PTU - Polskie Towarzystwo Urologiczne
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Evaluation of effectiveness of urethral IVS suspension in women with urinary incontinence. Four-year follow-up
Article published in Urologia Polska 2007/60/3.

authors

Mariusz Blewniewski, Waldemar Różański, Michał Markowski
II Klinika Urologii Uniwersytetu Medycznego w Łodzi

keywords

urinary tract, female urinary incontinence, retropubic procedure, IVS

summary

Introduction. Female stress urinary incontinence (SUI) occurs as a result of downward displacement of the bladder neck and urethra due to flacidity of the supporting tissues and intrinsic urethral sphincteric deficiency. Among the numerous methods of treatment used in SUI according to the stage of the disease, procedures involving suspension of the urethra are the most frequent ones. The aim of the study was to assess the effectiveness of urethral suspension procedures utilizing self-supporting prolene tape, IVS was used in the procedures. Material and method. From October 2001 to October 2005, 95 retropubic urethral suspension procedures with IVS tape treating urinary incontinence in women were performed in our department. The patients' age ranged from 36 to 81, with the mean of 62 years. The diagnosis of SUI was established on the basis of anamnesis and diagnostic examinations. The patients were divided into 3 groups (I group – stress incontinence, II group – recurrent incontinence, III group – mixed urinary incontinence). The average duration of this low-invasive procedure is ca. 20 min., and of hospitalization 2 days. The patients were followed up post-operatively for 3 to 48 months.
Results.
88 women were observed. Complete cure was obtained in 80 patients (90.1%), improvement in 8 (9.9%). Urine retention after micturition was observed in 3 women, and the symptoms of urgency, which regressed completely or were reduced within 4 weeks after the procedure, were noted in 13 cases (14.7%). In group III (mixed type incontinence), the operated patients required additional administration of anticholinergic drugs because of urgency. The bladder wall was accidentally perforated in 5 (5.2%) patients during the blind passage of the tuneller through retropubic space. These complications occurred at the beginning of the procedure performance.
Conclusion.
The obtained results allow to conclude that the IVS method is a low-invasive, relatively safe and effective procedure in the treatment of SUI, even in cases of recurrences. Short period of hospitalization allows to reduce costs, convalescence time and favors quicker recovery. Four years period allows to objectively assess the method.

references

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correspondence

Mariusz Blewniewski
II Klinika Urologii UM
ul. Pabianicka 62
93-513 Łódź
tel. 0 601 32 28 32
blewniewski@poczta.onet.pl