Evaluation of The Transobturator Tape Operation Results and Complications in The Patient with Stress Incontinence

Öz

Aim: In this study, we aimed to evaluate the characteristics of stress urinary incontinence (SUI) patients admitted to our clinic besides the success rate and complications of the Transobturator Tape (TOT) surgery, which was offered to some of these patients. Material and Method: We retrospectively reviewed the SUI patients and the cases of TOT surgery in our urology clinic in State Hospital (Southeastern area in Turkey) between January 2014 and January 2017. The success rate and follow-up complications of TOT surgical treatments were evaluated by examining each of the case records. Among the patients who were followed during six months after the treatment, elderly patients who did not have urinary incontinence due to an increase in intraabdominal pressure were considered successful cases, while those with an ongoing urinary incontinence complaint were considered failures. Results: The 252 patients were between 22 and 90 years old, with a mean age of 45.6 years. All patients were multiparous; the mean number of children per patient was 3.14. Difficult births were reported by 156 (61.9%) of the patients, and 98 (38.8%) of them were postmenopausal. Twenty-five patients (10%) had prior surgery as a treatment for incontinence, and 47 (18.6%) had urogenital prolapse. Out of 60 patients who complained of SUI, 52 (86.6%) were continent after one month after TOT operation. Forty-nine (81.6%) of the 60 patients were continent throughout 6 months after the TOT treatment. Conclusion: The majority of patients in our region have many deliveries and they experience urinary incontinence. However, they do not know whether the urinary incontinence can be treated surgically and medically. The success rate with TOT is consistent with what was reported in the literature despite the less control patients. Our results show that it is appropriate to recommend TOT surgery to SUI patients who do not benefit from other medical treatments.

Anahtar Kelimeler

• stres incontinence; transobturator tape; urinary incontinence

Stres İnkontinansı Olan Hastalarda Transobturator Tape Operasyonu Komplikasyonu ve Sonuçlarının Değerlendirilmesi

Öz

Amaç: Bu çalışmada, üroloji kliniğimize başvuran stres üriner inkontinanslı (SÜİ) hastaların özelliklerini ve bu hastalardan kendilerine Transobturator Tape (TOT) cerrahisi uygulanan hastalarda tedavi başarısının ve komplikasyonlarının değerlendirilmesi amaçlandı. Materyal ve Metot: Güneydoğu bölgesinde bulunan bir devlet hastanesinin bünyesindeki üroloji kliniğimize Ocak 2014-Ocak 2017 tarihleri arasında stres inkontinans şikayeti ile gelen ve TOT uygulanan hastalar retrospektif olarak incelendi. Olguların kontrollerine ait kayıtlar incelenerek, her birinin TOT başarısı ve tedavileri ve aynı zamanda takipte gelişen komplikasyonlar değerlendirildi. Operasyon sonrası ve altı ay boyunca takibe gelen hastalardan herhangi bir karın içi basınç artışına bağlı olarak idrar kaçırması gözlenmeyen hastaların tedavisi başarılı olarak kabul edildi; öte yandan devam eden idrar kaçırma şikâyetinin olması TOT başarısızlığı olarak değerlendirildi. Bulgular: Yaş ortalamaları 45,6 (22–90) yıl olan 252 kadın hastanın tamamı multipardı. Ortalama çocuk sayısı 3,14 idi. Hastaların 156’sında (%61,9) zorlu doğum hikâyesi mevcuttu. Hastaların 98’i (%38,8) postmenapozal dönemdeydi. Ayrıca, 25 hasta (%10) daha önce de bir inkontinans cerrahisi geçirmişti. Muayenesinde ürogenital prolapsusu bulunan 47 hasta (%18,6) mevcuttu. Toplamda yapılan 60 TOT operasyonu sonrası, bir ay sonra kontrole gelen hastalardan stres inkontinans şikayeti ortadan kalkan 52 (%86,6) hasta mevcuttu. Altı ay sonra kontrole gelen 52 hastanın ise 49’u (%81,6) kontinandı. Sonuç: Bölgemizdeki kadın hastalar, genel olarak fazla sayıda doğum yapmakta ve bunun sonucu olarak idrar kaçırma problemi yaşamaktadırlar. Ancak bu problemi yaşayan hastalar bu durumun cerrahi ve medikal olarak tedavi olabileceğini bilmediği için, polikliniğimize bu nedenle başvuran kadın hasta sınırlıdır. Öte yandan, tedavi ettiğimiz hastalarımızdaki TOT operasyonu başarımız alan yazınla uyumludur. Sonuç olarak, stres inkontinans şikayeti olan ve bu durumu komplike olmayan hastalarda TOT cerrahisi oldukça başarılı bulunduğu için medikal tedaviden fayda görmeyen hastalara TOT cerrahisinin önerilmesinin uygun olduğu düşünülmektedir

Anahtar Kelimeler

• stres inkontinans; transobturator tape; üriner inkontinans

Kaynakça

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