Surgical outcome of the transobturator tape procedure for management of female urinary incontinence – A single center experience
Sažetak
Uvod/Cilj. Procedura plasiranja trake suburetralno, transobturatornim putem (engl. transobturator tape – TOT) predstavlja jedan od zlatnih standarda hirurškog lečenja stres urinarne inkontinencije (SUI) kod žena. Cilj ove studije bio je da se odredi efikasnost ove procedure u hirurškom lečenju SUI analizom kratkoročnih rezultata dobijenih u jednom centru. Metode. U periodu od aprila 2011. do januara 2018. godine, standardnom TOT tehnikom operisano je 40 bolesnika sa preovlađujućom SUI. Polipropilenska traka pozicionirana je u visini srednje uretre prekutanim transobturatornim pristupom. Postoperativna procena sprovedena je nedelju dana, jedan, tri i šest meseci nakon operacije. Inicijalna procena (nedelju dana po operaciji) podrazumevala je test kašljanja i odredjivanje rezidualnog volumena urina nakon mokrenja sa dodatim kliničkim pregledom i određivanjem urinokulture posle jednog, tri i šest meseci. Rezultati. Prosečna starost bolesnica iznosila je 58 (42–78) godina. Sa SUI je bilo 32 (80%), a sa mešovitom inkontinencijom 8 (20%) bolesnica. Na inicijalnoj (prva nedelja) proceni, test kašljanja bio je pozitivan kod 3 (7,5%) bolesnice, a kod 4 (10%) je, zbog problema sa mokrenjem, plasiran urinarni kateter. Na drugom kontrolnom pregledu, 2 (5%) bolesnice su imale pozitivan test kašljanja, kod 2 (5%) bolesnice je ostavljen urinarni kateter zbog značajnog rezidualnog volumena urina, a 2 (5%) bolesnice su imale pozitivnu urinokulturu. Na tromesečnoj i šestomesečnoj postoperativnoj proceni, 3 (7,5%) bolesnice su i dalje imale pozitivan test kašljanja. Nakon 6 meseci od operacije, kod 36 (90%) bolesnica je konstatovano izlečenje, kod jedne (2,5%) poboljšanje, a kod 3 (7,5%) bolesnice neuspeh operativnog lečenja. Zaključak. Rezultati naše studije slažu se sa rezultatima drugih objavljenih kratkoročnih studija gde je analiziran hirurški ishod TOT procedure u lečenju ženske urinarne inkontinencije. Ovo nam dozvoljava tvrdnju da je TOT procedura sigurna, efikasna i jednostavna nakon adekvatne obuke.
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