복압성 요실금 환자에서 Intravaginal Slingplasty (IVS) 수술과 Tension-free Vaginal Tape (TVT) 수술의 장기추적 비교

Abstract

Purpose: Intravaginal slingplasty (IVS) is a alternative technique in the treatment of stress urinary incontinence in women. The author reports the long-term results of IVS procedure and compares to the long-term results of tension-free vaginal tape (TVT) procedure. Materials and Methods: 25 women treated with IVS were compared to 25 women treated with TVT. The follow up period of all patients was mean of 30 months. All patients were preoperatively evaluated with detailed history, physical exam, 1 hour pad test and urodynamic study. Operation was carried out under general anesthesia. Operation time, hospitalization time, perioperative complication, cure rate and long-term follow-up data were evaluated. Long-term follow-up data was obtained from questionnaires on whether or not continuation of stress incontinence and subjective satisfaction. Results: Two groups were similar in their mean ages, body mass index and mean parities. No patient contraction in cystometry. Mean operation time were 29.4 minutes (20-40). 31.6 minutes (25-40), and mean hopitalized duration were 3.3 days, 4.0 days for IVS and TVT, respectively. Perioperative bladder injury were 0 case (0%) and 2 cases (8%) and hemoglobin decrease were 1.5 gm/dl and 1.7 am/dl for IVS and TVT, respectively. Vaginal erosion and infection were 1 case (4%) and O cases (0%) for IVS and TVT, respectively. Objectively, 3 months postoperative cured/improved/failed rates were 88%/12%/0%, 84%/16%/0% for IVS and TVT, long-term follow-up cured improved/failed rates were 76%/20%74%, 80%/12%/8% for IVS and TVT, respectively. Subjective satisfaction rates with the procedure were 80% and 88%, respectively. Conclusion: Both procedures had equally high rate of long-term cure, satisfaction and perioperative complication in the surgical treatment of stress urinary incontinence. IVS is simple, safe and effective treatment. (J. Korean Continence Society 2006;10:158-164)