Miks Üriner 􀄝nkontinans􀃖 Olan Kad􀃖nlarda Transobturator Band Uygulamas􀃖n􀃖n Uzundönem Cerrahi Sonuçları

Year 2014, Volume: 67 Issue: 2, 73 - 78, 31.08.2014

Tarık Yonguç , Özgü Aydoğdu , İbrahim Halil Bozkurt , Salih Polat , Bülent Günlüsoy Volkan Şen , Tansu Değirmenci , Burak Arslan

Abstract

Amaç: Miks üriner inkontinans􀃖 (MÜ􀄝) olan hastalarda transobturator bant (TOT) i􀄹lemine ait postoperative sonuçlar ve komplikasyonlar􀃖n de􀃾erlendirilmesi.

Gereç ve yöntem: TOT yap􀃖lan 193 kad􀃖n hasta de􀃾erlendirildi. Bu hastalardan MÜ􀄝 olan 75 kad􀃖n hasta incelendi. Tüm hastalar preoperatif dönemde ve postoperatif kontrollerde International Consultation on Incontinence Questionnaire-Short formunu (ICIQ-SF) ile de􀃾erlendirildi. Postoperatif hasta memnuniyet visual analog scale (VAS) ile de􀃾erlendirildi. Tüm hastalar postoperatif 15. günde idrar kültürü ile ve olas􀃖 postoperatif erken komplikasyonlar aç􀃖s􀃖ndan de􀃾erlendirildi. Hastalar postoperatif 3. ve 12. aylarda ve y􀃖ll􀃖k olarak pelvik muayene, VAS, öksürük stress testi (CST) ve ICIQ-SF ile de􀃾erlendirildi. Cerrahi sonuçlar, sübjektif ve objektif iyile􀄹me oranlar􀃖 ile i􀄹lemle ili􀄹kili komplikasyonlar not edildi. 􀄝statiksel analizler SPSS 17.0 program􀃖 (SPSS version 17.0, Chicago, IL, USA) kullan􀃖larak yap􀃖ld􀃖.

Bulgular: Çal􀃖􀄹ma kriterlerine uygun olan toplam 67 hasta çal􀃖􀄹maya dahil edildi. Objektif iyile􀄹me, sübjektif iyile􀄹me ve hasta memnuniyet oranlar􀃖 s􀃖ras􀃖yla %89,6, %53,7 ve %70,1 olarak bulundu. Postoperatif 5. y􀃖l ICIQ-SF skoru >0 olan 29 hastan􀃖n ortalama skoru 12,2 (SD ± 4,2) idi. 67 hastadan, 12 hastan􀃖n (%17.9) urge üriner inkontinans (UUI) 􀄹ikayeti postoperatif dönemde iyile􀄹ti. Postoperatif dönemde UUI 􀄹ikayeti devam eden 55 (%82) hastaya antimuskarinik ilaç tedavisi ba􀄹land􀃖. Hiçbir hastada intraoperatif komplikasyon izlenmedi. Takip s􀃖ras􀃖nda iki hasta (%3) rekürren stres üriner inkontinans (SUI) nedeniyle tekrar opere edildi.

Sonuç: Uzun dönemde TOT, bask􀃖n komponenti SUI olan MUI hastalar􀃖n􀃖n cerrahi tedavisinde ba􀄹ar􀃖l􀃖 bir yöntemdir. Ço􀃾u kad􀃖n için operasyon tatmin edicidir. UUI’􀃖n devam etmesi hasta memnuniyetsizli􀃾inin temel nedenidir.

Keywords

TOT , miks üriner inkontinans , stres üriner inkontinans

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Long-Term Surgical Outcomes of Transobturator Tape Procedure in Women With Mixed Urinary Incontinence

Abstract

Objective: To evaluate postoperative outcomes and complications of transobturator tape (TOT) procedure in the treatment of patients with mixed urinary incontinence (MUI).

Materials and methods: We analyzed 193 consecutive female patients who underwent TOT procedure. Among these patients 75 women with MUI were the subjects of this study. All patients were evaluated with the International Consultation on Incontinence Questionnaire-Short form (ICIQ-SF) preoperatively and at the postoperative follow-up visits. Patient satisfaction was evaluated with Visual analog scale. On the postoperative 15th day, all patients were routinely evaluated with urine culture and possible early postoperative complications were examined. Patients were evaluated on the postoperative 3rd, 12th months and annually with pelvic examination, VAS, cough stress test (CST) and ICIQ-SF. Surgical outcomes were evaluated and data of subjective and objective cure rates, any complications related to the procedure were registered. Statistical analyses were performed with SPSS 17.0 (SPSS version 17.0, Chicago, IL, USA).

Results: A total of 67 women who met the requirements for inclusion and who had available records for analysis were included in the study. Objective cure, subjective cure and patient satisfaction rates were 89.6, 53.7 and 70.1% respectively. The mean score for 29 patients with a postoperative 5th year ICIQ-SF score >0 was 12.2 (SD ± 4.2). Of the 67 patients, the urgency urinary incontinence (UUI) component of 12 patients (17.9%) had improved postoperatively. Fifty-five (82%) patients with persistent UUI postoperatively were treated with antimuscarinic drugs. None of our patients experienced intraoperative complications. Two (3%)

patients required re-operation for recurrent stress urinary incontinence (SUI) in the follow-up. Conclusion: TOT procedure is successful for surgical treatment of MUI with predominant SUI in long-term follow-up. The operation was satisfactory for the most of the women. Persistence of UUI was the main reason for dissatisfaction

Keywords

TOT , mixed urinary incontinence , stress urinary incontinence

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