Mehmet Sühha BOSTANCI, Aykan YÜCEL, Gökhan KARAKOÇ, Kıvılcım GÖREN

Stres Üriner İnkontinans Tedavisinde Tensıon Free Vaginal Tape Yöntemi Ve Transobturator Yaklaşımların Karşılaştırılması

Stres ürinerin kontinans detrusor basıncında artış olmaksızın öksürme, hapşırma, egzersiz, eforla ile istemsiz idrar kaçırma yakınması olarak tanımlanır. Tension- free vaginal tape TVT yöntemi 1995 yılından beri üriner stresin kontinans tedavisinde kullanılan standart minimal invaziv bir yöntemdir. 2001 yılında TVT yönteminin mesane yaralanması gibi bazı komplikasyonlarından kaçınmak için yerleştirilen tape materyalinin obturator foramen yoluyla yerleştirildiği yeni bir yöntem olan transobturatortape TOT kullanılmaya başlanmıştır. 2003 yılında ise tension-free vaginal tape obturatorroute TVT-O olarak adlandırılan modifiye yöntem kullanılmaya başlandı. TVT-O yöntemi ile birlikte kullanılan iğne vajinal insizyondan doğru obturator foramenden geçecek şekilde TOT tekniğinin ters yönünde uygulanmaya başlandı iç – dış . Bu derlemenin amacı varolan yayınları sistematik olarak inceleyerek stres ürinerin kontinans için uygulanan midüretral sling operasyonlarından retropubic ve transobturator yaklaşımları sonuçları ve komplikasyonları açısından gözden geçirmektir.

Anahtar Kelimeler:

Stres üriner inkontinans, tension-free vaginal tape, transobturator tape

Comparison Of Tension Free Vaginal Tape Method And Transobturator Approaches In The Treatment Of Stress Urinary Incontinence

Stress urinary incontinence is defined as the complaint of involuntary urine leakage on effort or exertion or on sneezing or coughing without rise in detrusor pressure. Tension-free vaginal tape TVT is a standard minimally invasive procedure used to treat urinary stress incontinence since 1995. In2001, a new method of inserting the tape called transobturator tape TOT , which passes through the obturator foramen, thus theoretically avoiding some of the complications of TVT such as bladder perforation. In 2003 a modified technique, termed the tension-free vaginal tape obturator route TVT-O was defined. With the TVT-Otechnique, the needle is passed in a reverse route of TOT technique, i.e. in through vaginal incision and out through the obturator foramen inside–out . The aims of this study were to systematically review the existing literature comparing retropubic and transobturator approaches to midurethral slings for stress urinary incontinence, and to compare outcomes and complications.

Keywords:

Stress urinary incontinence, tension-free vaginal tape, transobturator tape,

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