Effects of Transobturator Adjustable Tape Sling Procedure on the Therapeutic Outcome in Patients with Stress Urinary Incontinence and Detrusor Underactivity
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Purpose: To evaluate the outcome and efficacy of transobturator adjustable (TOA) tape sling operations on women with intrinsic sphincter deficiency (ISD) and/or detrusor underactivity (DU) combined with stress urinary incontinence (SUI). Materials and Methods: This retrospective analysis comprised 60 TOA patients. 30 patients hadDU (Qmax < 15ml/s) and/or ISD (Valsalva leak point pressure;VLPP < 60cmH20) on the preoperative UDS and the rest only had SUI. I-QoL, visual analog scale (VAS), Patient’s Perception of Urgency Severity (PPUS), and Self-Assessment/Sandvik Questions were performed before and 1 year after surgery. The mesh tension was controlled at 1 day after surgery. The objective cure rate was defined as no leakage using the cough test with a full bladder. Results: Patients were divided into two groups: Group A:SUI with ISD and/or DU, n=30; Group B:only SUI without ISD and DU, n=30. The two groups showed a difference in Qmax and VLPP preoperatively. Objective success rates were 18 (60.0%) completely cured, 10 (33.3%) improved in Group A, and 23 (76.7%) completely cured, 7 (23.3%) improved in Group B. Three cases needed tape-tension adjustment due to urinary leakage one-day after surgery (2 in Group A, 1 in Group B). There was no postoperative urinary retention. Conclusions: After TOA for SUI with ISD and/or DU, 3 cases were needed tension adjustment after surgery. TOA procedures seem to be effective and safe, more clinical studies with long-term follow up are required for a definite conclusion.
Abstract
Purpose: To evaluate the outcome and efficacy of transobturator adjustable (TOA) tape sling operations on women with intrinsic sphincter deficiency (ISD) and/or detrusor underactivity (DU) combined with stress urinary incontinence (SUI). Materials and Methods: This retrospective analysis comprised 60 TOA patients. 30 patients hadDU (Qmax < 15ml/s) and/or ISD (Valsalva leak point pressure;VLPP < 60cmH20) on the preoperative UDS and the rest only had SUI. I-QoL, visual analog scale (VAS), Patient’s Perception of Urgency Severity (PPUS), and Self-Assessment/Sandvik Questions were performed before and 1 year after surgery. The mesh tension was controlled at 1 day after surgery. The objective cure rate was defined as no leakage using the cough test with a full bladder. Results: Patients were divided into two groups: Group A:SUI with ISD and/or DU, n=30; Group B:only SUI without ISD and DU, n=30. The two groups showed a difference in Qmax and VLPP preoperatively. Objective success rates were 18 (60.0%) completely cured, 10 (33.3%) improved in Group A, and 23 (76.7%) completely cured, 7 (23.3%) improved in Group B. Three cases needed tape-tension adjustment due to urinary leakage one-day after surgery (2 in Group A, 1 in Group B). There was no postoperative urinary retention. Conclusions: After TOA for SUI with ISD and/or DU, 3 cases were needed tension adjustment after surgery. TOA procedures seem to be effective and safe, more clinical studies with long-term follow up are required for a definite conclusion.
참고문헌 (16)
- Abrams P, "Fourth International Consultation on Incontinence Recommendations of the International Scientific Committee: Evaluation and treatment of urinary incontinence, pelvic organ prolapse, and fecal incontinence", Neurourol Urodyn, 29, pp.213~240 (2010)
- Nitti VW, "Urinary incontinence: epidemiology, pathophysiology, evaluation, and management overview in: Campbell's urology. 9th ed", pp.2064~2078 (2007), Saunders
- Ulmsten U, "An ambulatory surgical procedure under local anesthesia for treatment of female urinary incontinence", Int Urogynecol J Pelvic Floor Dysfunct, 7, pp.81~85 (1996)
- Delorme E, "Transobturator tape (Uratape): a new minimally-invasive procedure to treat female urinary incontinence", Eur Urol, 45, pp.203~207 (2004)
- Maroto JR, "Transobturator adjustable tape (TOA) permits to correct postoperatively the tension applied in stress incontinence surgery", Int Urogynecol J Pelvic Floor Dysfunct, 20, pp.797~805 (2009)
- Stamey TA, "Endoscopic suspension of the vesical neck for urinary incontinence in females. Report on 203 consecutive patients", Ann Surg, 192, pp.465~471 (1980)
- Petros PE, "An integral theory and its method for the diagnosis and management of female urinary incontinence", Scand J Urol Nephrol Suppl, 153, pp.1~93 (1993)
- Choi SK, "Early clinical outcome and complications of tension freevaginal tape procedure in stress incontinent women", Korean J Urol, 42, pp.589~593 (2001)
- 석노성, "여성 복압성요실금 환자에서 Monarc(Transobturator Tape) 수술의 임상결과: 2년 추적", Korean Journal of Urology, 47(8), pp.835~840 (2006), 대한비뇨기과학회
- de Leval J, "Novel surgical technique for the treatment of female stress urinary incontinence: transobturator vaginal tape inside-out", Eur Urol, 44, pp.724~730 (2003)
- Araco F, "Results 1 year after the Reemex system was applied for the treatment of stress urinary incontinence caused by intrinsic sphincter deficiency", Int Urogynecol J Pelvic Floor Dysfunct (2007)
- Romero MJ, "Transvaginal adjustable tape: an adjustable mesh for surgical treatment of female stress urinary incontinence", Int Urogynecol J Pelvic Floor Dysfunct, 19, pp.1109~1116 (2008)
- Liapis A, "Monarc vs TVT-O for the treatment of primary stress incontinence: a randomized study", Int Urogynecol J Pelvic Floor Dysfunct, 19, pp.185~190 (2008)
- Davila GW, "Multicenter experience with the Monarc transobturator sling system to treat stress urinary incontinence", Int Urogynecol J Pelvic Floor Dysfunct, 17, pp.460~465 (2006)
- Costa P, "Surgical treatment of female stress urinary incontinence with a trans-obturator-tape (T.O.T.) Uratape: short term results of a prospective multicentric study", Eur Urol, 46, pp.102~106 (2004)
- Lee KS, "Prospective comparison of the 'inside-out' and 'outside-in' transobturator-tape procedures for the treatment of female stress urinary incontinence", Int Urogynecol J Pelvic Floor Dysfunct, 19, pp.577~582 (2008)