Stres Tip İdrar Kaçırma Tedavisinde Orta Üretra Askı Cerrahilerinin Uzun Dönem Etkinlik ve Güvenirliliğinin Karşılaştırılması

Yıl 2020, , 456 - 463, 20.12.2020

Murat Akgül , Çağrı Doğan , Cenk Murat Yazıcı , Rıdvan Özcan Mehmet Fatih Şahin

https://doi.org/10.37696/nkmj.759712

Öz

Giriş:
Transobturator tape (TOT) ve tension free vaginal tape (TVT) operasyonları stres tipte idrar kaçırma (StİK) tedavisinde kullanılan standart orta üretra askı cerrahileridir. Çalışmamızda, TOT/TVT operasyonlarının; klinik başarı, komplikasyon ve uzun dönem etkinlik/güvenilirliğini değerlendirmeyi amaçladık.
Materyal-Method:
Tek bir cerrah tarafından 2011-2020 tarihleri arasında spinal anestezi altında orta üretral askı (TOT ve TVT) cerrahisi uygulanan toplam 79 hasta retrospektif olarak değerlendirildi. Hastaların pre-operatif anamnez, fizik muayene, labarotuvar değerlendirmesi ve ürodinamik incelemeleri yapıldı. Hastaların cerrahi başarısı, per-operatif komplikasyonları, post-operatif erken dönem ve geç dönem komplikasyonları değerlendirildi.
Bulgular:
Orta üretra askı operasyonu uygulanan 41(%51,9) hastaya TOT ve 38 (%48,1) hastaya TVT cerrahisi uygulandı. Hastaların ortalama yaşı 54,5±9,5 yıl ve ortalama takip süresi 55,4 (min 2,9-max 113,7) aydır. Cerrahi sonrası 77 hastada (%97,5) StİK şikayetinin tamamen ortadan kalktığı gözlenirken, TVT uygulanan 2 (%2,5) hastada sıklığı azalmış olsa da StİK’nın devam ettiği gözlendi. Post-operatif dönemde 4 (%5) TVT hastasında ve 5 (%6,3) TOT hastasında de-novo sıkışma tipi idrar kaçırma gözlendi.
Sonuç:
Orta üretra askı operasyonlarından TOT ve TVT cerrahileri StİK tedavisinde başarı oranları yüksek tedavi seçenekleridir. TVT operasyonunda TOT cerrahisine göre komplikasyon oranlarının düşük oranda da olsa yüksek olmasına rağmen uzun dönem izlem sonrası her iki operasyonun da etkili ve güvenilir olduğu tespit edildi.

Anahtar Kelimeler

Orta üretral askı cerrrahisi, Trans-obturator tape (TOT), Tension free vaginal tape (TVT), Stres tipte idrar kaçırma

Destekleyen Kurum

destekleyen kurum yoktur

Comparison of Long-Term Efficacy and Reliability of Mid-Urethral Sling Surgeries in Stress Type Urinary Incontinence Treatment

Öz

Objective:
Trans-obturator tape (TOT) and tension free vaginal tape (TVT) operations are standard mid urethral sling surgeries used in stress type urinary incontinence (STUI) treatment. We aimed to evaluate the clinical success, complications and long-term efficacy / reliability of TOT / TVT surgeries.
Materials and Methods:
A total of 79 patients who underwent middle urethral sling (TOT and TVT) operation by a single surgeon under spinal anesthesia between 2011-2020 were evaluated retrospectively. Pre-operative anamnesis, physical examination, laboratory evaluation and urodynamic examinations of the patients were analysed. Surgical success, per-operative complications, post-operative early and late complications were evaluated.
Results:
Trans-obturator tape and TVT surgery was performed in 41 (51.9%) and 38 (48.1%) patients respectively. The average age of the patients was 54.5 ± 9.5 years and the mean follow-up period was 55.4 (min 2.9-max 113.7) months. It was observed that STUI symptoms disappeared completely in 77 patients (97.5%) after surgery, while STUI symptoms continued in 2 (2.5%) patients with TVT. De-novo urgency incontinence was observed in 4 (5%) TVT patients and 5 (6.3%) TOT patients at post-operative period.
Conclusion:
Mid-urethral sling operations (TOT and TVT surgeries) are the treatment options with high success rates in STUI treatment. Although complication rates were higher in TVT operation compared to TOT surgery, after long-term follow-up, it was found that both operations were effective and reliable.

