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복압성요실금에서 Multifilament Propylene Tape과 Monofilament Propylene Tape을 이용한 수술에서 질미란과 효용성의 비교

Comparison of the Efficacy and Vaginal Erosion Rate between Monofilament and Multifilament Polypropylene Tapes for Treating Urinary Incontinence

대한비뇨기과학회지 2008년 49권 9호 p.844 ~ 849
김태홍 ( Kim Tae-Hong ) - 관동대학교 의과대학 비뇨기과학교실

서주태 ( Seo Ju-Tae ) - 관동대학교 의과대학 비뇨기과학교실

Abstract


Purpose: We compared the efficacy and vaginal erosion rates between a polypropylene multifilament tape(anterior intravaginal slingplasty; IVS) and a polypropylene monofilament tape(tension free vaginal tape; TVT) as surgical implants for suburethral, tension-free tape for the treatment of stress urinary incontinence(SUI).

Materials and Methods: We retrospectively reviewed the women(n=272) who underwent an anterior IVS(n=142) or a TVT (n=130) procedure for managing SUI, between January 2004 and December 2005 at Cheil General Hospital. Only 216 patients (the anterior IVS group: 112, the TVT group: 104) with a follow-up of at least 24 months were included in this study. Preoperatively, each patient received a history review, a physical examination, a voiding diary, a pad test, uroflowmetry and determination of the postvoid residual urine. Follow-up evaluations were performed at 1 month, 3 months and annually after the operation.

Results: The two groups were similar for their preoperative characteristics. There was no significant difference between the 2 groups in terms of the cure rate: cure(89.29% vs. 89.42%, respectively, p=0.974), improvement (6.25% vs. 7.69%, respectively, p=0.677), and failure(4.46% vs. 2.89%, respectively, p=0.539) for the anterior IVS and TVT groups, respectively. Nine women developed vaginal erosion, and this occurred significantly more in the anterior IVS group than the TVT group(7.14% vs. 0.96%, respectively, p=0.036).

Conclusions: Anterior IVS and TVT appear to be equally effective for the surgical treatment of female SUI. However the number of women who were diagnosed with vaginal erosion was significantly higher in the anterior IVS group than in the TVT group. It is possible that the multifilamentous nature of the anterior IVS tape might contribute to vaginal erosion.

키워드

Urinary incontinence;stress;Suburethral slings;Complications
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