Stres üriner inkontinans hastalarında midüretral transobturator bant cerrahisi: Klinik gözlem ve erken dönem sonuçları

Ayhan Aksoy; Hakan Nazik; Raziye Narin; Mehmet Narin; Hakan Aytan; Murat Api

EN TR

Stres üriner inkontinans hastalarında midüretral transobturator bant cerrahisi: Klinik gözlem ve erken dönem sonuçları

Abstract

Aim. In stress urinary incontinence patients (SUI), the evalution of the results and complications of Transobturator tape (TOT) procedure by using clinical and life quality analysis. Method. 30 patients, who are diagnosed as SUI or MUI and operated with TOT procedure were included in the study. The mean patient age was 46.5±7. Preoperative urological and gynecological histories were taken; gynecological examination, ultrasonography, stres test, Q tip test were performed. Incontinence questionnaires were filled. TOT procedure was performed to all 30 patients by using monofilament tape with outside-in technique. The mean postoperatif follow-up was 16.7 months. In the postoperative period all patients’ clinical and laboratory tests were repeated and compared with the preoperative parameters. Results were evaluated with Wilcoxon signed rank test for statistical significance. Results. Eight (26.7%) patients had SUI, 22 (73.3%) patients had MUI. No additional operations were performed to nine (30%) patients. In addition to TOT, six (20%) of patients had colporraphy anterior (CA), twelve (40%) patients had CA and colporraphy posterior (CP), 1 (3.3%) patient had CP, two (6.6%) patients had vaginal hysterectomy (VAH) and CA+CP. Intraoperative one (3.3%) bladder perforation has occured. Postoperative one patient had de nove urge. While TOT procedure was successful in 26 cases (86.7%), 4 (13.3%) of them have failed. In the life quality analysis IIQ-7 (Incontinence impact questionnaire) and UDI-6 (Urinary distress inventory) scores showed significant improvement (P<0.001 ve P=0.026). Conclusion. Our study confirmed high objective cure rate, improvement of symptoms and quality of life with TOT operation. These results suggest that the transobturator tape procedure is a valueable alternative to the other surgical procedures in SUI, with a low rate of complications and convenience of learning and application.

Keywords

Stress urinary incontinence, transobturator tape, TVT

Stres üriner inkontinans hastalarında midüretral transobturator bant cerrahisi: Klinik gözlem ve erken dönem sonuçları

Öz

Amaç. Stres üriner inkontinans (SUI) olgularında, Transobturator bant (TOT) operasyonunun sonuçlarının ve komplikasyonlarının, klinik ve yaşam kalitesi analizi yapılarak değerlendirilmesi. Yöntem. SUI veya mikst üriner inkontinans (MUI) tanısı ile TOT yapılan 30 hasta çalışmaya alındı. Hastaların yaş ortalaması 46,5±7 idi. Preoperatif ürolojik ve jinekolojik anamnez alındı ve jinekolojik muayene, ultrasonografi, stres test, Q tip test yapıldı, inkontinans anketleri dolduruldu. TOT operasyonu monoflaman tape kullanılarak dıştan içe yöntem kullanılarak yapıldı. Hastaların postoperatif dönemde tüm klinik ve laboratuar bulguları değerlendirilerek preoperatif parametreler ile karşılaştırıldı. Operasyondan sonra hastaların ortalama takip süresi 16,7 aydı. Sonuçlar Wilcoxon signed rank testi ile istatistiksel anlamlılık açısından değerlendirildi. Bulgular. Sekiz hastada (%26,7) SUI, 22 hastada (%73,3) MUI mevcuttu. TOT ameliyatına ek olarak 6 (%30) hastaya kolporafi anterior (KA), 1 (%3,3) hastaya kolporafi posterior (KP), 12 (%40) hastaya KA ve KP 2 (%6,6) hastaya vaginal histerektomi, KA, KP uygulanmıştır. Bir hastada mesane perforasyonu, bir hastada postoperatif urge inkontinans görüldü. TOT operasyonu ile hastaların 26’sında (%86,7) başarılı olunurken, dördünde (%13,3) başarısız olunmuştur. Yaşam kalitesi değerlendirilmesinde IIQ-7 (Incontinence impact questionnaire) ve UDI-6 (Urinary distress inventory) skorlarında istatistiksel olarak anlamlı düzelme saptanmıştır (P<0,001 ve P=0,026). Sonuç. Bu çalışmada, SUI tedavisinde TOT uygulaması ile yüksek objektif iyileşme ve yaşam kalitesinde anlamlı düzelme sağlandığı saptanmıştır. Uygulama kolaylığı ve komplikasyon oranının düşük olması sebebiyle TOT operasyonunun diğer inkontinans cerrahi prosedürlerine iyi bir alternatif olduğu sonucuna varılmıştır.

Anahtar Kelimeler

Stres üriner inkontinans, midüretral transobturator bant, TVT

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Details

Primary Language

Turkish

Subjects

-

Journal Section

-

Authors

Ayhan Aksoy

Publication Date

March 5, 2013

Submission Date

March 5, 2013

Acceptance Date

-

Published in Issue

Year 2013 Volume: 35 Number: 4

IZ

https://izlik.org/JA93NY25LW

Cite

RIS / Bibtex

AMA

1.Aksoy A, Nazik H, Narin R, Narin M, Aytan H, Api M. Stres üriner inkontinans hastalarında midüretral transobturator bant cerrahisi: Klinik gözlem ve erken dönem sonuçları. CMJ. 2013;35(4):540-547. https://izlik.org/JA93NY25LW