| Abstract (english) | The aim of this study was to determine the efficacy and surgical outcome of the sling procedures in stress incontinent women in comparison to conventional anterior colporrhaphy. Total of 56 patients with stress urinary incontinence (SUI) were treated with sling procedure between November 2011 and March 2013, 39/56 (69.6%) with suprapubic arc (SPARC) and 17/56 (30.4%) with MiniArc method. During the same period total of 49 patients with SUI were treated with traditional anterior colporrhaphy according to Bagovid method as the control group. All patients were prospectively clinically assessed over aperiod of 3, 6 and l2 months after surgery. The objective cure rate after the follow-up was 92.9% (52/56) in observed group of patients and 79.6% (39/49) in control group and improvement was occurred in rest of 5.4% (3/56) and 18.4% (9/49), respectively (p < 0.05). The overall complications rate was significantly lower in the observed group of patients than in the control group, 12.5% (7/56) vs. 28.6% (14/49), (p < 0.05). In the sling group was postoperatively noticed slightly higher rate of urinary incontinence, but in the colporrhaphy group was emphasized rate of urinary retention. Only one from the each group of patients failed the surgical procedure and required additional correction for SUI. The mean operating time for SPARC and MiniArc procedure was 19 +/- 7 and 9 +/- 5 minutes, respectively (p < 0.0001). Mean duration of hospitalization was significantly shorter in the sling group of patients (2.6 +/- 1.0, range 2-7) days than in the control group of (9.6 +/- 1.8, range 6-18), (p < 0.001 < 0.0001). According to presented results, sling is a highly effective method in patients with SUI with low incidence of perioperative complications, promising long-term results and high patient's satisfaction. |
| Abstract (croatian) | Cilj ovog istraživanja bilo je utvrditi učinkovitost i operacijski ishod sling postupaka u žena sa statičkom inkontinencijom
urina (SIU) u poredbi sa konvencionalnom prednjom kolporafijom. U razdoblju od studenog 2011. do ožujka 2013.
sling postupcima liječeno je ukupno 56 bolesnica sa SIU, 39/56 (69,6%) metodom SPARC i 17/56 (30,4%) metodom
MiniArc. Tijekom istog razdoblja ukupno je 49 bolesnica sa SIU operirano primjenom klasične prednje kolporafije metodom
po Bagoviću kao poredbena skupina. Sve bolesnice prospektivno su klinički nadzirane u razdoblju od 3, 6 i 12
mjeseci nakon operacije. Ukupna stopa izlječenja nakon razdoblja kliničkog nadzora iznosila je 92,9% (52/56) u promatranoj
skupini bolesnica i 79,6% (39/49) u poredbenoj skupini, a do poboljšanja je došlo u ostalih 5,4% (3/56) bolesnica u
promatranoj i 18,4% (9/49) bolesnica u poredbenoj skupini (p<0,05). Ukupna stopa komplikacija bila je značajno niža u
promatranoj skupini bolesnica nego u poredbenoj skupini, 12,5% (7/56) naspram 28,6% (14/49), (p<0,05). U skupini
bolesnica liječenih sling metodama poslijeopreacijski je zabilježena nešto viša stopa inkontinencije, a u skupini klasično
operiranih bolesnica nešto izraženija stopa urinarne retencije. Kirurško liječenje nije uspjelo samo kod jedne bolesnice
iz svake skupine i bilo je potrebno učiniti dodatnu korekciju SIU. Prosječno trajanje operacije iznosilo je 19±7 minuta
za SPARC, a 9±5 minuta za MiniArc, (p<0,0001). Prosječno trajanje bolničkog liječenja bilo je značajno kraće u skupini
bolesnica liječenih sling postupkom (2,6±1,0, raspon 2–7) dana nego u poredbenoj skupinu (9,6±1,8, raspon 6–18),
(p<0,001<0,0001). Slijedom prikazanih rezultata, sling metode su vrlo učinkovite u liječenja SIU sa niskom pojavnošću
perioperacijskih komplikacija i obećavajućim dugoročnim rezultatima te primjerenim zadovoljstvom bolesnica. |
