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Transobturator TAPE Operasyonunun Etkinliği ve Komplikasyonları: 120 Vakanın Analizi

The Effectiveness And Complications of Transobturator Tape Operation: Analysis of 120 cases

Journal Name:

  • Abant Tıp Dergisi

Publication Year:

  • 2012
DOI: 
http://dx.doi.org/10.5505/abantmedj.2012.46338

Key Words:

Keywords (Original Language):

Author NameUniversity of AuthorFaculty of Author
Abstract (2. Language): 
Objective: The aim of this study is to evaluate the effective-ness and complications of TOT (trans-obturator tape) opera-tion which is a minimally-invasive technique. Methods: 120 patients who had suburethral tension-free vaginal TOT operation due to pure stress urinary inconti-nence (SUI) or mixt urinary incontinence (MUI) between 2011-2012 were reviewed. All of the operations were per-formed outside to inside with the Obtryx™ (Boston Scien-tific, Natick, MA, USA) trademark kit. Postoperatively pa-tients were called at 1st and 3rd months; urogynecologic examinations were done, the success and perioperative complications of the operations were evaluated Results: All of the patients were multiparaous and median age was 49,6±11,3 years. Forty-seven (%39.2) patients were postmenaupausal and thirty-six patients (%30) who had TOT operation had extra surgery. Objective cure rates of the patients were %91.7 and subjective cure rates of the pa-tients were %88.3. Treatment failure was %8.3. Only one patient had blood transfusion requirement due to TOT oper-ation. Intraoperatively, 4 patients had bleeding more than 200 ml. Three patients had vaginal fornix perforation. Two patients had perineal pain. De novo urge incontinence was seen in 5 patients postoperatively and was treated with anticholinergic drugs. Mesh excisions were done for 4 pa-tients who had vaginal erosion and vaginal mucosa was sutured again. Conclusion: TOT operation is a minimally invasive operation which overcomes all the other techniques for the surgical treatment of SUI with its lower complication rates and high-er curability rates. Complication rates decrease with surgical experience so the management of complications simplify with experience.
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Abstract (Original Language): 
Amaç: Bu çalışmanın amacı; minimal-invazif bir teknik olarak tanımlanan transobturator tape (TOT) operasyonunun etkin-liğinin ve komplikasyonlarının değerlendirilmesidir. Yöntemler: 2011-2012 yılları arasında saf stres üriner inkon-tinans (SÜİ) veya mikst üriner inkontinans (MÜİ) nedeniyle subüretral gergisiz vajinal TOT operasyonu yapılan 120 hasta çalışmaya alındı. Tüm operasyonlar dıştan-içe Obtryx™ (Bos-ton Scientific, Natick, MA, USA) marka kit ile gerçekleştirildi. Hastalar postoperatif 1. ve 3. aylarda kontrollere çağrılarak ürojinekolojik muayeneleri yapıldı, operasyon başarısı ve perioperatif komplikasyonları değerlendirildi. Bulgular: Olguların tamamı multipardı ve yaş ortalaması 49,6±11,3 idi. Hastaların 47 (%39,2) tanesi postmenopozal, 73 (%60,8) tanesi ise premenopozal idi. Transobturator tape operasyonu olan olgulardan 36 (%30) tanesi ek cerrahi ope-rasyon geçirdi. Olguların objektif kür oranı %91,7 ve subjektif kür oranı %88,3 idi. Tedavi başarısızlığı %8,3 olarak bulundu. Transobturator tape operasyonuna bağlı kan transfüzyonu gereksinimi sadece 1 hastada gerekli oldu. İntraoperatif 200ml üzerinde kanama 4 hastada izlendi. Vajinal forniks perforasyonu sadece 3 vakada izlendi. Perineal ağrı 2 olguda mevcuttu. De novo urge inkontinans postoperatif 5 hastada izlendi ve antikolinerjikler ile tedavi edildi. Vajinal erozyon görülen 4 hastada mesh eksize edildi ve vajen mukozası tekrar sütüre edildi. Sonuç: Stres üriner inkontinans cerrahi tedavisinde minimal-invazif, komplikasyon oranı düşük ve kür oranı yüksek bir yöntem olan transobturator tape operasyonu diğer teknikle-re üstünlük sağlamıştır. Cerrahi tecrübe arttıkça komplikas-yon oranları azalmakta ve bunların yönetimi kolaylaşmakta-dır.
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  • 3
125-128
  • Turkish

REFERENCES

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