Stres üriner inkontinans tedavisinde transobturator teyp ve transvajinal teyp yöntemlerinin etkinliğinin ve komplikasyonlarının karşılaştırılması

Yıl 2023, , 10 - 16, 21.06.2023

Ali Buhur , Ömer Ünal , Dilek Erdem

https://doi.org/10.30565/medalanya.1120024

Öz

Amaç: Stres üriner inkontinans tedavisinde transobturator teyp ve transvajinal teyp yöntemlerinin etkinlik ve komplikasyonlarının karşılaştırılması.

Yöntem: Ocak 2015-Aralık 2016 tarihleri arasında İstanbul Kanuni Sultan Süleyman Eğitim Eğitim ve Araştırma Hastanesinde stres üriner inkontinans (SUI) nedeniyle opere edilen 106 hastanın klinik kayıtları retrospektif incelendi. Transobturator teyp (TOT) Grup 1 ve gerilimsiz trans vajinal teyp (TVT) Grup 2 olarak sınıflandırıldı. Hastalarda preoperatif ve postoperatif inkontinans şiddetini ve operasyon başarı düzeylerini değerlendirmek için Q tip test, pet test, rezidü idrar ölçümü, stres testi ve yaşam kalitesini karşılaştırmak için ürogenital distres envanteri-6 (UDI-6) ve inkontinans etki anketi-7 (IIQ-7) kullanıldı. İki gruptaki demografik bilgiler, yapılan ek cerrahiler, komplikasyonlar, preoperatif ve postoperatif altıncı aydaki başarı ve memnuniyet düzeyleri için yapılan klinik test sonuçları karşılaştırıldı.

Bulgular: Gruplar arasında ortalama parite, vücut kitle indeksi, sigara kullanımı, inkontinans tipi, preoperatif ve postoperatif altıncı ayda yapılan, klinik ve yaşam kalitesini ölçen test sonuçları ve operasyon başarı düzeyleri yönünden istatiksel olarak anlamlı fark saptanmadı (p>0.05). İki grup arasında ortalama yaş, menopoz durumu, inkontinans süresi, eş zamanlı yapılan cerrahiler, mesane perforasyonu ve ameliyat süresi açısından anlamlı fark saptandı (p<0.05). Diğer komplikasyonlar açısından anlamlı fark saptanmadı.

Sonuç: TOT ve TVT sonuçlarının değerlendirilmesinde klinik testler yanında UDI-6 ve IIQ-7 testleri kullanılabilir. SUI tedavisinde etkinlik ve başarı açısından iki yöntem arasında anlamlı fark saptanmadı. TVT yönteminde komplikasyon riski TOT yöntemine göre daha yüksek saptandı. Her iki yöntemde inkontinans şiddetinde iyileşme ve yaşam kalitesi anketi sonuçlarına göre belirgin iyileşme saptandı.

Anahtar Kelimeler

transobturator teyp, transvaginal teyp, stres inkontinans, UDI-6, IIQ-7

Comparison of the effectiveness and complications of transobturator tape and transvaginal tape methods in the treatment of stress urinary incontinence

Öz

Aim: Comparison of the effectiveness and complications of transobturator tape and transvaginal tape methods in the treatment of stress urinary incontinence.

Method: Clinical records of 106 patients who underwent surgery in Istanbul Kanuni Sultan Suleyman Training and Research Hospital due to stress urinary incontinence between January 2015 and December 2016 were retrospectively analyzed. The patients were divided into two groups. Trans obturator tape (TOT) was classified as Group 1, and transvaginal tape (TVT) was classified as Group 2. The urogenital distress inventory-6 (UDI-6) and the incontinence impact questionnaire-7 (IIQ-7) were used to determine the severity of preoperative and postoperative incontinence and objectively compare the quality of life in all patients. The ethics committee approval was obtained from the ethics committee of Kanuni Training and Research Hospital. Statistical analysis of data was performed using SPSS version 24 (SPSS Inc, Chicago, Illinois).

Results: There was a significant difference between the two groups in terms of mean age, menopausal status, complications, and duration of surgery (p<0.05). In both groups, there was a significant improvement in postoperative UDI-6 and IIQ-7 tests evaluating the negative effects of urinary incontinence on daily life (p=0.01* and p=0.028*, respectively).

Conclusion: A significant improvement was observed in UDI-6 and IIQ-7 scores after TOT and TVT operations. There is no significant difference between TOT and TVT methods in terms of efficacy and success in the treatment of stress urinary incontinence.

Anahtar Kelimeler

Transobturator tape, trans vaginal tape, stress urinary incontinence, UDI-6, IIQ-7

Kaynakça

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