Transobturator Tape and Kelly’s Plication Procedures Comparison: A Case-Control Study with One-Year Follow-Up

Abstract

Objective: To investigate the factors that may affect urinary incontinence and compare the outcomes of surgical methods used to treat it, specifically Transobturator Tape (TOT) and Kelly’s plication procedures. Method: The data of 213 patients who underwent TOT and Kelly’s Plication procedures for urinary incontinence at the Department of Obstetrics and Gynecology, Gaziantep University Faculty of Medicine, between January 2016 and December 2021, were retrospectively analyzed with consideration of their evaluations one year postoperatively. The patients were divided into two groups: those who underwent TOT and those who underwent Kelly’s’s Plication. The differences between the two groups were evaluated. Subsequently, the urinary incontinence complaints of both groups were assessed one year later, and the risk factors for patients whose complaints persisted were examined using logistic regression analysis. Results: One year postoperatively, the success of the TOT procedure was higher than that of the Kelly’s’s Plication. However, multivariate regression analysis revealed that patients who underwent the TOT procedure had a higher likelihood of persistent complaints compared to those who underwent Kelly’s’s Plication (OR: 2.07 [1.12-3.93], P=0.02). While there was a significant difference between the two groups in terms of parity and gravidity, no significant differences were observed in terms of age, BMI, menopausal status, type of urinary incontinence, and the presence of chronic diseases. Conclusion: The success rate of the TOT procedure was found to be higher compared to Kelly’s’s Plication. However, regression analysis indicated that patients who underwent the TOT procedure were more likely to have persistent urinary incontinence complaints. Keywords: Urinary Incontinence, Stress Urinary Incontinence , Transobturator Tape, Kelly’s’s Plication

Keywords

• Urinary Incontinence
• Stress Urinary Incontinence
• Transobturator Tape
• Kelly’s’s Plication

Üriner İnkontinans Nedeni İle Yapilan Transobturatuar Tape Ve Kelly Plikasyonu Operasyonlarinin Karşılaştırılması

Abstract

Amaç: Çalışmamızda üriner inkontinansı etkileyebilecek faktörleri araştırmak ve üriner inkontinans tedavisinde kullanılan cerrahi yöntemlerden TOT ve Kelly plikasyonu operasyonlarının sonuçlarını karşılaştırmak amaçlanmıştır. Yöntem: Ocak 2016 ve Aralık 2021 tarihleri arasında Gaziantep Üniversitesi Tıp Fakültesi Kadın Hastalıkları ve Doğum Kliniği’nde üriner inkontinans nedeni ile transobturator tape (TOT) ve Kelly Plikasyonu operasyonu uygulanan, 213 hastanın verileri ameliyattan sonraki 1 yıllık değerlendirmeleri göz önünde bulundurularak retrospektif olarak incelendi. Hastaların yaş, operasyon çeşidi, tam idrar analizi, üre, kreatinin sonuçları, kronik hastalık durumları, menopoz durumu, gravide ve pariteleri, vücut kitle indeksleri, idrar kaçırma(üriner inkontinans) tipi, stres testinin pozitif olup olmaması, vajinal prolapsus dereceleri, postoperatif kontrollerde idrar kaçırma şikayetlerinin devam edip etmemesi incelendi. Hastalar TOT ve Kelly plikasyonu operasyonu olanlar olmak üzere iki gruba ayrıldı. Bulgular: Ameliyattan sonraki 1 yılın sonunda TOT operasyonu sonrası başarı oranı Kelly plikasyonu yapılan gruptan daha yüksekti. Ancak multivariant regresyon analizleri sonucunda TOT yapılan hastaların şikayetlerinin devam etme olasılığı Kelly plikasyonuna göre daha yüksek saptanmıştır (OR: 2.07 1.12-3.93 ) (P=0.02). Parite ve gravida sayısına bakıldığında iki grup arasında anlamlı fark varken, yaş, VKİ, menopozal durum, üriner inkontinans tipi, kronik hastalık durumu konusunda anlamlı fark izlenmedi. Sonuç: TOT operasyonunun başarı oranı Kelly plikasyonuna göre daha yüksek bulunmuştur. Ancak, yapılan regresyon analizi sonucunda, TOT operasyonu geçiren hastalarda idrar kaçırma şikayetinin devam etme olasılığının daha fazla olduğu tespit edilmiştir.

Keywords

• Üriner inkontinans
• Stres Üriner İnkontinans
• Transobturator Tape
• kelly plikasyonu

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