Transobturator Bant Cerrahisinde İçten Dışa ve Dıştan İçe Teknik Kullanılarak Meş Uygulaması Başarıyı Değiştirir mi?

Abstract

Amaç: Bu çalışmanın amacı kadınlarda stres üriner inkontinans (SÜİ) tedavisinde uygulanan transobturator bant (TOT) cerrahisinin içten dışa veya dıştan içe tekniği kullanılarak yapılmasının cerrahinin başarısına etkisini değerlendirmektir. Gereç ve Yöntemler: Bu ileriye yönelik randomize çalışmaya SÜİ tanısı alan ve TOT ameliyatı yapılmasına karar verilen 65 kadın dahil edildi. Katılımcılar iki gruba ayrıldı, 32 kadına içten dışa teknik kullanılarak TOT ameliyatı, 33 kadına ise dıştan içe teknik kullanılarak TOT ameliyatı yapıldı. Hastaların cerrahi verileri, 3 aylık komplikasyon insidansları, ameliyat öncesi ve sonrası idrar kaçırmanın etki anketleri (incontinence impact questionnaire, IIQ-7) ve Uluslararası İnkontinans Değerlendirmesi Anketi-Kısa Formu (International Consultation on Incontinence Questionnaire-Short Form, ICIQ-SF) skorları kaydedildi. Tedavinin başarısının değerlendirilmesinde objektif, subjektif ve yetersiz tedavi oranları belirlendi. Bulgular: İki grup karşılaştırıldığında yaş, vücut kitle indeksi, parite, menopoz durumu, inkontinans süresi, ameliyat öncesi IIQ-7 skorları ve ICIQ-SF skorları açısından istatistiksel olarak anlamlı fark yoktu. Ameliyat süreleri, hastanede kalış süreleri, erken dönem cerrahi komplikasyonlar ve ameliyat sonrası 3. ay IIQ-7 ve ICIQ-SF skorları arasında istatistiksel olarak anlamlı fark saptanmadı. Objektif, sübjektif ve yetersiz tedavi oranları açısından iki grup arasında istatistiksel olarak anlamlı fark yoktu. Sonuç: TOT cerrahisi SÜİ olan hastalarda her iki teknikle de oldukça başarılıdır. Cerrahın deneyimli olduğu ve kendini en güvende hissettiği tekniği seçmesi, teknik ne olursa olsun TOT ameliyatının başarısını artıracaktır.

Keywords

• Transobturator teyp
• subüretral slingler
• üriner inkontinans
• stres

Does Mesh Application by Using Inside-Out and Outside-In Techniques during Transobturator Tape Surgery Change the Success?

Abstract

Aim: This study aimed to evaluate the effect of transobturator tape (TOT) surgery, which is performed in the treatment of stress urinary incontinence (SUI) in women, using the inside-out or outside-in technique on the success of the surgery. Material and Methods: Sixty-five women diagnosed with SUI and for whom it was decided to perform TOT surgery were included in this prospective randomized study. Participants were divided into two groups, 32 women underwent TOT surgery using the inside-out technique and 33 women underwent TOT surgery using the outside-in technique. The surgical data of patients, the 3-month incidence of complications, pre-, and postoperative scores of the incontinence impact questionnaire (IIQ-7), and the International Consultation on Incontinence Questionnaire-Short Form (ICIQ-SF) were recorded. Objective, subjective, and inadequate treatment rates were determined for the evaluation of the success of the treatment. Results: When the two groups were compared, there was no statistically significant difference in terms of age, body mass index, parity, menopause status, duration of incontinence, and preoperative IIQ-7 and ICIQ-SF scores. There were no statistically significant differences between surgical durations, length of hospital stay, early surgical complications, and postoperative 3rd month IIQ-7 and ICIQ-SF scores. There were no statistically significant differences between the two groups in terms of objective, subjective, and inadequate treatment rates. Conclusion: TOT surgery is successful with both techniques in patients with SUI. Choosing the technique with which the surgeon is experienced and feels most confident will increase the success of TOT surgery regardless of the technique.

Keywords

• Transobturator tape
• suburethral slings
• urinary incontinence
• stress

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