Anahtar Kelimeler

Mid-urehtral Sling Surgery,, Trans-obturator tape (TOT),, Tension free vaginal tape (TVT),, Stress type urinary incontinence,

Kaynakça

• 1) Kim S, Son JH, Kim HS, Ko JS, Kim JC. Tape shortening for recurrent stress urinary incontinence after transobturator tape sling: 3-year follow-up results. International neurourology journal. 2010;14(3):164.
• 2) Hunskaar S, Lose G, Sykes D, Voss S The prevalence of urinary incontinence in women in four European countries. BJU international. 2004;93(3):324-30
• 3) Hannestad YS, Rortveit G, Sandvik H, Hunskaar S. A community-based epidemiological survey of female urinary incontinence:: The Norwegian EPINCONT Study. Journal of clinical epidemiology. 2000; 53(11):1150-57.
• 4) Biri A, Durukan E, Maral I, Korucuoğlu Ü, Biri H, Týraş B, et al. Incidence of stress urinary incontinence among women in Turkey. International Urogynecology Journal. 2006;17(6):604-10.
• 5) Ulmsten U, Petros P. Surgery for female urinary incontinence. Current opinion in obstetrics & gynecology. 1992;4(3):456-62.
• 6) Novara G, Artibani W, Barber MD, Chapple CR, Costantini E, Ficarra V, et al. Updated systematic review and meta-analysis of the comparative data on colposuspensions, pubovaginal slings, and midurethral tapes in the surgical treatment of female stress urinary incontinence. European urology, 2010; 58(2):218-38.
• 7) Song B, He Y, Shen R, Shao H, He X, Wang X, et al. TVT‐O versus TVT‐S for female stress urinary incontinence: a systematic review and meta‐analysis. International Journal of Clinical Practice. 2020;e13506.
• 8) Brazzelli M, Javanbakht M, Imamura M, Hudson J, Moloney E, Becker F,et al. Surgical treatments for women with stress urinary incontinence: the ESTER systematic review and economic evaluation. Health Technology Assessment, 2019; 23(14).
• 9) Chapple CR. Contemporary surgical management of stress urinary incontinence. Current Opinion in Urology. 2020; 30(2):271.
• 10) Al-Shaikh G, Syed S, Osman S, Bogis A, Al-Badr A. Pessary use in stress urinary incontinence: a review of advantages, complications, patient satisfaction, and quality of life. International journal of women's health. 2018;10:195.
• 11) Brazzelli M, Javanbakht M, Imamura M, Hudson J, Moloney E, Becker F,et al. Surgical treatments for women with stress urinary incontinence: the ESTER systematic review and economic evaluation. Health Technology Assessment, 2019; 23(14).
• 12) Wu JM, Visco AG, Weidner AC, Myers ER. Is Burch colposuspension ever cost-effective compared with tension-free vaginal tape for stress incontinence?. American journal of obstetrics and gynecology, 2007;197(1):62-e1.
• 13) Kilonzo M, Vale L, Stearns SC, Grant A, Cody J, Glazener CM, et al. Cost effectiveness of tension-free vaginal tape for the surgical management of female stress incontinence. International journal of technology assessment in health care. 2004; 20(4):455.
• 14) Manca A, Sculpher MJ, Ward K, Hilton P. A cost–utility analysis of tension-free vaginal tape versus colposuspension for primary urodynamic stress incontinence. BJOG: an international journal of obstetrics and gynaecology. 2003;110(3):255-62.
