Iskustvo u hirurškom lečenju primenom transopturatorne trake: urodinamska procena 220 bolesnika u tercijarnom centru u Turskoj
Sažetak
Uvod/Cilj. Urinarna stres inkontinencija (USI) je nevoljno ispuštanje urina posle povećanja intraabdominalnog pritiska što predstavlja značajan zdravstveni problem, smanjuje kvalitet života, uzrokuje seksualnu disfunkciju i povećava troškove nege zbog povećanog morbiditeta. Cilj rada bio je da se ispitaju intra˗ i postoperativni rezultati i stopa komplikacija u procedurama u kojima se primenjuje transopturatorna traka (TOT) u lečenju USI, u tercijarnom zdravstvenom centru u centralnoj Turskoj. Metode. Prospektivnom studijom ispitana su 22 bolesnika podvrgnuta proceduri u kojoj se primenjuje TOT u lečenju USI. Analizirane su demografske i kliničke karakteristike, preoperativne i postoperativne vrednosti cistometrije i parametri ishoda operativnog lečenja. Rezultati. Nije utvrđena značajna razlika između preoperativnog i postoperativnog perioda u odnosu na rezidualni volumen (27,09 ± 8,51 mL vs. 26,01 ± 3,51 mL, p = 0,125), a nađena je značajna razlika u pogledu prvog poziva na mokrenje (142,61 ± 20,25 mL vs. 145,64 ± 20,91 mL, p < 0,001), maksimalnog kapaciteta mokraćne bešike (423,70 ± 38,43 mL vs. 402,32 ± 39,46 mL, p < 0,001), Q-tip ugla (45,54 ± 5,330 vs. 43,81 ± 6,150, p = 0,001), maksimalnog protoka urina (37,65 ± 11,54 mL/s vs. 24,38 ± 9,26 mL/s, p < 0,001), prosečnog protoka urina (19,92 ± 9,64 mL/s vs. 14,77 ± 8,71 mL/s, p < 0,001), broja mokrenja (BM) u toku dana (7,29 ± 1,35 vs. 6,58 ± 1,29, p < 0,001) i BM u toku noći (1,48 ± 1,01 vs. 0,92 ± 0,83, p < 0,001). Zaključak. Procedura u kojoj se primenjuje TOT poboljšava kvalitet života bolesnika sa USI i može smanjiti morbiditet. Neophodna su dodatna istraživanja da bi se potvrdili rezultati ove studije i utvrdili dugoročni efekti.
Reference
1. Kaplan PB, Usta U, Inal HA, Tastekin E, Tokuc B. Neuromuscu-lar morphometry of the uterine ligaments and vaginal wall in women with pelvic organ prolapse. Neurourol Urodyn 2011; 30(1): 126‒32.
2. Abrams P, Andersson KE, Apostolidis A, Birder L, Bliss D, Brubaker L, et al. Members of the committees. 6th Interna-tional Consultation on Incontinence. Recommendations of the International Scientific Committee: Evaluation and treatment of urinary incontinence, pelvic organ prolapse and faecal incontinence. Neurourol Urodyn 2018; 37(7): 2271‒2.
3. Inal HA, Kaplan PB, Usta U, Taştekin E, Aybatli A, Tokuc B. Neuromuscular morphometry of the vaginal wall in women with anterior vaginal wall prolapse. Neurourol Urodyn 2010; 29(3): 458‒63.
4. Santini S, Andersson G, Lamura G. Impact of incontinence on the quality of life of caregivers of older persons with inconti-nence: A qualitative study in four European countries. Arch Gerontol Geriatr 2016; 63: 92‒101.
5. Gibson W, Hunter KF, Camicioli R, Booth J, Skelton DA, Dumoulin C, et al. The association between lower urinary tract symptoms and falls: Forming a theoretical model for a research agenda. Neurourol Urodyn 2018; 37(1): 501‒9.
6. Inal ZO, Inal HA, Kucukkendirci H, Oruc AS. Investigation of cesarean sections at Konya Training and Research Hospital Obstetrics and Gynecology Department between 2010 and 2015. Ginekol Pol 2017; 88(4): 185‒90.
7. Matthews CA, Whitehead WE, Townsend MK, Grodstein F. Risk factors for urinary, fecal, or dual incontinence in the Nurses' Health Study. Obstet Gynecol 201; 122(3): 539‒45.
8. Minassian VA, Bazi T, Stewart WF. Clinical epidemiological insights into urinary incontinence. Int Urogynecol J 2017; 28(5): 687‒96.
