmaz olur
\n
\u0130leri evre sarkmalarda cerrahinin \u00f6n plana \u00e7\u0131kt\u0131\u011f\u0131n\u0131 belirten Op. Dr. G\u00fcltekin Ko\u00e7un, s\u00f6zlerine \u015f\u00f6yle devam etti: “Rahmin vajina d\u0131\u015f\u0131na \u00e7\u0131kt\u0131\u011f\u0131 ileri evre sarkmalarda, \u015fiddetli idrar ve ba\u011f\u0131rsak problemleri geli\u015fti\u011finde, vajinal yaralar ve enfeksiyonlar olu\u015ftu\u011funda ya da hastan\u0131n ya\u015fam kalitesi ciddi \u015fekilde bozuldu\u011funda cerrahi ka\u00e7\u0131n\u0131lmaz hale gelir. Ayr\u0131ca ameliyats\u0131z y\u00f6ntemlerden fayda g\u00f6rmeyen hastalarda da cerrahi planlanmaktad\u0131r. G\u00fcn\u00fcm\u00fczde rahim sarkmas\u0131 ameliyatlar\u0131 b\u00fcy\u00fck oranda kapal\u0131 y\u00f6ntemlerle ger\u00e7ekle\u015ftirilmektedir. Laparoskopik ve robotik cerrahi y\u00f6ntemlerde kar\u0131n b\u00f6lgesine b\u00fcy\u00fck kesi yap\u0131lmaz. K\u00fc\u00e7\u00fck kesilerden girilerek rahim asma i\u015flemi ger\u00e7ekle\u015ftirilir. Bu y\u00f6ntemler sayesinde hastalar daha az a\u011fr\u0131 hisseder, kan kayb\u0131 minimum olur ve genellikle k\u0131sa s\u00fcrede g\u00fcnl\u00fck hayatlar\u0131na d\u00f6nebilirler. Ameliyat sonras\u0131 iyile\u015fme s\u00fcreci genellikle 4 ila 6 hafta s\u00fcrmektedir. Ameliyat sonras\u0131 ilk g\u00fcnlerde erken mobilizasyon \u00e7ok \u00f6nemlidir. Evde dinlenme s\u00fcrecinde hafif a\u011fr\u0131lar normaldir ve kontrol alt\u0131na al\u0131nabilir. Ancak ilk 6 hafta a\u011f\u0131r kald\u0131rmamak, cinsel ili\u015fkiden ka\u00e7\u0131nmak, kab\u0131z kalmamak ve enfeksiyon riskine kar\u015f\u0131 dikkatli olmak gerekir. Bu kurallara uyum, ameliyat\u0131n ba\u015far\u0131s\u0131n\u0131 do\u011frudan etkiler.”<\/p>\n
Tekrarlama riski ya\u015fam tarz\u0131yla ili\u015fkili
\n
Rahim sarkmas\u0131n\u0131n cerrahi sonras\u0131 tekrar edebilece\u011fine dikkat \u00e7eken Op. Dr. G\u00fcltekin Ko\u00e7un, “Bilimsel veriler, ameliyat sonras\u0131 hastalar\u0131n yakla\u015f\u0131k y\u00fczde 10 ile y\u00fczde 30\u2019unda ilerleyen y\u0131llarda yeniden sarkma geli\u015febilece\u011fini g\u00f6stermektedir. Bu noktada en \u00f6nemli fakt\u00f6r hastan\u0131n ya\u015fam tarz\u0131d\u0131r. A\u011f\u0131r kald\u0131rmak, kronik kab\u0131zl\u0131k, fazla kilo ve sigara kullan\u0131m\u0131na ba\u011fl\u0131 \u00f6ks\u00fcr\u00fck gibi durumlar pelvik tabana y\u00fck bindirerek sarkman\u0131n tekrar\u0131na neden olabilir. Ayr\u0131ca ba\u011f dokusunun genetik olarak zay\u0131f olmas\u0131 ve menopoz sonras\u0131 hormonal de\u011fi\u015fimler de riski art\u0131r\u0131r” diye konu\u015ftu.<\/p>\n
G\u00fc\u00e7l\u00fc kas, d\u00fc\u015f\u00fck bas\u0131n\u00e7 ile korunmak m\u00fcmk\u00fcn
\n
Ameliyats\u0131z tedavi se\u00e7eneklerinin \u00f6zellikle ba\u015flang\u0131\u00e7 ve orta evrelerde etkili oldu\u011funu vurgulayan Op. Dr. G\u00fcltekin Ko\u00e7un, rahim sarkmas\u0131n\u0131n tamamen \u00f6nlenemese de b\u00fcy\u00fck \u00f6l\u00e7\u00fcde engellenebilece\u011fini de kaydetti. Op. Dr. G\u00fcltekin Ko\u00e7un, “D\u00fczenli pelvik taban egzersizleri yapmak, ideal kiloyu korumak, kab\u0131zl\u0131\u011f\u0131 \u00f6nlemek ve a\u011f\u0131r kald\u0131rmaktan ka\u00e7\u0131nmak en \u00f6nemli koruyucu ad\u0131mlard\u0131r. Sigaran\u0131n b\u0131rak\u0131lmas\u0131 ve kronik \u00f6ks\u00fcr\u00fc\u011f\u00fcn tedavi edilmesi de pelvik taban sa\u011fl\u0131\u011f\u0131 a\u00e7\u0131s\u0131ndan kritiktir. Menopoz d\u00f6neminde uygun hastalarda lokal \u00f6strojen tedavileri dokular\u0131n g\u00fcc\u00fcn\u00fc korumaya yard\u0131mc\u0131 olabilir. \u00d6zetle; g\u00fc\u00e7l\u00fc kas yap\u0131s\u0131 ve d\u00fc\u015f\u00fck kar\u0131n i\u00e7i bas\u0131nc\u0131 sa\u011fland\u0131\u011f\u0131nda sarkma riski \u00f6nemli \u00f6l\u00e7\u00fcde azalt\u0131labilir” dedi. Op. Dr. G\u00fcltekin Ko\u00e7un, pelvik taban kas egzersizleri yani Kegel egzersizlerinin, rahim sarkmas\u0131n\u0131 \u00f6nlemede en temel ve etkili y\u00f6ntem oldu\u011funu belirterek, s\u00f6zlerini \u015f\u00f6yle tamamlad\u0131: “Kegel egzersizi, pelvik taban kaslar\u0131n\u0131 do\u011fru \u015fekilde \u00e7al\u0131\u015ft\u0131rmaya dayanmaktad\u0131r. Bu kaslar, idrar yaparken ak\u0131\u015f\u0131 durdurmaya yarayan kaslard\u0131r. Egzersiz s\u0131ras\u0131nda bu kaslar s\u0131k\u0131l\u0131r, 3-5 saniye boyunca tutulur ve ard\u0131ndan gev\u015fetilir. Bu hareket g\u00fcn i\u00e7inde d\u00fczenli aral\u0131klarla tekrarlanmal\u0131 ve zamanla al\u0131\u015fkanl\u0131k haline getirilmelidir. D\u00fczenli uyguland\u0131\u011f\u0131nda pelvik taban\u0131 g\u00fc\u00e7lendirerek rahmi destekleyen yap\u0131y\u0131 korur, sarkman\u0131n ilerlemesini yava\u015flatabilir ve idrar ka\u00e7\u0131rma gibi \u015fikayetlerin azalmas\u0131na katk\u0131 sa\u011flar. Bunun yan\u0131 s\u0131ra vajinal pesser dedi\u011fimiz destek halkalar\u0131 rahmi mekanik olarak yukar\u0131da tutar ve ameliyata g\u00fc\u00e7l\u00fc bir alternatif olu\u015fturabilir. Pelvik taban fizyoterapisi, biofeedback ve elektriksel stim\u00fclasyon gibi y\u00f6ntemler de kaslar\u0131n g\u00fc\u00e7lenmesine katk\u0131 sa\u011flar.”
<\/p>\n","protected":false},"excerpt":{"rendered":"
Medicana Sa\u011fl\u0131k Grubu Kad\u0131n Hastal\u0131klar\u0131 ve Do\u011fum B\u00f6l\u00fcm\u00fc\u2019nden Op. Dr. G\u00fcltekin Ko\u00e7un, kad\u0131nlar\u0131n korkulu r\u00fcyas\u0131 olan rahim sarkmas\u0131n\u0131n \u00f6nlenebilece\u011fini vurgulayarak, pelvik taban\u0131 g\u00fc\u00e7lendiren egzersizlerin korunmada kritik rol oynad\u0131\u011f\u0131n\u0131 ifade etti. Op. Dr. G\u00fcltekin Ko\u00e7un, “G\u00fcnde yaln\u0131zca 5 dakika ayr\u0131larak yap\u0131lacak Kegel egzersizleri sarkma riskini azaltabilir. Ayr\u0131ca d\u00fczenli egzersiz ve do\u011fru ya\u015fam al\u0131\u015fkanl\u0131klar\u0131yla s\u00fcre\u00e7 kontrol alt\u0131na…<\/p>\n","protected":false},"author":1,"featured_media":97120,"comment_status":"open","ping_status":"open","sticky":false,"template":"","format":"standard","meta":{"_crdt_document":"","footnotes":""},"categories":[2],"tags":[],"class_list":["post-97119","post","type-post","status-publish","format-standard","has-post-thumbnail","hentry","category-saglik"],"_links":{"self":[{"href":"https:\/\/www.egemtv.com\/index.php?rest_route=\/wp\/v2\/posts\/97119","targetHints":{"allow":["GET"]}}],"collection":[{"href":"https:\/\/www.egemtv.com\/index.php?rest_route=\/wp\/v2\/posts"}],"about":[{"href":"https:\/\/www.egemtv.com\/index.php?rest_route=\/wp\/v2\/types\/post"}],"author":[{"embeddable":true,"href":"https:\/\/www.egemtv.com\/index.php?rest_route=\/wp\/v2\/users\/1"}],"replies":[{"embeddable":true,"href":"https:\/\/www.egemtv.com\/index.php?rest_route=%2Fwp%2Fv2%2Fcomments&post=97119"}],"version-history":[{"count":1,"href":"https:\/\/www.egemtv.com\/index.php?rest_route=\/wp\/v2\/posts\/97119\/revisions"}],"predecessor-version":[{"id":97121,"href":"https:\/\/www.egemtv.com\/index.php?rest_route=\/wp\/v2\/posts\/97119\/revisions\/97121"}],"wp:featuredmedia":[{"embeddable":true,"href":"https:\/\/www.egemtv.com\/index.php?rest_route=\/wp\/v2\/media\/97120"}],"wp:attachment":[{"href":"https:\/\/www.egemtv.com\/index.php?rest_route=%2Fwp%2Fv2%2Fmedia&parent=97119"}],"wp:term":[{"taxonomy":"category","embeddable":true,"href":"https:\/\/www.egemtv.com\/index.php?rest_route=%2Fwp%2Fv2%2Fcategories&post=97119"},{"taxonomy":"post_tag","embeddable":true,"href":"https:\/\/www.egemtv.com\/index.php?rest_route=%2Fwp%2Fv2%2Ftags&post=97119"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}