The relationships between preoperative urodynamic parameters and clinical outcomes in urinary stress incontinence

Abstract

The aim of present study was to evaluate the influence of urodynamic parameters on preoperative and postoperative clinical pictures in stress incontinence. Charts of patients, who were operated for stress incontinence using autologous rectus fascia sling between March 1999 and January 2005 in Tepecik Training and Research Hospital Urology Clinic, were evaluated retrospectively. A total of 41 patients were divided into two subgroups as, pure (10 patients) and mixed stress incontinence (31 patients) groups. Mean age of patients was 50.4 (33-70) years. Fifteen patients had intrinsic sphincter insufficiency (ISI). Mixed incontinence group had lower volume for first sensation and more detrusor overactivity than pure group. ISI did not alter the success of operation. Urodynamically no relationship was found between detrusor pressure and postoperative postvoiding residual urine (P>0.05). In conclusion, urodynamic evaluation before surgery was not related to preoperative and postoperative clinical picture of patients, but first sensation of bladder is only predictive for the success in fascial sling surgery.

Keywords

• incontinence, urodynamic parameters, fascial sling.

Üriner Stres nkontinansda Sling Cerrahisi Öncesi Ürodinamik Degiskenlerin Preoperatif ve Postoperatif Klinik Yansımaları

Abstract

Bu çalısmada, üriner stres inkontinansda (saf veya karısık tip) otolog rektus fasyal sling cerrahisiöncesi ürodinamik degiskenlerin preoperatif ve postoperatif klinige yansımasını degerlendirmeyiamaçladık.Tepecik Egitim ve Arastırma Hastanesi Üroloji Kliniginde Mart 1999- Ocak 2005 tarihleriarasında üriner stres inkontinans nedeniyle otolog rektus fasyal sling cerrahi operasyonu yapılan hastadosyaları retrospektif olarak incelendi.Çalısmaya 10 saf, 31 karısık tipte inkontinansı bulunan toplam 41 hasta alındı. Yas ortalaması 50.4(33-70) yıl idi. Onbes hastada intrensek sfinkter yetmezligi (SY) mevcuttu. Karısık tip inkontinansdaürodinamik incelemede; ilk duyu hissi düsük hacimde olmus ve detrusor asırı aktivitesi fazla görülmüstü.SY basarı sonucunu degistirmemekteydi. Ürodinamideki detrusor basıncı (Pdet) ile postoperatifrezidü idrar arasında anlamlı bir iliski bulunmadı (P>0.05).Üriner stres inkontinansda; rektus fasyal sling cerrahisi öncesi yapılan ürodinamik inceleme,preoperatif ve postoperatif hasta klinigi ile uyumlu bulunmadı. Cerrahi basarıyı öngörmedeürodinamideki parametrelerden sadece ilk duyu hacmi anlamlı bulundu.

Keywords

• nkontinans, ürodinamik parametreler, fasyal sling.

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