한국에서 긴장성 요실금의 새로운 수술적 치료법인 원위부 요도하 폴리프로필렌 슬링술 (Distal Urethral Polypropylene Sling)에 관한 예비 보고
Preliminary Report on Distal Urethral Polypropylene Sling (DUPS) in the New Surgical Management of Stress Urinary Incontinence in Korea
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목적: 한국에서 긴장성 요실금의 새로운 수술적 치료로서 원위부 요도하 폴리프로필렌 슬링술 (Distal Urethral Polypropylene Sling)을 소개하고, 임상 결과를 분석하기 위해 시행하였다. 연구 방법: 2005년 2월부터 2005년 5월까지 4개월 동안 본 교실에서 시행된 DUPS 환자 12명을 대상으로 병록일지를 분석하여, 환자의 과거력, 나이, 분만력, 체계화된 증상 질문, 배뇨일지, 배뇨후 잔뇨감, 요역동학 검사 등을 조사하였고, 수술시간, 혈색소 변화, 재원일수, 동반질환, 동반된 수술 등을 후향적으로 연구하였다. 결과: 수술 시행 시 평균 연령은 48.08±9.3세 이었고, 분만력은 2.9±1.1회였다. 동시 에 시행된 수술로는 직장류 복원술 5예, 복강경하 질식 전자궁적출술 및 직장류 복원술 1예, 복강경하 질식 전자궁적출술 1예, 질식 전자궁적출술 및 방광류 및 직장류 복원술 1예 등이 있었으며, 평균 수술 시간은 29.00±15.8분 이었고, 평균 혈색소 변화는 1.57±1.14 g/dL, 평균 재원 일수는 3.74±0.88일 이었다. 특별한 수술 중, 후 합병증 등은 발생하지 않았다. 평균 94.7%의 요실금 증상의 치료 효과가 있었다. 결론: DUPS는 긴장성 요실금 환자에게 시행할 수 있는 저렴하고, 안전한 새로운 수술 방법이다.
Abstract
Objective: The purpose of this study is to introduce and evaluate new anti-incontinence surgical procedure, Distal Urethral Polypropylene Sling (DUPS) for stress urinary incontinence in Korea. Methods: DUPS were performed on 12 patients with stress urinary incontinence at Kangbuk Samsung Hospital from Feb. 2005 to May 2005. Patients were evaluated preoperatively with history, physical examination, standardized symptom questionnaire, voiding diary, post-void residual urine and urodynamics. We reviewed medical records and clinical characteristics and evaluated the efficacy of the sling procedure, retrospectively. Results: The mean age was 48.08±9.3 years. The average operative time was 29.00±15.8 minutes for the sling procedure. The average hemoglobin change is 1.57±1.14 g/dL. The mean hospital stay day is 3.74±0.88 days. Concomitant procedures were performed including rectocele repair (n=5), LAVH with rectocele repair (n=2), LAVH (n=1), VTH with cystocele and rectocele repair (n=1). There was no intraoperative complications or major postoperative complications. The cure rate (patients' satisfaction) was 94.7%. Conclusion: DUPS is a new, inexpensive, safe and simple alternative treatment for patients with stress urinary incontinence.
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