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Stres Üriner İnkontinansın Tedavisinde Tension-free Vajinal Tape (TVT) ve Transobturator Tape (TOT) Yöntemlerinin Başarı ve Komplikasyon Oranlarının Karşılaştırılması

Year 2020, Volume: 27 Issue: 3, 267 - 272, 01.09.2020
https://doi.org/10.17343/sdutfd.593764

Abstract

Amaç: Tension-free
vaginal tape (TVT) ve transobturator tape (TOT) gibi midüretral slingler son
yıllarda sıkça kullanılmaktadır. Literatürde değişken komplikasyon ve başarı
oranları bildirilmiştir. Biz bu çalışmada, stres üriner inkontinans nedeni ile
TVT ve TOT cerrahisi yapılan hastaların komplikasyon ve başarı oranlarını
karşılaştırmayı amaçladık.



Gereç ve Yöntem: Çalışmada, stres üriner
inkontinans nedeni (SÜİ) ile TVT ameliyatı yapılan 43 hasta ile TOT ameliyatı
yapılan 38 hastanın verileri retrospektif olarak analiz edildi. Çalışmaya,
muayene veya ürodinami ile SÜİ tanısı konan hastalar dahil edildi. Mesane
disfonksiyonu yapan nörolojik hastalığı olan, idrar yolu enfeksiyonu, aşırı
aktif mesane ve kronik sistiti olan hastalar çalışmaya dahil edilmedi.
Hastaların intraoperatif ve postoperatif komplikasyonları ile 6. ayda ki cerrahi
başarı oranları değerlendirildi.



Bulgular: Hastaların yaş ortalamaları TVT grubunda
TOT grubuna göre daha düşük bulunmuştur (sırasıyla 46.2+6.1 ve 53.3+8.1) (p<0.05).  Parite sayısı, vücut kitle indeksi, menopoz
durumu ve sigara kullanımı bakımından istatistiksel olarak anlamlı bir fark
saptanmamıştır (p>0.05). Operasyon
süresi TVT grubunda 19.7+4.3,
TOT grubuna 13.8+2.6
göre daha uzun bulunmuştur (p<0.05). İntraoperatif komlikasyon olarak sadece
TVT grubunda 1 (%2.3) hastada
retziusta oluşan retroperitonal hematom görülmüştür. Postoperatif
komplikasyonlar olan üriner retansiyon, re-operasyon, de-novo urgency ve kasık
ağrısı açısından gruplar arasında fark izlenmemiştir (p>0.05). Her
iki grupta başarı oranları benzer olarak izlenmiştir ve istatistiksel fark
saptanmamıştır (p>0.05).



Sonuç: TVT ve TOT
operasyonlarının her ikisi de SÜİ tedavisinde başarıyla kullanıldığı
gösterilmiştir ve etkinlik açısından aralarında fark yoktur. Literatürde uzun
donem sonuçlar hakkında başarılı sonuçlar mevcuttur. Her iki yöntemde güvenle
uygulanabilir. 

