İnsitu vajinal ön duvar slinglerin başarısında beden kitle indeksi bir etken mi?
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Dosyalar
Tarih
2004
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Erişim Hakkı
info:eu-repo/semantics/openAccess
Özet
Bu çalışmamızda Tip II stres inkontinans nedeniyle modifiye insitu vajinal on duvar sling onarımı yapılan olgularda, Beden kitle indeksinin (BKİ) cerrahi tedavi üzerine olumsuz etkisi olup olmadığını incelemeyi amaçladık. Beden kitle indeksi 18-25 kg/m2 arasında, ortama yaşı 54,8 ve ortalama doğum sayısı 2,58 olan 29 olgu ile beden kitle indeksi 25-30 kg/m2 arasında, ortalama hasta yaşı 56,9, ortalama doğum sayısı 2,27 olan 22 olguya Tip II stres inkontinans nedeniyle modifıye insitu vajinal ön duvar sling onarımı yapılmış ve beden kitle-indeksiyle operasyon başarısı arasındaki ilişki araştırılmış, sonuçlar istatistiksel olarak ki kare testiyle karşılaştırılmıştır.Tip II stres inkontinans nedeniyle modifiye insitu vajinal ön duvar sling onarımı yapılan Beden kitle indeksi 18- 25 kg/m2 olan 29 olguda kür, düzelme ve başarısızlık oranları sırasıyla %75,8, %6,9 ve %17,3 olarak bulunurken, beden kitle indeksi 25-30 kg/m2 olan 22 olguda kür, düzelme ve başarısızlık oranları sırasıyla %72,7, %9,2 ve %18,2 olarak bulunmuştur. Bu iki grup arasında beden kitle indeksiyle operasyon başarısı arasında anlamlı bir farklılık gözlenmemiştir. Vajinal ön duvar sling onarımı öncesi beden kitle indeksi ile ameliyat sonuçları arasında ilişki araştırılarak ameliyat öncesi kilo fazlalığının ameliyat sonuçlarını olumsuz etkilemediği gösterilmiştir.
Introduction: In this study, we aimed to analyse whether body mass index (BMI) have a negative impact on the outcome of insitu vaginal wall sling surgery for Type II stress urinary incontinence. Materials and Methods: The results of modified insitu vaginal wall sling in 29 women with an average age of 54.8 years and a parity rate of 2.58 having a Body Mass Index (BMI) between 18-25 kg/m2 were compared statistically with the results of 22 women with an average age of 56.9 years and a parity rate of 2.27 having a body mass index of 25-30 kg/m2 by using Chi Square test to assess whether preoperative overweight has a negative impact on surgical outcome of our technique. There was no patient in the obese group with a body mass index of more than 30 kg/m2. Preoperative evaluations included history, pet usage per day, parity rate and frequency, urgency, urgency incontinence questionnaire. Physical examinations included vaginal examination in lithotomy position to assess the condition and) the accompanying pathologies such as cystocele, rectocele and enterocele, Q tip test to assess the degree of urethral mobility, cystoscopic examination to rule out intravesical pathologies such as carcinoma insitu, neoplasms and interstitiel cystitis followed by Bonney test, urodynamic examination, by using Andromeda Elipse 4 multichannel cystometry and only the patients who met type II stress incontinence definition were included to the study. Body mass index was calculated by dividing the body weight in kilograms to the square of the length of the patient in meters. The patients with the body mass index of 18.5-25 kg/m2 were accepted as normal weight and 25-30 kg/m2 were accepted as overweight. All patients were operated by using a modified insitu vaginal wall sling procedure between the periods of 1996 to 2002 and followed with an average follow-up period of 28.7 (12-62) months. In our technique a rectangular vaginal wall sling incision 3x2 cm was made corresponding to the level of bladder neck and it was dissected of the surrounding vaginal wall. Two polypropylene 1-0 sutures were passed on the short sides of the rectangle, as coil fashion and transferred to the suprapubic region by two bended kishner needles. The dissected vaginal wall was sutured onto the rectangular sling to cover it by two layers to reinforce its strength. Prolene sutures were tied as cross manner on the rectus fascia arid'urethral catheter was taken on the fifth postoperative day. The cure was "defined as no more pet usage in any .condition, improvement as the decrease of the pet usage more than 50% and failure if incontinence persists despite surgery. Results There were no statistical difference between the. parity rates; of Jj$iS3/wi)jgroups and no statistical difference between the ages of the groups. In patients whom modified insitu tağhıal, wall sling were performed for type II stress incontinence, the cure, improvement and failure rates in norinal weight group (BMI 18-25 kg/m2) were found as 75.8%, 6.9% and 17.3% respectively while the results in.oferweight group (BMI 25-30 kg/m2) were 72.7%, 9.2% and 18.2%-respectively. There were no significant'difference in the surgical outcomes.between the two groups (p<0.05). Conclusions- We didn't find-the preoperative overweight to be a risk factor for the failures of modified insitu vaginal wall sling operations that were followed for about 28 months when compared to normal weight group.
