긴장성 요실금에서 경질벽 방광경부 수술법과 치골상부 개복적 수술법의 성적비교
Comparison of the Transvaginal Procedure and Retropubic Procedure for Stress Incontinence
장덕진, 조성룡,
소속 상세정보
장덕진 ( )
대구파티마병원
조성룡 ( )
대구파티마병원
KMID : 0358319930340020335
Abstract
For the successful surgical treatment of genuine stress urinary uncontinence many procedures have been applied. We report on 36 cases of stress incontinence surgically treated by the transvaginal procedure(19 cases) and retropubic procedure(17
cases)
during the period from November, 1981 to October, 1991. The patient varied in age from 34 to 65 years in the transvaginal procedure and 26 to 68 years in the retropubic procedure (total mean age was 47.2 years). The surgical procedures were
performed by
Pereyra's method 17 cases, Stamey's method 2 cases, MMK's method 11 cases, Montague's method 1 case, Burch's method 5 cases. Clinical symptom classification (grade I -Grade IV) of stress incontinence reported byBall was used. There were symptom
distribution of Grade I, 3 cases; Grade II, 14 cases; Grade III, 2 cases in the transvaginal procedure. Grade I, 3 cases; Grade II, 11 cases; Grade III, 3 cases were done by the retropubic procedures. The success rate was 84% in the transvaginal
procedure and 89% in the retropubic procedure with minimum follow up of six months. Postoperative complications were urinary retention 8 cases, bladder perforation 1 case, vaginitis 1 case(total 59%) in the transvaginal procedures, while urinary
retention 10 cases, wound infection 1 case(total 70%) in the retropubic procedures. The values of postoperative days on catheter, operative time and postoperative hospitalization in the transvaginal procedures were 6.8±2.1 days, 91.6±23.2
minutes
and
7.2±0.5 days, and in the retropubic procedures 6.9±3.2, 123.5±21.5 and 7.8±0.6 respectively (p<0.01). On the basis of the results we concluded that the transvaginal procedure had advantages including operative simplicity, extensive
indication,
rarer
postoperative complication, compared with retropubic procedures.
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