26 nov. BANDELETA SUBURETRALĂ TOT IN TRATAMENTUL INCONTINENŢEI URINARE DE STRESS
Experienţa clinicii de Ginecologie a Spitalului Dr. Dumitru Popescu Timişoara şi a Clinicii de Chirurgie II a Spitalului Municipal Timişoara
L. Pirtea*, D. Grigoraş*, M. Bacila**, I. Sas*, R. Ilina***, Marilena Pirtea ****
*.UMF Timişoara Catedra obstetrica-ginecologie
** Spitalul Dr Dumitru Popescu Timişoara
*** UMF Timişoara catedra de chirurgie
**** Spitalul Clinic Municipal de Urgenţă Timişoara
Rezumat
Incontinenţa urinară de stress reprezintă pierderea de urină pe uretră ca urmare a unor activităţi, care produc creşterea presiunii intraabdominale, este foarte frecventă la femeile peste 40 de ani, în special la cele care au avut multiple naşteri vaginale.
Scopul studiului a fost evaluarea tratamentului incontinenţei urinare de stress, efectuat in cele 2 clinici, folosind bandelete suburetrale de polipropilena montate tension-free cu pasaj transobturator, outside–in.
Material şi metodă – am evaluat toate pacientele tratate in clinica noastra cu incontineta urinara de efort in perioada 03.2008- 03. 2011.
Rezultate: Au fost găsite 192 de cazuri internate şi operate – 72% au fost cu vârste cuprinse 40-60 ani, in 37% din cayuri a fost asociat cu cistocel, 38% au avut interventie chirurgicala strict pentru incontinenţă urinară. Durata medie de spitalizare a fost de 48 ore.
Discuţii: cea mai frecventă complicatie a fost sangerare intraoperatorie, hematurie, eroziune vaginală. A fost evaluata curba de invatare.
Concluzii: tehnica este minim invazivă si foare eficientă.
Abstract – Suburethral TOT sling in treatment of urinary stress incontinence
Urinary stress incontinence, the leak of urine during activities that increase intraabdominal presure, is a very common condition among women over 40 years, espeaceally if they had multiple vaginal deliveries.
The aim of our study was to assess the results of treating stress incontinence by suburethral sling, TOT passage.
Matherial and method: we evaluated all the patients with stress incontinents treated by this method between 03.2008- 03. 2011, in our clinics.
Results: 192 cases were found 72 % were age 40- 60; in 37% of the cases a cystocele was associated; 38% of the patients had surgery strictly for stress incontinence, for the rest this procedure was associated with cystocele repair, posterior colporaphy or hysterectomy. 82% of the patients were continent second day after surgery. The median hospitalization time was 48 hours. Discussions: the most common complications were discussed: intraoperative bleeding, hematuria, vaginal erozion. Also the lerning curve for this procedure was evaluated.
Conclusions: this technique is a minimally invasive and very effective one. It is also easy to learn and no major complications are expected if the anatomy of the area is respected.
Keywords: urinary stress incontinence, TOT passage
