A Review of Our Experience in Trans Obturator Tension Free Vaginal Tape Surgery in 16 Patients

AMAÇ: Bu çalışmada objektif kriterlerle stres inkontinans tanı- sı konmuş 16 hastaya yapılan trans obturator vajinal bant ameliyatıyla ilgili deneyimlerimizi paylaşmak istedik. GEREÇ VE YÖNTEM: Stres inkontinans tarifleyen 16 hasta çalışma grubuna alındı. Hastaların tümü multipar olup ortalama yaş 36 yaş 36±3 idi. Tanı için tüm hastalar detaylı bir şekilde ürodinamik olarak muayene edildi. Hastalar, tanı konduktan sonra dıştan içe trans obturator bant (TOT) yöntemiyle ameliyat edildi. BULGULAR: Takip döneminde, ürojinekolojik ve ürodinamik muayenelerle bir hasta dışında tüm hastaların tedavi edildiği görüldü. Bu durumda 16 hastadan oluşan bu seride objektif ve sübjektif tedavi oranı %93,75 olarak belirlendi. SONUÇ: TOT lokal anestezi altında dahi yapılabilen, öğrenimi kolay ve efektif bir cerrahi teknik olarak kabul edilebilir.

Onaltı Hastada Trans Obturator Vajinal Bant Ameliyatı ile İlgili Deneyimlerimiz

OBJECTIVE: We aim to share our surgical experience in 16 patients that were complaining of genuine stress urinary incontinence, in which trans obturator tension (TOT) free vaginal tape procedure was performed. STUDY DESIGN: 16 patients complaining of genuine stress incontinence were admitted into the study group. Patients were all multiparous with a mean age of 36 ± 3. All patients were carefully examined and urodynamically tested for diagnosis. After getting positive results as genuine stress incontinence, surgery was planned. Patients were operated using outside-inside TOT technique. RESULTS: All patients except for one were found to be completely cured of stress incontinence in the reevaluation period. Urogynecological examinations and urodynamical tests were performed to objectively confirm these foundings. Therefore our objective cure ratio in 16 patients is found to be 93.75% as well as our subjective cure ratio. CONCLUSION: TOT is described as a minimally invasive procedure that can be performed even under local anesthesia to an outpatient which is an effective and easy to learn surgical technique.

Kaynakça

1. Abrams P, Blavias JG, Stanton SL, Anderson JT. The Standardization of terminology for lower urinary tract function. Br J Obstet Gynaecol 1990:97:1-16

2. Kelleher C. Epidemiology and classification of urinary incontinence. In: Urogynecology Cordozo L, Curchill Livingstone, NewYork 1997:P:3-26

3. Yalçın ÖT. Ürojinekoloji. In: Temel Kadın Hastalıkları ve Doğum Bilgisi. Kişnişçi H, Gökşin E, Üstay K. Güneş Kitapevi Ankara 1996: p: 730-747

4. Weber AM, Taylor RJ, Wei JT, Lemack G, Piet Monte MR, Walters MD. The cost effectiveness of preoperative testing for stress urinary incontinence in women. BJU Int 2002:89:356-63

5. Bergman A, Elia G. Three surgical procedures for genuine stress incontinence. Five year follow up of a prospective randomized study. Am J Obstet Gynecol 1995:173:66-72.

6. Burch JC. Cooper's ligament urethrovesical suspension for urinary stress incontinence. Am J Obstet Gynecol 1968:100:764-72.

7. Klutke JJ, Klutke CG, Carlin B. Altered voiding after the tension free vaginal tape procedure, is increase resistance the mechanism of therapy? Obstet Gynecol 2000:95:55.

8. Liapis A, Bakas P, Creatsas G. Burch colposuspension and tension free vaginal tape in the management of stress urinary incontinence in women. European Urology 2002:41: 469-73.

9. Ward K, Hilton P, Browning J. A randomized trial of colposuspension and tension free vaginal tape for primary genuine stress incontinence. Neurourol Urodynam 2000: 19:385-6.

10. Peschers U, Tunn R, Buczkowski M, Perumlhini D. Tension free vaginal tape for the treatment of stress urinary incontinence. Clin Obstet Gynecol 2000:43:670-5.

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