• 15) Javanbakht M, Moloney E, Brazzelli M, Wallace S, Omar MI, Monga A, et al. Surgical treatments for women with stress urinary incontinence: a systematic review of economic evidence. Systematic reviews. 2020;9:1-13.
• 16) Laudano M, Seklehner S, Xie D, Osterberg EC, Chughtai B, Lee R, et al. A cost-effectiveness analysis of retropubic tension-free vaginal tape vs. transobturator tape for female stress urinary incontinence. Neurourol Urodynamics. 2013;32(2):151–2.
• 17) Köse O, Mimaroğlu Ş, Önal ŞY, Şimşek A, Özgör F, Çilli M ark. Kadın stres üriner inkontinansında TVT ve TOT yöntemlerinin etkinliğinin ve güvenilirliğinin karşılaştırılması. Yeni Üroloji Dergisi. 2014; 9(3):64-71.
• 18) Karaca K, Akgül HM, Karaca E. The Outcomes of ‘Surgeon-Tailored’Mesh with Midurethral Polypropylene Sling Operation. The Medical Journal Of Haydarpaşa Numune Training and Research Hospital; 56(1):28-33.
• 19) Palva K, Nilson CG. Effectiveness of the TVT procedure as a repeat mid-urethra operation for treatment of stres incontinence. Int Urogynecol J 2009; 20:769–74
• 20) Meyer F, Hermieu JF, Boyd A et al. Repeat mid-urethral sling for recurrent female stress urinary incontinence. Int Urogynecol J 2013;24:817-22
• 21) Seklehner S, Laudano MA, Xie D, Chughtai B, Lee RK. A meta-analysis of the performance of retropubic mid urethral slings versus transobturator mid urethral slings. The Journal of urology. 2015; 193(3):909-15.
• 22) Meschia M, Pifarotti P, Bernasconi F, Magatti F, Viganò R, Bertozzi R, et al. Tension-free vaginal tape (TVT) and intravaginal slingplasty (IVS) for stress urinary incontinence: a multicenter randomized trial. American journal of obstetrics and gynecology. 2006;195(5):1338-42.
• 23) Novara G, Ficarra V, Boscolo-Berto R, Secco S, Cavalleri S, Artibani W. Tension-free midurethral slings in the treatment of female stress urinary incontinence: a systematic review and meta-analysis of randomized controlled trials of effectiveness. European urology. 2007;52(3):663-79.
• 24) Jain P, Jirschele K, Botros SM, Latthe PM. Effectiveness of midurethral slings in mixed urinary incontinence: a systematic review and meta-analysis. International urogynecology journal. 2011;22(8):923-32.
• 25) Meschia M, Pifarotti P, Buonaguidi A, Gattei U, Spennacchio M. Tension-free vaginal tape (TVT) for treatment of stress urinary incontinence in women with low-pressure urethra. European Journal of Obstetrics & Gynecology and Reproductive Biology. 2005;122(1):118-21.
• 26) Laurikainen E, Valpas A, Kivelä A, Kalliola T, Rinne K, Takala T, et al. Retropubic compared with transobturator tape placement in treatment of urinary incontinence: a randomized controlled trial. Obstetrics & Gynecology. 2007;109(1):4-11.
• 27) Falkert A, Seelbach-Gobel B: TVT versus TOT for surgical treatment of female stres urinary incontinence. Int J Gyna-ecol Obstet 2007; 96: 40- 1.
• 28) Zullo MA, Plotti F, Calcagno M, Marullo E, Palaia I, Bellati F, et al. One-year follow-up of tension-free vaginal tape (TVT) and trans-obturator suburethral tape from inside to outside (TVT-O) for surgical treatment of female stress urinary incontinence: a prospective randomised trial. European urology. 2007;51(5):1376-84.
