Servet GENÇDAL, Emre DESTEGÜL, Serdinç OZDOĞAN, Orçun OZDEMİR, Adem ALTUNKOL

Transobturator Tape Operasyonu Deneyimlerimiz ve Erken Dönem Sonuçlarımız

Amaç: Transobturatuar tape (TOT) kadın stres üriner inkontinansın (SUI) tedavisinde üretral süspansiyon için tasarlanmış yapay bir banttır. Bu çalışmamızda stres üriner inkontinans için kullanılan TOT tekniğinin yaşam kalitesi üzerine etkileri, komplikasyonları ve başarı oranlarını değerlendirmeyi amaçladık. Materyal ve Metod: 2012 Mart ile 2013 Ocak tarihleri arasında TOT uygulanan 30 hastanın dosyaları retrospektif olarak analiz edildi. Demografik özellikler, yaşam kalitesi anketleri (IIQ-7, UDI-6), muayene bulguları, stres test, Q-tip test ve cerrahi kaydedildi. Bulgular: Ortalama hasta yaşı 44,2 ± 6,8 yıl idi. UDI-6 ve IIQ-7 hayat kalite ölçeklerinde, postoperatif 1. gün, 6. ay ve 12. aydaki skorlarda, preoperatif skorlar ile karşılaştırıldığında istatistiksel olarak anlamlı düşüşler saptandı (p<0,05). Cerrahi esnasında major komplikasyon görülmedi. Bir hastada lateral vajinal duvarda yaralanma, iki hastada üriner retansiyon ve bir hastada denovo urgency gelişti. Sonuç: SUI için yapılan TOT tekniğinin etkili, düşük morbiditeye sahip, kolay uygulanabilir ve güvenli bir yöntem olabileceği kanısındayız.

Anahtar Kelimeler:

Stres inkontinans, Transobturator Tape, Yaşam Kalitesi.

Our Experience And Short Term Outcomes Of Transobturator Tape

Background: Transobturator tape is an artifıcial tape designed for urethral suspension to treat female stress urinary incontinence. in this study, we aimed to assessment of preliminary success, complications and effect on quality oflife of transobturator tape (TOT) technique as a treatment of stress urinary incontinence (SUI) Methods: 30 fıles of patients who had undergone TOT between March 2012 and January 2013 were retrospectively analyzed. Demographic characteristics, quality of life questionnaires (IIQ-7, UDI-6), examination fındings, stress test, Q-tip test and surgery are recorded. Results: The mean patient age was 44,2 ± 6,8 years. UDI-6 and IIQ-7 in quality of life questionnaire, preoperative scores in both quality oflife scale, when postoperatif 1 day, 6 months and 12 months compared with the scores revealed a statistically signifıcant reduction (p<0,05)(Table 3). There were no major complications during surgery. üne patients had a lateral vagina! wall injury, two patients had a urinary retantion and one patients had a denovo urgency. Peri-operative complications are also listed in Table 2. Conclusions: We believe that with an efficacy, low morbidity, easy to applicable and safety, TOT technique may be performed for SUI.

Keywords:

