Abstract
Aim: The aim of this study is to evaluate the surgical outcomes and complications of transobturator
tape (TOT) procedure.
Material and Methods: In this study, 175 patients
who were undergone TOT procedure due to pure
stress urinary incontinence (SUI) or mixt urinary incontinence (MUI) from 2011-2014 and examined at
1st and 3rd postoperative months with physical examination and stress tests were evaluated retrospectively.
Results: All of the patients were multiparous and
the median age was 50.0±11.3 years. Sixty-eight
(38.8%) of the patients were postmenopausal and
sixty-two (35%) of the patients who had TOT operation had extra surgery. One patient is complicated
with bladder perforation. Only one patient had blood transfusion requirement due to TOT operation.
Intraoperative bleeding more than 200 ml. is seen
in 6 patients. Four patients had vaginal fornix perforation. Three patients had developed perineal pain.
De-novo urge incontinence was seen in 8 patients
in the postoperative period and was successfully
treated with anticholinergic drugs. Mesh removals
and reconstruction of vaginal mucosa were done for
6 patients who had vaginal erosions. The objective
and subjective cure rates were found to be 87.4%
and 82.8%, respectively.
Conclusion: The use of mid-urethral synthetic slingis the first-choice of the surgical treatment of SUI
nowadays. The main reasons for this are low complication rates due to surgical technique, the use of
good quality materials, short operation time, and
short hospital stay
References
- Fong ED, Nitti VW. Review article: Mid-urethral synthetic slings for female stress urinary incontinence. BJU Int 2010;106:596–608.
- Petros PE, Ulmsten UI. An integral theory of female urinary incontinence. Experimental and clinical considerations. Acta Obstet Gynecol Scand Suppl 1990; 153: 7–31.
- DeLancey JO. Structural support of the urethra as it relates to stress urinary incontinence: the hammock hypothesis. Am J Obstet Gynecol 1994; 170: 1713–23.
- Delorme E. Transobturator urethral suspension: mini-invasive procedure in the treatment of stress urinary incontinence in women. Prog Urol 2001, 11(6):1306-1313.
- Liapis A, Bakas P, Creatsas G. Monarc vs TVT-O for the treatment of primary stress incontinence: a randomized study. Int Urogynecol J Pelvic Floor Dysfunct 2008; 19: 185–90.
- Abdel-Fattah M, Ramsay I, Pringle S, Hardwick C, Ali H. Evaluation of transobturator tapes (E-TOT) study: randomised prospective single-blinded study comparing inside-out vs. outside-in transobturator tapes in management of urodynamic stress incontinence: short term outcomes. Eur J Obstet Gynecol Reprod Biol 201
Abstract
Amaç: Bu çalışmanın amacı transobturator teyp
(TOT)operasyonunun etkinliğinin ve komplikasyonlarının değerlendirilmesidir.
Gereç ve Yöntemler: Bu çalışmada 2011-2014 yılları arasında saf stres ürinerinkontinans(SÜİ)veya
mikstürinerinkontinans(MÜİ) nedeniyle dıştan-içe
TOT operasyonu uygulananve postoperatifdönemde 1. ve 3. ayda kontrol muayenesi ve stres testleri
yapılarak değerlendirilen175 hasta retrospektifolarak incelendi.
Bulgular: Hastaların tamamı multipar veyaş ortalaması 50±11,3 (24-87) yıldı. Hastaların 68 (%38,8)
tanesi postmenopozal dönemde ve 62 (%35)’indeek cerrahi uygulanmıştı.Bir hastada mesane perforasyonuoluşmuştu. TOT operasyonuna bağlı kan
transfüzyonu gereksinimi sadece 1 hastada gerekli olmuştu. İntraoperatif 200ml üzerinde kanama 6
hastada izlendi. Vajinal forniksperforasyonu 4 vakada izlenmişti. Perineal ağrı 3 olguda ortaya çıkmıştı.
De novourgeinkontinanspostoperatif 8 hastada izlenmişti ve bu hastalara antikolinerjik tedavisiuygulanmıştı. Vajinal erozyon görülen 6 hastada mesh
eksize edildi ve vajen mukozası tekrar sütüre edildi.
Objektif ve sübjektif kür oranları sırasıyla %87,4 ve
%82,8 olarak bulundu.
Sonuç: Mid-üretralsentetik slingkullanımı SÜİ cerrahi tedavisinde günümüzde ilk seçenek olarak tercih edilmektedir. Kaliteli malzeme kullanımı ve cerrahi teknik sayesinde komplikasyon oranının düşük
olması, operasyon süresinin kısa oluşu ve hastanede kalış süresinin az olması bunda esas etkili olan
faktörlerdir.
References
- Fong ED, Nitti VW. Review article: Mid-urethral synthetic slings for female stress urinary incontinence. BJU Int 2010;106:596–608.
- Petros PE, Ulmsten UI. An integral theory of female urinary incontinence. Experimental and clinical considerations. Acta Obstet Gynecol Scand Suppl 1990; 153: 7–31.
- DeLancey JO. Structural support of the urethra as it relates to stress urinary incontinence: the hammock hypothesis. Am J Obstet Gynecol 1994; 170: 1713–23.
- Delorme E. Transobturator urethral suspension: mini-invasive procedure in the treatment of stress urinary incontinence in women. Prog Urol 2001, 11(6):1306-1313.
- Liapis A, Bakas P, Creatsas G. Monarc vs TVT-O for the treatment of primary stress incontinence: a randomized study. Int Urogynecol J Pelvic Floor Dysfunct 2008; 19: 185–90.
- Abdel-Fattah M, Ramsay I, Pringle S, Hardwick C, Ali H. Evaluation of transobturator tapes (E-TOT) study: randomised prospective single-blinded study comparing inside-out vs. outside-in transobturator tapes in management of urodynamic stress incontinence: short term outcomes. Eur J Obstet Gynecol Reprod Biol 201
Details
| Primary Language | English |
|---|---|
| Subjects | Health Care Administration |
| Journal Section | Original Research |
| Authors | |
| Publication Date | August 6, 2014 |
| Published in Issue | Year 2014 |