References

  • 1. Haylen BT, de Ridder D, Freeman RM, Swift SE, Berghmans B, Lee J, et al. An International Urogynecological Association (IUGA)/International Continence Society (ICS) joint report on the terminology for female pelvic floor dysfunction. Neurourol Urodyn 2010;29:4-20. 2. Carls C. The prevalence of stress urinary incontinence in high school and collegeage female athletes in the midwest: implications for education and prevention. Urol Nurs 2007;27:21–4. 3. Ulmsten U, Henriksson L, Johnson P, Varhos G. An ambulatory surgical procedure under local anesthesia for treatment of female urinary incontinence. Int Urogynecol J Pelvic Floor Dysfunct 1996;7:81–6.4. Delorme E. Transobturator urethral suspension: mini-invasive procedure in the treatment of stress urinary incontinence in women. Prog Urol 2001;11:1306–13.5. Leone Roberti Maggiore U, Finazzi Agrò E, Soligo M, Li Marzi V, Digesu A, Serati M. Long-term outcomes of TOT and TVT procedures for the treatment of female stress urinary incontinence: a systematic review and meta-analysis. Int Urogynecol J 2017;28:1119-30.6. Daneshgari F, Kong W, Swartz M. Complications of mid urethral slings: Importantoutcomes for future clinical trials. J Urol 2008;180:1890–7.7. Meschia M, Bertozzi R, Pifarotti P, Baccichet R, Bernasconi F, Guercio E, et al. Perioperative morbidity and early results of a randomised trial comparing TVT and TVT-O. Int Urogynecol J 2007;18:1257-61. 8. Ford AA, Rogerson L, Cody JD, Aluko P, Ogah JA. Midurethral sling operations for stress urinary incontinence in women. Cochrane Database of Systematic Reviews 2017;7:CD006375.9. Medina CA, Costantini E, Petri E, Mourad S, Singla A, Rodríguez-Colorado S, et al. Evaluation and surgery for stress urinary incontinence: A FIGO working group report. Neurourol Urodyn. 2017;36:518-28. 10. Laurikainen E, Valpas A, Kivela A. Retropubic compare with transobturator tape placement in treatment of urinary incontinence: a randomized controlled trial. Obstet Gynecol 2007;109:4-11. 11. Falkert A, Seelbach-Gobel B. TVT versus TOT for surgical treatment of female stres urinary incontinence. Int J Gynaecol Obstet 2007;96:40-1. 12. de Tayrac R, Deffieux S, Chauveaud-Lambling A, Clavanese-Benamour L, Fernandez H. A prospective randomized trial comparing tension-free vaginal tape and transobturator suburethral tap efor surgical treatment of stres urinary incontinence. Am J Obstet Gynecol 2004;190:602-8. 13. Laurikainen E, Valpas A, Kivela A, Kalliola T, Rinne K, Takala T, et al. Retropubic compared with transobturator tape placement in treatment of urinary incontinence: a randomized controlled trial. Obstet Gynecol 2007;109:4-11.14. Barber MD, Gustilo Ashby AM, Chen CC, Kaplan P, Paraiso MF, Walters MD. Perioperative complications and adverse events of the MONARC transobturator tape, compared with the tension-free vaginal tape. Am J Obstet Gynecol 2006;195:1820-5. 15. Gobrecht U, Kuhn A, Fellman B. Injury of the corona mortis during vaginal tape insertion (TVT-SecurTM using the U-Approach). Int Urogynecol J 2011;22:443-5. 16. Larsson PG, Teleman P, Persson J. A serious bleeding complication with injury of the corona mortis with the TVT-Secur procedure. Int Urogynecol J 2010;21:1175-7.17. Schimpf MO, Rahn DD, Wheeler TL, Patel M, White AB, Orejuela FJ, et al. Society of Gynecologic Surgeons Systematic Review Group. Sling surgery for stress urinary incontinence in women: a systematic review and metaanalysis. Am J Obstet Gynecol 2014;211:7. 18. Nilsson CG, Falconer C, Rezapour M. Seven-year follow-up of the tension-free vaginal tape procedure for treatment of urinary incontinence. Obstet Gynecol 2004;104:1259-62. 19. Sander P, Møller LM, Rudnicki PM, Lose G. Does the tension-free vaginal tape procedure affect the voiding phase? Pressure-flow studies before and 1 year after surgery. BJU Int 2002;89:694-8. 20. Mellier G, Moore R, Jacquetin B. A meta-analysis of the intraoperative safety and effectiveness of the transobturator hammock seen in results of two prospective studies in 9 countries with 204 patients. ICS/IUGA Joint meeting. Paris 2004. 21. Schimpf MO, Rahn DD, Wheeler TL, Patel M, White AB, Orejuela FJ, et al. Society of Gynecologic Surgeons Systematic Review Group. Sling surgery for stress urinary incontinence in women: a systematic review and metaanalysis. Am J Obstet Gynecol 2014;211:71.22. McLennan MT, Melick CF. Bladder perforation during tension-free vaginal tape procedures: analysis of learning curve and risk factors. J Obstet Gynecol 2005;106:1000–4. 23. Abdel-Fattah M, Ramsay I, Pringle S. Lower urinary tract injuries after transobturator tape insertion by different routes: a large retrospective study. BJOG 2006;113:1377–81.
Year 2020, Volume: 27 Issue: 3, 267 - 272, 01.09.2020
https://doi.org/10.17343/sdutfd.593764