Stress İncontinence, TransobturatorTape, Quality of Life,

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1) Abrams P, Blavias JG, Stanton SL, Andersen JT. The standardization of terminology for lower urinary tract function. Br JObstetGynaecol 1990; 97(6):1-16 2) Yalçın ÖT. Ürojinekoloji. In: Kişnişçi H, Gökşin E, Ustay K, ed. Temel Kadın Hastalıklan ve Doğum Bilgisi. GUneş Kitap Evi,Ankara. 1996: 730- 4 7 3) Hunskaar S, Arnold EP, Burgio K, Diolaıo AC, Herzog AR, Mallett VT. Epidemiology and natura! history ofurinary incontinence. Int Urogynecol J Pelvic Floor Dysfunct2000; 11( 5):301-19. 4) Hampel C, Wienhold D, Benken N, Eggersmann C, Thüroff JW. Definition of overactive bladder and epidemiology of urinary incontinence. Urology 1997; 50:4-14. 5) Nordling J, Abrams P, Ameda K, Andersen JT, Donovan J, Griffiths O et al. Outcome measures for research in treatment of adult males with symptoms of lower urinary tract dysfunction. Neurourol Urodyn. 1998; 17( 3):263-71. 6) Nickel RF, Wiegand U, van den Brom WE. Evaluation of a transpelvic sling procedure with and without colposuspension for treatment of female dogs with refractory urethral sphincte mechanism incompetence. VetSurg 1998; 27(2):94-104. 7) Petros PE, Ulmsten U1. An integral theory and its ınethod for the diagnosis and ınanagement of female urinary incontinence. Scand J Urol Nephrol 1993; 153:1-93 8) DelormeE. Transobturator urethral suspension: Miniinvasive procedure in the treatment of stress urinary incontinence in women. Prog Urol 2001; 11 (6): 1306-13. 9) Delorme E, Droupy S, de Tayrac R, Delmas V. Transobturator tape (Uratape ): a new minimallye invasive procedure to treat fmale urinary incontinence. 10) Ward K, Hilton P. A prospective multicenter randomized trial of tension-free vagina! tape and colposuspension for primary urodynamic stres incontinence: two-year follow-up. Anı J Obstet Gynecol 2004; 190(2):324-31. 11) Wang AC, Chen MC. Comparison of tension-free vagina! tape versus modified Burch colposuspension on urethral obstruction: a randomize controlled trial. Neurourol Urodyn 2003; 22(3): 185-90. 12) Tellez Martinez-Fomes M, Femandez Perez C, Fouz L6pez C, Femandez Lucas C, Borrego Hemando J. A three year follow-up of a prospective open randomized trial to compare tension-free vagina! tape with Burch colposuspension for treatrnent of female stress urinary incontinence. Actas Uro!Esp2009; 33( 10): 1088-96. 13) El-Barky E, El-Shazly A, El-Wahab OA, Kehinde EO, Al-Hunayan A, Al-Awadi KA. Tension free vagina! tape versus Burch colposuspension for treatment of female stress urinary incontinence., lnt Urol Nephrol 2005; 37(2):277-81. 14) deTayrac R, Deffieux X, Droupy S, ChauveaudLambling A, Calvanese-Benamour L, Femandez H. A prospective randornized trial comparing tension-free vagina! tape and transobturator suburethral tape for surgical treatrnent of stres urinary incontinence. Am J ObstetGynecol2004; 190(3):602-8. 15) Spinosa JP, Dubuis PY. Suburethral sling inserted by the transobturator route in the treatment of female stress urinary incontinence: preliminary results in 117 cases. Eur J ObstetGynecol ReprodBio12005; 123(2):212-17. 16) Latthe P, Foon R, Toozs-Hobson P. Transobturator and retropubic tape procedures in stress urinary incontinence: a systematic review and meta-analysis of effectiveness and complications. BJOG 2007; 114(5):522-31. 17) Sung VW, Schleinitz MD, Rardin CR, Ward RM, Myers DL. Comparison of retropubic vs transobturator approach to rnidurethral slings: a systematic review and metaanalysis.Am. J. Obstet. Gynecol. 2007; 197( 1):3-11. 18) Novara G, Galfano A, Boscolo-Berto R, Secco S, Cavalleri S, Ficarra V et al. Complication rates of tensionfree rnidurethral slings in the treatment of female stress urinary incontinence: a systematic review and metaanalysis ofrandomized controlled trials comparing tensionfree midurethral tapes to other surgical procedures and different devices. Eur. Urol. 2008; 53(2):288-308. 19) Long CY, Hsu CS, Wu MP, Liu CM, Wang TN, Tsai EM. Comparison oftension-free vagina! tape and transohturator tape procedure for the treatment of stress urinary incontinence. Curr. Opin. Obstet. Gynecol. 2009; 21( 4): 342-7. 20) Grise P, Droupy S, Saussine C, Ballan ger P, Monneins F, Hermieu JF et al. Transobturator tape sling for female stres incontinence with polypropylene tape and outside-in procedure: 1 year of minimal follow-up and review of transobturator tape sling. Urology2006; 68( 4):759-63. 21) Kaelin-Gambirasio I, Jacob S, Boulvain M, Dubuisson JB, D?llenbach P. Complications associated with transobturator sling procedures: analysis of233 consecutive cases with a 27 months follow-up.Joumal List BMC Womens Health2009; 25;9:28. 22) Holmgren C, Nilsson S, Lanner L, Hellberg D. LongTerm Results With Tension-Free Vagina! Tape on Mixed and Stress Urinary Incontinence. Obstet Gynecol 2005; 106( 1):38-43. 23) Domingo S, Alama P, Ruiz N, La.zara G, Morell M, Pellicer A. Transobturator tape procedure outcome: a clinical and quality oflife analysis ofa 1-year follow-up. Int Urogynecol JPelvic Floor Dysfunct2007; 18( 8):895-900.