Abstract
Anatomy of the female pelvic viscera was investigated before and after the Tension free Vaginal tape (TVT-O). Forty patients were included in the study. Surgery was performed between 2009 and 2012 in Clinic of Urology (Clinical Center Nis) and Department of Urology (Municipal Hospital Prokuplje). Stress Urinary Incontinence (SUI) and anterior vaginal wall prolapse was confirmed in all patients. In all patients with anterior vaginal wall prolapse (grade≥2) both tension free vaginal tape (TVT-O) and anterior vaginal wall repair were performed. Pelvic Organ Prolapse Quantification (POPQ) system was used for the evaluation of prolapse before and after the surgery. Mean age of patients was 61 years. Spinal anesthesia was performed in thirty patients and general anesthesia in 10 patients. Intraoperative blood loss was under 50 ml. There were no bladder, nerve and blood vessels injuries . Thirty eight out of forty patients (95%) were satisfied with the outcome of the surgery. There was a significant correction of prolapse after the surgery. Recurrence of prolapse was found in patients with the high grade prolapse before the surgery, as well as, in patients with the history of previous anterior vaginal repair. Pelvic organ prolapse, congenital or acquired, is supported by the congenital weakness of the pelvic floor.
Highlights
Forty patients were included in the study
anterior vaginal wall prolapse was confirmed in all patients
system was used for the evaluation of prolapse
Summary
Laketić Darko Klinika za Urologiju, Kliničko Bolnički Centar „Dragiša Mišović“ - Dedinje Beograd. Ispitivali smo anatomski status organa male karlice pre i posle operacije stres urinarne inkontinencije upotrebom metode Tension Free Vaginal Tape Obturator Technique (TVT-O). Kod svih žena je primenjena operativna tehnika transobturatornog plasmana trake od “unutra prema spolja”(TVT-O) a kod anatomskog spada većeg od gradusa II i prednja kolpoplastika.Ispitivao se anatomski status karličnog dna pomoću Organ prolapse Quantitative(POP-Q sistem) pre i posle operacije. Etiologija prolapsa karličnih organa nije u celosti poznata, ali se pretpostavlja da je povezana s vaginalnim porođajem.Kliničkoj manifestaciji ovog poremećaja doprinose i neki drugi činioci poput slabosti karlične muskulature i vezivnog tkiva, konstitucija bolesnice, operacije u području male karlice, gubitak estrogenih hormona najčešće zbog starosti, lekovi i faktori koji povećavaju intraabdominalni pritisak kao što su npr. STADIJUM I Kod I stadijuma prolapsa nema posebnih kriterijuma osim da je najdistalnija tačka spada više od 1cm iznad himena(vrednosti svih definisanih tačaka moraju biti
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