9. Schierlitz L, Dwyer PL, Rosamilia A, Murray C, Thomas E, De Sou-za A, et al. Effectiveness of tension-free vaginal tape com-pared with transobturator tape in women with stress urinary incontinence and intrinsic sphincter deficiency: a randomized controlled trial. Obstet Gynecol 2008; 112(6): 1253‒61.
10. Ulubay M, Fıratlıgil FB, Ozturk M, Kıncı MF, Fidan U. Periopera-tive outcomes of female stress urinary incontinence treated with transobturator tape. Cukurova Med J 2017; 42(4): 670‒4.
11. Malallah MA, Al-Shaiji TF. Pharmacological treatment of pure stress urinary incontinence: a narrative review. Int Urogynecol J 2015; 26(4): 477‒85.
12. Labrie J, Berghmans BL, Fischer K, Milani AL, van der Wijk I, Smalbraak DJ, et al. Surgery versus physiotherapy for stress urinary incontinence. N Engl J Med 2013; 369(12): 1124‒33.
13. Marshall WF, Marchetti AA, Krantz KE. The correction of stress incontinence by simple vesicourethral suspension. Surg Gyne-col Obstet 1949: 88(4): 509‒18.
14. Burch JC. Cooper's ligament urethrovesical suspension for stress incontinence. Nine years' experience-results, complica-tions, technique. Am J Obstet Gynecol 1968; 100(6): 764‒72.
15. Tanagho EA. Colpocystourethropexy. The way we do it. J Urol 1976; 116(6): 751‒3.
16. Walters MD, Karram MM. Sling procedures for stress urinary incontinence. In: Walters MD, Karram MM, editors. Uro-gynecology and Reconstructive Pelvic Surgery. 3rd ed. Phila-delphia, PA: Mosby Elsevier; 2007. p. 197.
17. Ulmsten U, Henriksson L, Johnson P, Varhos G. An ambulatory surgical procedure under local anesthesia for treatment of fe-male urinary incontinence. Int Urogynecol J Pelvic Floor Dys-funct 1996; 7(2): 81‒5; discussion 85‒6.
18. Delorme E. La bandelette trans-obturatrice: unprocédé mini-invasif pour traiterl'incontinenceurinaired'effort de la femme [Transobturator urethral suspension: mini-invasive procedure in the treatment of stress urinary incontinence in women]. Prog Urol 2001; 11(6): 1306‒13.
19. Aygül C, Özyurt R, Şık BA, Kumbasar S. Evaluation of the effi-cacy of transobturator tape surgery in the treatment of stress urinary incontinence using urodynamics and questionnaires. Turk J Obstet Gynecol 2016; 13(4): 172‒7.
20. Ulubay M, Ozturk M, Keskin U, Fidan U, Firatligil FB, Alanbay I, et al. Long Term Patient Satisfaction of Burch Colposuspen-sion with or Without Concomitant Total Abdominal Hysterec-tomy. J Clin Diagn Res 2015; 9(12): QC01‒3.
21. Inal ZO, Inal HA. Comparison of abdominal, vaginal, and lapa-roscopic hysterectomies in a tertiary care hospital in Turkey. Ir J Med Sci 2018; 187(2): 485‒91.
22. Magon N, Chopra SV. Transobturator Tape in Treatment of Stress Urinary Incontinence: It is Time for a New Gold Stand-ard. N Am J Med Sci 2012; 4(5): 226‒30.
23. Purnichescu V, Cheret-Benoist A, Eboué C, Von Theobald P. Surgical treatment for female stress urinary incontinence by transobturator tape (outside in). Study of 70 cases. J Gyne-col Obstet Biol Reprod (Paris) 2007; 36(5): 451‒8. (French)
24. Alagiakrishnan K, Valpreda M. Ultrasound bladder scanner pre-sents falsely elevated postvoid residual volumes. Can Fam Physician 2009; 55(2): 163‒4.
25. Wadie BS, El-Hefnawy AS. TVT versus TOT, 2-year prospec-tive randomized study. World J Urol 2013; 31(3): 645‒9.
26. Deval B, Ferchaux J, Berry R, Gambino S, Ciofu C, Rafii A, et al. Objective and subjective cure rates after trans-obturator tape (OBTAPE) treatment of female urinary incontinence. Eur Urol 2006; 49(2): 373‒7.
27. Latthe PM, Foon R, Toozs-Hobson P. Transobturator and ret-ropubic tape procedures in stress urinary incontinence: a sys-tematic review and meta-analysis of effectiveness and compli-cations. BJOG 2007; 114(5): 522‒31.
28. Inal ZO, Inal HA, Gorkem U. Experience of Tubo-Ovarian Ab-scess: A Retrospective Clinical Analysis of 318 Patients in a Single Tertiary Center in Middle Turkey. Surg Infect (Larchmt) 2018; 19(1): 54‒60.