Hakan AYTAN, Raziye NARİN, Mehmet Ali NARİN, Ayhan AKSOY, Hakan NAZİK, Murat APİ

Stres üriner inkontinans hastalarında midüretral transobturator bant cerrahisi: Klinik gözlem ve erken dönem sonuçları

Amaç. Stres üriner inkontinans (SUI) olgularında, Transobturator bant (TOT) operasyonununsonuçlarının ve komplikasyonlarının, klinik ve yaşam kalitesi analizi yapılarak değerlendirilmesi.Yöntem. SUI veya mikst üriner inkontinans (MUI) tanısı ile TOT yapılan 30 hasta çalışmayaalındı. Hastaların yaş ortalaması 46,5±7 idi. Preoperatif ürolojik ve jinekolojik anamnez alındı vejinekolojik muayene, ultrasonografi, stres test, Q tip test yapıldı, inkontinans anketleri dolduruldu.TOT operasyonu monoflaman tape kullanılarak dıştan içe yöntem kullanılarak yapıldı. Hastalarınpostoperatif dönemde tüm klinik ve laboratuar bulguları değerlendirilerek preoperatif parametrelerile karşılaştırıldı. Operasyondan sonra hastaların ortalama takip süresi 16,7 aydı. SonuçlarWilcoxon signed rank testi ile istatistiksel anlamlılık açısından değerlendirildi. Bulgular. Sekizhastada (%26,7) SUI, 22 hastada (%73,3) MUI mevcuttu. TOT ameliyatına ek olarak 6 (%30)hastaya kolporafi anterior (KA), 1 (%3,3) hastaya kolporafi posterior (KP), 12 (%40) hastaya KAve KP 2 (%6,6) hastaya vaginal histerektomi, KA, KP uygulanmıştır. Bir hastada mesaneperforasyonu, bir hastada postoperatif urge inkontinans görüldü. TOT operasyonu ile hastaların26sında (%86,7) başarılı olunurken, dördünde (%13,3) başarısız olunmuştur. Yaşam kalitesideğerlendirilmesinde IIQ-7 (Incontinence impact questionnaire) ve UDI-6 (Urinary distressinventory) skorlarında istatistiksel olarak anlamlı düzelme saptanmıştır (P

In stress urinary incontinence patients, evalution of transobturator tape procedure: Clinical observation and early results

Aim. In stress urinary incontinence patients (SUI), the evalution of the results and complicationsof Transobturator tape (TOT) procedure by using clinical and life quality analysis. Method. 30patients, who are diagnosed as SUI or MUI and operated with TOT procedure were included in thestudy. The mean patient age was 46.5±7. Preoperative urological and gynecological histories weretaken; gynecological examination, ultrasonography, stres test, Q tip test were performed.Incontinence questionnaires were filled. TOT procedure was performed to all 30 patients by usingmonofilament tape with outside-in technique. The mean postoperatif follow-up was 16.7 months.In the postoperative period all patients clinical and laboratory tests were repeated and comparedwith the preoperative parameters. Results were evaluated with Wilcoxon signed rank test forstatistical significance. Results. Eight (26.7%) patients had SUI, 22 (73.3%) patients had MUI. Noadditional operations were performed to nine (30%) patients. In addition to TOT, six (20%) ofpatients had colporraphy anterior (CA), twelve (40%) patients had CA and colporraphy posterior(CP), 1 (3.3%) patient had CP, two (6.6%) patients had vaginal hysterectomy (VAH) and CA+CP.Intraoperative one (3.3%) bladder perforation has occured. Postoperative one patient had de noveurge. While TOT procedure was successful in 26 cases (86.7%), 4 (13.3%) of them have failed. Inthe life quality analysis IIQ-7 (Incontinence impact questionnaire) and UDI-6 (Urinary distressinventory) scores showed significant improvement (P

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