• 29) Porena M, Costantini E, Frea B, Giannantoni A, Ranzoni S, Mearini L, et al. Tension-free vaginal tape versus transobturator tape as surgery for stress urinary incontinence: results of a multicentre randomised trial. European Urology, 2007; 52(5): 1481-91.
• 30) Schraffordt Koops SE, Bisseling TM, Heintz APM, et al. Prospective analysis of complications of tension-free vaginal tape from The Netherlands Tension-free Vaginal Tape study. Am J Obstet Gynecol.2005;193:45–52.
• 31) Niknejad K, Plzak LS, Staskin DR, et al. Autologous and synthetic urethral slings for female incontinence. Urol Clin North Am.2002;29:597–611.
• 32) deTayrac R, Deffieux X, Droupy S, Chauveaud-Lambling A, Calvanese-Benamour L,Fernandez H. A prospective randomized trial comparing tension-free vaginal tape and transobturator suburethral tape for surgical treatment of stress urinary incontinence. Am J Obstet Gynecol. 2004;190(3):602-8.
• 33) Ulmsten U, Johnson P, Rezapour M. A three-year follow up of tension free vaginal tape for surgical treatment of female stres urinary incontinence. BJOG. 1999;106:345-50.
• 34) Meschia M, Pifarotti P, Bernasconi F, Guercio E, Maffiolini M, Magatti F, et al. Tension-free vaginal tape: analysis of outcomes and complications in 404 stress incontinent women. Int Urogyne-col J Pelvic Floor Dysfunct.2001;12(2 Suppl):S24-7.
• 35) Ulmsten U, Falconer C, Johnson P, Jomaa M, Lanna ̈er L, Nilsson CG, et al. A multicenter study of tension-free vaginal tape (TVT) for surgical treatment of stress urinary incontinence. Int Urogy-necol J Pelvic Floor Dysfunct.1998;9:210-3.
• 36) Debodinance P, Delporte P, Engrand JB, Boulogne M. Tension-free vaginal tape (TVT) in the treatment of urinary stres incontinence: 3 years experience involving 256 operations. Eur JObstet Gynecol Reprod Biol.2002;105:49-58.
• 37) Soulie M, Cuvillier X, Benaissa A, Mouly P, Larroque JM, Bernstein J, et al. The tension-free transvaginal tape procedure in the treatment of female urinary stress incontinence: a French prospective multicentre study. Eur Urol.2001;39:709-14.
• 38) Karram MM, Segal JL, Vassallo BJ, Kleeman SD. Complications and untoward effects of the tension-free vaginal tape procedure. Obstet Gynecol. 2003;101:929-32.
• 39) Porena M, Costantini E, Frea B, Giannantoni A, Ranzoni S, Mearini L, et al. Tension-free vaginal tape versus transobturator tape as surgery for stress urinary incontinence: results of a multicentre randomised trial. European Urology, 2007; 52(5): 1481-91.
• 40) Bodelsson G, Henriksson L, Osser S, Stjernquist M. Short term complications of the tension free vaginal tape operation for stress urinary incontinence in women. Int J Obstet Gynaecol.2002;109:566–8.
• 41) Domingo S, Alama P, Ruiz N, Perales A, Pellicer A. Diagnosis, management and prognosis of vaginal erosion after transobturator suburethral tape procedure using a nonwoven thermally bonded polypropylene mesh. J Urol. 2005;173:1627–30.
• 42) Tamussino KF, Hanzal E, Kölle D, Ralph G, Riss PA, Austrian Urogynecology Working Group. Tension-free vaginal tape operation: results of the Austrian registry. Obstetrics & Gynecology. 2001;98(5):732-36.
• 43) Kuuva N, Nilsson CG. A nationwide analysis of complications associated with the tension-free vaginal tape (TVT) procedure. Acta obstetricia et gynecologica Scandinavica, 2002; 81(1):72-77.