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Pubovajinal sling uzun dönem sonuçları

Long-term results of pubovaginal sling

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Abstract (2. Language): 
Long term results of 56 patients who underwent pubovaginal sling procedure with the diagnosis of genuine stres incontinence were evaluated in this study. Of a total of 56 patients with a mean age of 51 (22-67) years, 40 were reached via phone contact by a physician out of the operation team. Responses to the questionnaire form including 19 questions were evaluated. Of 40 patients with a mean follow up period of 42.6 (7.1- 107.9) months, 12 (30%) had incontinence. Of these patients, incontinence did not recover after surgery in 3 patients, recurred in the first year after surgery in 3 patients and recurred after 1 year in 6 patients. All the patients, 4 cases 1 ped/day and 8 cases 2-3 peds/day, were using ped. Four patients (10%), 5 patients (13%) and two patients (5%) had stress, urgency and mixed type incontinence, respectively. One patient was not sure about the type of incontinence. Eight out of the 12 patients with incontinence had used oxybutinin hydrochlorid. Three patients were still taking oral medication and they were continent as long as they took the medication. One (3%) of the three patients with incontinence was performing clean intermittent catheterization. When all the patients reached were evaluated, 35 (87.5%) declared recovery in their social activities after surgery. When the preoperative and postoperative status were compared with respect to incontinence, 27 (67.5%) patients were completely good, 8 (20%) were better, 2 (5%) were good and 3 (7.5%) were the same. Thirty six patients declared that their results were reasonable and can again choose the same surgery and advise this type of surgery to the patients with similar symptoms. Success rate of pubovaginal sling was 77.5%. There was a subgroup of patients (22.5%) needing further evaluation.
Abstract (Original Language): 
Bu çalışmada gerçek stres inkontinans tanısı ile pubovajinal sling operasyonu uygulanan 56 kadın hastanın uzun dönem sonuçları değerlendirildi. Yaş ortalaması 51 (22-67) yıl olan 56 kadın hastadan 40'ına operasyon ekibine dahil olmayan bir kişi tarafından telefonla ulaşıldı. On dokuz sorudan oluşan değerlendirme formuna verilen yanıtlar değerlendirildi. Ortalama takip süreleri 42.6 (7.1-107.9) ay olan 40 hastadan 12'si (%30) idrar kaçırması olduğunu belirtti. Bu hastaların 3'ünde inkontinansın hiç düzelmediği, 3'ünde operasyonu takiben 1. yıl içinde ve 6'sında 1. yıldan sonra inkontinansın tekrarladığı görüldü. Dört hastada 1 ped/gün, 8 hastada 2-3 ped/gün olmak üzere hastaların tamamının ped kullandığı tespit edildi. Dört hastada (%10) stres, 5 hastada (%13) sıkışma, 2 hastada (%5) ise her iki durumda da inkontinans görüldü. Bir hasta ise hangi durumda kaçırdığından emin değildi. İnkontinan 12 hastadan 8'inde oksibutinin hidroklorid başlandığı belirlendi. Üç hastanın halen ilaç kullandığı ve ilaç kullandıkları sürece kontinan oldukları saptandı. İnkontinan hastalardan 1'inin (%3) temiz aralıklı kateterizasyon yaptığı belirlendi. Ulaşılan tüm hastalar değerlendirildiğinde 35 hasta (%87.5) operasyondan sonra günlük aktivitelerinde düzelme sağladığını belirtti. İnkontinans açısından ameliyat öncesi ve sonrası durum karşılaştırıldığında 27 (%67.5) hasta tam iyi, 8 hasta (%20) daha iyi, 2 (%5) hasta iyi ve 3 hasta (%7.5) aynı durumda olduğunu belirtti. Otuz altı hasta (%90) böyle bir sonuçla tekrar aynı ameliyatı olabileceğini ve benzer yakınmaları olanlara tavsiye edebileceğini vurguladı. Gerçek stres inkontinans tedavisinde pubovajinal sling ile %77.5 başarı sağlandığı görüldü. Ayrıca %22.5 oranında ileri tetkik gerektiren bir hasta grubu olduğu belirlendi.
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