Abstract

References

  • 1. Haylen BT, de Ridder D, Freeman RM, Swift SE, Berghmans B, Lee J, et al. An International Urogynecological Association (IUGA)/International Continence Society (ICS) joint report on the terminology for female pelvic floor dysfunction. Neurourol Urodyn 2010;29:4-20. 2. Carls C. The prevalence of stress urinary incontinence in high school and collegeage female athletes in the midwest: implications for education and prevention. Urol Nurs 2007;27:21–4. 3. Ulmsten U, Henriksson L, Johnson P, Varhos G. An ambulatory surgical procedure under local anesthesia for treatment of female urinary incontinence. Int Urogynecol J Pelvic Floor Dysfunct 1996;7:81–6.4. Delorme E. Transobturator urethral suspension: mini-invasive procedure in the treatment of stress urinary incontinence in women. Prog Urol 2001;11:1306–13.5. Leone Roberti Maggiore U, Finazzi Agrò E, Soligo M, Li Marzi V, Digesu A, Serati M. Long-term outcomes of TOT and TVT procedures for the treatment of female stress urinary incontinence: a systematic review and meta-analysis. Int Urogynecol J 2017;28:1119-30.6. Daneshgari F, Kong W, Swartz M. Complications of mid urethral slings: Importantoutcomes for future clinical trials. J Urol 2008;180:1890–7.7. Meschia M, Bertozzi R, Pifarotti P, Baccichet R, Bernasconi F, Guercio E, et al. Perioperative morbidity and early results of a randomised trial comparing TVT and TVT-O. Int Urogynecol J 2007;18:1257-61. 8. Ford AA, Rogerson L, Cody JD, Aluko P, Ogah JA. Midurethral sling operations for stress urinary incontinence in women. Cochrane Database of Systematic Reviews 2017;7:CD006375.9. Medina CA, Costantini E, Petri E, Mourad S, Singla A, Rodríguez-Colorado S, et al. Evaluation and surgery for stress urinary incontinence: A FIGO working group report. Neurourol Urodyn. 2017;36:518-28. 10. Laurikainen E, Valpas A, Kivela A. Retropubic compare with transobturator tape placement in treatment of urinary incontinence: a randomized controlled trial. Obstet Gynecol 2007;109:4-11. 11. Falkert A, Seelbach-Gobel B. TVT versus TOT for surgical treatment of female stres urinary incontinence. Int J Gynaecol Obstet 2007;96:40-1. 12. de Tayrac R, Deffieux S, Chauveaud-Lambling A, Clavanese-Benamour L, Fernandez H. A prospective randomized trial comparing tension-free vaginal tape and transobturator suburethral tap efor surgical treatment of stres urinary incontinence. Am J Obstet Gynecol 2004;190:602-8. 13. Laurikainen E, Valpas A, Kivela A, Kalliola T, Rinne K, Takala T, et al. Retropubic compared with transobturator tape placement in treatment of urinary incontinence: a randomized controlled trial. Obstet Gynecol 2007;109:4-11.14. Barber MD, Gustilo Ashby AM, Chen CC, Kaplan P, Paraiso MF, Walters MD. Perioperative complications and adverse events of the MONARC transobturator tape, compared with the tension-free vaginal tape. Am J Obstet Gynecol 2006;195:1820-5. 15. Gobrecht U, Kuhn A, Fellman B. Injury of the corona mortis during vaginal tape insertion (TVT-SecurTM using the U-Approach). Int Urogynecol J 2011;22:443-5. 16. Larsson PG, Teleman P, Persson J. A serious bleeding complication with injury of the corona mortis with the TVT-Secur procedure. Int Urogynecol J 2010;21:1175-7.17. Schimpf MO, Rahn DD, Wheeler TL, Patel M, White AB, Orejuela FJ, et al. Society of Gynecologic Surgeons Systematic Review Group. Sling surgery for stress urinary incontinence in women: a systematic review and metaanalysis. Am J Obstet Gynecol 2014;211:7. 18. Nilsson CG, Falconer C, Rezapour M. Seven-year follow-up of the tension-free vaginal tape procedure for treatment of urinary incontinence. Obstet Gynecol 2004;104:1259-62. 19. Sander P, Møller LM, Rudnicki PM, Lose G. Does the tension-free vaginal tape procedure affect the voiding phase? Pressure-flow studies before and 1 year after surgery. BJU Int 2002;89:694-8. 20. Mellier G, Moore R, Jacquetin B. A meta-analysis of the intraoperative safety and effectiveness of the transobturator hammock seen in results of two prospective studies in 9 countries with 204 patients. ICS/IUGA Joint meeting. Paris 2004. 21. Schimpf MO, Rahn DD, Wheeler TL, Patel M, White AB, Orejuela FJ, et al. Society of Gynecologic Surgeons Systematic Review Group. Sling surgery for stress urinary incontinence in women: a systematic review and metaanalysis. Am J Obstet Gynecol 2014;211:71.22. McLennan MT, Melick CF. Bladder perforation during tension-free vaginal tape procedures: analysis of learning curve and risk factors. J Obstet Gynecol 2005;106:1000–4. 23. Abdel-Fattah M, Ramsay I, Pringle S. Lower urinary tract injuries after transobturator tape insertion by different routes: a large retrospective study. BJOG 2006;113:1377–81.
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Details

Primary Language Turkish
Subjects Surgery
Journal Section Research Articles
Authors

Yakup Yalcin 0000-0002-8826-6481

Serenat Eris Yalcin

Publication Date September 1, 2020
Submission Date July 18, 2019
Acceptance Date July 29, 2019
Published in Issue Year 2020 Volume: 27 Issue: 3

Cite

Vancouver Yalcin Y, Eris Yalcin S. Stres Üriner İnkontinansın Tedavisinde Tension-free Vajinal Tape (TVT) ve Transobturator Tape (TOT) Yöntemlerinin Başarı ve Komplikasyon Oranlarının Karşılaştırılması. Med J SDU. 2020;27(3):267-72.

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