Stres üriner inkontinans hastalarında midüretral transobturator bant cerrahisi: Klinik gözlem ve erken dönem sonuçları

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Aim. In stress urinary incontinence patients (SUI), the evalution of the results and complications of Transobturator tape (TOT) procedure by using clinical and life quality analysis. Method. 30 patients, who are diagnosed as SUI or MUI and operated with TOT procedure were included in the study. The mean patient age was 46.5±7. Preoperative urological and gynecological histories were taken; gynecological examination, ultrasonography, stres test, Q tip test were performed. Incontinence questionnaires were filled. TOT procedure was performed to all 30 patients by using monofilament tape with outside-in technique. The mean postoperatif follow-up was 16.7 months. In the postoperative period all patients’ clinical and laboratory tests were repeated and compared with the preoperative parameters. Results were evaluated with Wilcoxon signed rank test for statistical significance. Results. Eight (26.7%) patients had SUI, 22 (73.3%) patients had MUI. No additional operations were performed to nine (30%) patients. In addition to TOT, six (20%) of patients had colporraphy anterior (CA), twelve (40%) patients had CA and colporraphy posterior (CP), 1 (3.3%) patient had CP, two (6.6%) patients had vaginal hysterectomy (VAH) and CA+CP. Intraoperative one (3.3%) bladder perforation has occured. Postoperative one patient had de nove urge. While TOT procedure was successful in 26 cases (86.7%), 4 (13.3%) of them have failed. In the life quality analysis IIQ-7 (Incontinence impact questionnaire) and UDI-6 (Urinary distress inventory) scores showed significant improvement (P<0.001 ve P=0.026). Conclusion. Our study confirmed high objective cure rate, improvement of symptoms and quality of life with TOT operation. These results suggest that the transobturator tape procedure is a valueable alternative to the other surgical procedures in SUI, with a low rate of complications and convenience of learning and application.