여성 복합성요실금 환자에서 TVT와 TVT-O 술식의 비교: 단기 치료성적 비교

Abstract

Purpose: The treatment of women with mixed urinary incontinence still posses a great challenge. This study evaluated surgical outcomes of tension free-vaginal tape (TVT) and tension-free vaginal tape obturator inside-out (TVT-O) in the treatment of mixed urinary incontinence. Materials and Methods : Fifty two women with mixed urinary incontinence were randomly assigned to the TVT (n=26) and TVT-O (n=29) procedure, between January 2002 and December 2006. The patient characteristics and urodynamic evaluations were similar in both groups. The preoperative evaluation included a careful history taking, physical examination, voiding diary, uroflow and a comprehensive urodynamic examination. The objective assessment was evaluated by clinical and urodynamic examinations. The satisfaction rate was evaluated by using a questionnaire via the telephone or a self-addressed. Results : Two groups were similar in their preoperative characteristics. There was no significant difference between the two groups in terms of the cure rate: Cure (76.9% vs 82.8%, p>0.05), improvement (15.4% vs 10.3%, p>0.05) and failure (7.7% vs 6.9%, p>0.05) for TVT and TVT-O procedure, respectively. In addition, the patient satisfaction rate was not different significantly between two groups. The rate of postoperative urethral obstruction, including retention, was 11.5% (n=3) in the TVT group, versus 10.3% (n=3) in the TVT-O group, but this was improved by conservative therapy. Conclusions : The TVT-O procedure appears to be equally efficient as the TVT procedure for the surgical treatment of mixed urinary incontinence in woman over a short-term follow up. Although further studies are needed to establish its long-term efficacy and safety, The TVT and TVT-O procedure might be attractive tools for the treatment of females mixed urinary incontinence.