복합성요실금 환자에서 중부요도슬링수술 전 항콜린성 약물치료의 효과
The Effect of Anticholinergic Drug Treatment before a Midurethral Sling Operation in Mixed Urinary Incontinence
오범석, 박상현, 박석산,
소속 상세정보
오범석 ( Oh Bum-Seok )
인제대학교 의과대학 비뇨기과학교실
박상현 ( Park Sang-Hyun )
인제대학교 의과대학 비뇨기과학교실
박석산 ( Park Seok-San )
인제대학교 의과대학 비뇨기과학교실
KMID : 0358320070480101075
Abstract
요실금은 중년 이상의 여성에서 흔히 나타나는 질환으로 사회적, 위생적 문제를 야기하여 환자의 삶의 질에 유의한 영향을 미치며, 일반인에서 15-35% 정도의 유병률을 보이고 연령이 증가함에 따라 유병률도 증가하는 경향을 보인다.1 복압성요실금은 방광경부와 후부요도의 해부학적 위치 변형으로 인해 발생하며, 이러한 위치 변형된 방광경부를 원래 위치인 치골후상부로 견인시킴으로써 요실금을 치료하고자 많은 수술 방법들이 고안되어 왔다.2 1996년에는 여성 복압성요실금의 치료법으로 tension-free vaginal tape(TVT) 수술이 고안되었으며 이는 Integral theory에 기초를 두어 중부 요도에 얇은 mesh를 걸어 주는 방법으로 85-90%
의 높은 성공률을 보이고 있다.3,4
Purpose:We investigated the effect of anticholinergic drug treatment before midurethral sling surgery in patients with mixed urinary incontinence(MUI).
Materials and methods:Between January 2004 and December 2006, 112 female patients with MUI were evaluated. Forty-seven patients were not medicated with anticholinergic drugs(Group A) and 65 patients were medicated with anticholinergic drugs(Group B) for 2 weeks or more(2-8 weeks, mean 2.34±1.02) before the midurethral sling operation. After the midurethral sling operation, the patients were followed up for 4 weeks or more(4-48 weeks, Group A is 7.83±8.70, Group B is 6.77±7.58). Cure of the incontinence after the procedure was defined as the absence of subjective symptoms such as frequency, urgency, urge incontinence and the absence of objective leakage on stress testing. All other cases were considered failures.
Results:There were no significant differences between the group that was not medicated preoperatively (Group A) and the group that was preoperatively medicated(Group B)(cure rate of Group A was 87.2% and Group B was 89.2%, p=0.745) in the cure rate for pure stress urinary incontinence. However, comparison of the postoperative results for the MUI showed significant differences (cure rate of Group A was 63.8% and Group B was 81.6%, p=0.035). The cure rate was significantly higher in the preoperatively medicated patients than in the patients who were not preoperatively medicated with regard to the MUI.
Conclusions:Our findings suggest that treatment with anticholinergic medications before a midurethral sling operation improves the cure rate in patients with MUI. (Korean J Urol 2007;48:1075-1081)
키워드
Urinary incontinence;Treatment
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