Introduction: In this study, we aimed to analyse whether body mass index (BMI) have a negative impact on the outcome of insitu vaginal wall sling surgery for Type II stress urinary incontinence. Materials and Methods: The results of modified insitu vaginal wall sling in 29 women with an average age of 54.8 years and a parity rate of 2.58 having a Body Mass Index (BMI) between 18-25 kg/m2 were compared statistically with the results of 22 women with an average age of 56.9 years and a parity rate of 2.27 having a body mass index of 25-30 kg/m2 by using Chi Square test to assess whether preoperative overweight has a negative impact on surgical outcome of our technique. There was no patient in the obese group with a body mass index of more than 30 kg/m2. Preoperative evaluations included history, pet usage per day, parity rate and frequency, urgency, urgency incontinence questionnaire. Physical examinations included vaginal examination in lithotomy position to assess the condition and) the accompanying pathologies such as cystocele, rectocele and enterocele, Q tip test to assess the degree of urethral mobility, cystoscopic examination to rule out intravesical pathologies such as carcinoma insitu, neoplasms and interstitiel cystitis followed by Bonney test, urodynamic examination, by using Andromeda Elipse 4 multichannel cystometry and only the patients who met type II stress incontinence definition were included to the study. Body mass index was calculated by dividing the body weight in kilograms to the square of the length of the patient in meters. The patients with the body mass index of 18.5-25 kg/m2 were accepted as normal weight and 25-30 kg/m2 were accepted as overweight. All patients were operated by using a modified insitu vaginal wall sling procedure between the periods of 1996 to 2002 and followed with an average follow-up period of 28.7 (12-62) months. In our technique a rectangular vaginal wall sling incision 3x2 cm was made corresponding to the level of bladder neck and it was dissected of the surrounding vaginal wall. Two polypropylene 1-0 sutures were passed on the short sides of the rectangle, as coil fashion and transferred to the suprapubic region by two bended kishner needles. The dissected vaginal wall was sutured onto the rectangular sling to cover it by two layers to reinforce its strength. Prolene sutures were tied as cross manner on the rectus fascia arid'urethral catheter was taken on the fifth postoperative day. The cure was "defined as no more pet usage in any .condition, improvement as the decrease of the pet usage more than 50% and failure if incontinence persists despite surgery. Results There were no statistical difference between the. parity rates; of Jj$iS3/wi)jgroups and no statistical difference between the ages of the groups. In patients whom modified insitu tağhıal, wall sling were performed for type II stress incontinence, the cure, improvement and failure rates in norinal weight group (BMI 18-25 kg/m2) were found as 75.8%, 6.9% and 17.3% respectively while the results in.oferweight group (BMI 25-30 kg/m2) were 72.7%, 9.2% and 18.2%-respectively. There were no significant'difference in the surgical outcomes.between the two groups (p<0.05). Conclusions- We didn't find-the preoperative overweight to be a risk factor for the failures of modified insitu vaginal wall sling operations that were followed for about 28 months when compared to normal weight group.
Açıklama
Anahtar Kelimeler
Beden Kitle İndeksi, İnkontinans Cerrahisi, Body Mass Index, Urinary Incontinence Surgery
Kaynak
Türk Üroloji Dergisi
Turkish Journal of Urology
Turkish Journal of Urology
WoS Q Değeri
Scopus Q Değeri
N/A
Cilt
30
Sayı
2
