The relationships between preoperative urodynamic parameters and clinical outcomes in urinary stress incontinence
Öz
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.
Anahtar Kelimeler
Kaynakça
- Flisser AJ, Blaivas JG. Evaluating incontinence in women. Urol Clin N Am 2002; 29: 515-26.
- Özkürkçügil C. Stres inkontinansta ürodinamik incelemenin yeri. TÜYK Sınavı Hazırlık Kursu Ders Notları (Ander H, Tekgül S) Uludağ 2004; 445-8.
- Raz S, Stothers L, Chopra A. Vaginal reconstructive surgery for incontinence and prolapse ın Campell's Urology (Walsh PC, Retik AB, Seventh edition. Philadelphia, Saunders 1998; 1: 1059-94. Wein AJ)
- Nager CW, FitzGerald MP, Kraus SR, et al. Urodynamic Measures don’t predict stress continence outcomes after surgery for stress urinary incontinence in selected women. J Urol 2008; 179: 1470-4.
- McGuire EJ, Clemens JQ. Pubovaginal slings. In Campbell’s Urology (Walsh PC, Retik AB, Vaughan ED, Wein AJ), Eighth edition. Saunders Company 2002; 2: 1152-71.
- Rodriguez LV, Almeida FD, Dorey F, Raz S. Does valsalva leak point pressure predict outcome after the distal urethral polypropylene sling? Role of urodynamics in the sling era. J Uro1 2004; 172: 210-4.
- Lowenstein L, Dooley Y, Kenton K, et al. The volume at which women leak first on urodynamic testing is not associated with quality of life, measures of urethral integrity or surgical failure. J Urol 2007; 178: 193-6.
- McGuire ED. Urodynamic evaluation of stress incontinence. Urol Clin N Am 1995; 22: 551-5.
- Miller EA, Amundsen CL, Toh KL, Flynn urodynamic evaluation may predict voiding dysfunction pubovaginal sling. J Urol 2003; 169: 2234-7. undergoing
- Chaikin DC, Rosental J, Blavias JG. Pubovaginal fascial sling for all types of stress urinary incontinence. Long term analysis. J Urol 1998; 160: 1312-6.
Üriner Stres nkontinansda Sling Cerrahisi Öncesi Ürodinamik Degiskenlerin Preoperatif ve Postoperatif Klinik Yansımaları
Öz
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.
Anahtar Kelimeler
Kaynakça
- Flisser AJ, Blaivas JG. Evaluating incontinence in women. Urol Clin N Am 2002; 29: 515-26.
- Özkürkçügil C. Stres inkontinansta ürodinamik incelemenin yeri. TÜYK Sınavı Hazırlık Kursu Ders Notları (Ander H, Tekgül S) Uludağ 2004; 445-8.
- Raz S, Stothers L, Chopra A. Vaginal reconstructive surgery for incontinence and prolapse ın Campell's Urology (Walsh PC, Retik AB, Seventh edition. Philadelphia, Saunders 1998; 1: 1059-94. Wein AJ)
- Nager CW, FitzGerald MP, Kraus SR, et al. Urodynamic Measures don’t predict stress continence outcomes after surgery for stress urinary incontinence in selected women. J Urol 2008; 179: 1470-4.
- McGuire EJ, Clemens JQ. Pubovaginal slings. In Campbell’s Urology (Walsh PC, Retik AB, Vaughan ED, Wein AJ), Eighth edition. Saunders Company 2002; 2: 1152-71.
- Rodriguez LV, Almeida FD, Dorey F, Raz S. Does valsalva leak point pressure predict outcome after the distal urethral polypropylene sling? Role of urodynamics in the sling era. J Uro1 2004; 172: 210-4.
- Lowenstein L, Dooley Y, Kenton K, et al. The volume at which women leak first on urodynamic testing is not associated with quality of life, measures of urethral integrity or surgical failure. J Urol 2007; 178: 193-6.
- McGuire ED. Urodynamic evaluation of stress incontinence. Urol Clin N Am 1995; 22: 551-5.
- Miller EA, Amundsen CL, Toh KL, Flynn urodynamic evaluation may predict voiding dysfunction pubovaginal sling. J Urol 2003; 169: 2234-7. undergoing
- Chaikin DC, Rosental J, Blavias JG. Pubovaginal fascial sling for all types of stress urinary incontinence. Long term analysis. J Urol 1998; 160: 1312-6.
Ayrıntılar
| Birincil Dil | Türkçe |
|---|---|
| Bölüm | Araştırma Yazıları |
| Yazarlar | |
| Yayımlanma Tarihi | 1 Aralık 2008 |
| Gönderilme Tarihi | 2 Mart 2015 |
| Yayımlandığı Sayı | Yıl 2008 Cilt: 35 Sayı: 4 |