중부요도를 넓게 걸어주는 변형 Transobturator Tape(TOT) 슬링 수술과 고식적 TOT 슬링수술의 비교

Abstract

Purpose: We have developed and applied novel modification of the sling tape covering mid-urethra more widely. This is to evaluation clinical result of this novel sling tape. Materials and Methods: 145 women with SUI were enrolled in a prospective randomized study. We have used a Prolene modified transobturator suburethral tape (M-TOT), in which the width of middle 20 mm portion was designed to cover wide portion of the urethra (17 mm) compared to the width of 11 mm of the conventional tape. The operative results were compared with those of conventional TOT. Results: 145 patients were included in the study (52 with M-TOT and 93 with conventional TOT). Success rate and satisfaction rate was not different between two groups. In patients with intrinsic sphincter deficiency (ISD), success rate and satisfaction rate were significantly higher in the M-TOT group. Post-operative parameters including peak flow rate were not different between groups. De novo urgency was developed in 3 patients treated with M-TOT but was significantly fewer than those with conventional TOT. Conclusion: Modified TOT designed for supporting bladder neck as well as mid-urethra showed comparable success rate with conventional TOT with no differences in postoperative voiding function. Furthermore, M-TOT seems to be more efficient than conventional TOT in the management of SUI associated with ISD. (J. Korean Continence Society 2007;11:30-35