Sik Bulat Aytek, Copur Hanife, Aba Yilda Arzu
Bulat Aytek Sik, Department of Obstetrics and Gynecology, Istanbul Aydin University, Istanbul, Turkey.
Hanife Copur, Department of Obstetrics and Gynecology, Istanbul Taksim Research and Education Hospital, Istanbul, Turkey.
Pak J Med Sci. 2019 Mar-Apr;35(2):477-482. doi: 10.12669/pjms.35.2.603.
To evaluate the clinical outcomes and the effects on quality of life of transobturator tape surgery during a 2-year follow-up period in our clinics.
Eighty-seven patients with stress or mixed urinary incontinence who underwent transobturator tape surgery were included in the study conducted in Istanbul. Taksim. Training. and Research Hospital Gynecology and Obstetrics Clinic, between 2011 and 2013. The patients' demographic features, incontinence questionnaires, quality of life scores [Incontinence Impact Questionnaire (IIQ-7) and urinary distress inventories (UDI-6)], examination findings, urodynamic results, stress tests, Q tip tests, number of daily pads, ultrasonography, surgery, and cystoscopy results were recorded. Patients were evaluated 23-27 months (mean: 25.40±1.31 months) after their discharge in terms of symptoms, quality of life scores, urodynamic findings, complications, and stress test.
Sixty-three (72.4%) patients had stress incontinence and 24 (27.6%) patients had mixed urinary incontinence. No perioperative complications were observed in our study. After a follow-up period of two years, a significant improvement was detected in the IIQ-7 and UDI-6 questionnaires when compared with the preoperative period. Moreover, the objective cure rate was found as 88.5% (n=77). De novo urge incontinence was obtained in 5.7% (n=5) of patients and was treated with anticholinergics. Perineal pain was present in 3 (3.44%) patients and was treated with analgesics and cold packs. In 2 (2.29%) patients, vaginal mesh erosion was detected and full recovery was achieved with an excision. Urinary retention and bladder perforation was not seen in any patients.
Our study revealed a high objective cure rate, and an improvement in symptoms and quality of life with the transobturator tape operation.
在我们诊所进行的为期2年的随访期内，评估经闭孔尿道中段无张力悬吊术的临床疗效及其对生活质量的影响。
纳入2011年至2013年期间在伊斯坦布尔塔克西姆培训与研究医院妇产科诊所接受经闭孔尿道中段无张力悬吊术的87例压力性或混合性尿失禁患者。记录患者的人口统计学特征、失禁问卷、生活质量评分[失禁影响问卷（IIQ-7）和排尿困难量表（UDI-6）]、检查结果、尿动力学结果、压力试验、棉签试验、每日使用尿垫数量、超声检查、手术及膀胱镜检查结果。患者出院后23 - 27个月（平均：25.40±1.31个月），对其症状、生活质量评分、尿动力学检查结果、并发症及压力试验进行评估。
63例（72.4%）患者为压力性尿失禁，24例（27.6%）患者为混合性尿失禁。本研究未观察到围手术期并发症。随访两年后，与术前相比，IIQ-7和UDI-6问卷显示有显著改善。此外，客观治愈率为88.5%（n = 77）。5.7%（n = 5）的患者出现了新发急迫性尿失禁，采用抗胆碱能药物治疗。3例（3.44%）患者存在会阴疼痛，采用镇痛药和冷敷治疗。2例（2.29%）患者检测到阴道网片侵蚀，经切除后完全恢复。所有患者均未出现尿潴留和膀胱穿孔。
我们的研究显示经闭孔尿道中段无张力悬吊术具有较高的客观治愈率，且症状及生活质量均有改善。
