Saratov JOURNAL of Medical and Scientific Research

stress urinary incontinence

Efficiency of the installation of suburetral loop by different methods in women with stress urinary incontinence

Year: 2020, volume 16 Issue: №1 Pages: 73-76
Heading: Urology Article type: Original article
Authors: Eizenakh I.A., Rakitin F.A., Mozes V.G., Mozes K.B., Zakharov I.S.
Organization: Novokuznetsk City Clinical Hospital №1, Kemerovo State Medical University, Institute of Cytology, Russian Academy of Sciences
Summary:

The aim: to assess the effectiveness of the installation of a suburethral loop with fixation in the obturator membrane in various ways in case of stress urinary incontinence in women. Material and Methods. 191 women aged from 35 to 65 years old were selected with stress urinary incontinence, which were installed with a suburethral loop with fixation in the obturator membrane in various ways: using an in-out trocar method (group A, n=65); trocar out-in method (group B, n=67); without trocar method in-out (group C, n=59). Randomization of patients into groups was carried out by random numbers. As the primary outcome of the installation of a suburethral loop with fixation in the obturator membrane, the frequency and severity of stress urinary incontinence recurrence was studied using a cough test and a Valsalva test after 12, 36 and 60 months. The timing of surgery, the structure and frequency of the immediate postoperative complications were evaluated as secondary outcomes. Results. The time of the operation in group Awas 31 (30; 33) minutes, in group В 53 (52; 54) minutes, in group С 29 (28; 30) minutes, respectively, F12=1908; p=0,001. Stress incontinence recurrence within 12 months after surgery developed in 3.1 % in group A, 0% in group В and 5.1 % in group С (p =0,14; pAC=0,57; p =0,061); within 36 months after surgery in 7.6; 0; 10.1%, respectively (p =0,02; pAC=0,628; pBC=0,007); for 60 months after the operation in 24.6; 11.9; 28.8%, respectively (pAB=0,017; p =0,421; pBC=0,018). Conclusion. Despite the longer time to perform surgery and greater technical complexity, the installation of a suburethral loop with fixation in the obturator membrane by the out-in trocar method is accompanied by a lower incidence of early postoperative complications and recurrence of the disease.

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Complications after different surgical methods of setting polypropylene suburethral meshes in women with stress urinary incontinence

Year: 2018, volume 14 Issue: №2 Pages: 277-280
Heading: Urology Article type: Original article
Authors: Eisenakh I.A., Korotkevich O.S., Mozes V.G., Vlasova V.V.
Organization: Kemerovo State Medical University, Novokuznetsk State Clinical Hospital № 1
Summary:

The aim: to determine the complication's rate, based on a seven-year experience, after the stress urinary incontinence correction in women with different methods of setting suburethral polypropylene meshes. Material and Methods. The analysis of seven years of experience of surgical correction with different methods of setting suburethral meshes in 1260 women with stress urinary incontinence; obturator fixation the mesh inside-outside and outside-inside: supra-pubic fixation the mesh; non-trocar fixation the mesh type mini-sling was carried out. Results. The greatest frequency of complications were identified in the first two years of implementation the setting of suburethral meshes, after that the complication's rate decreased progressively and it was in the range 7-8% the last three years. The frequency of early operative complications at a different setting of suburethral meshes had no statistically significant differences, but there were more the statistically significant intraoperative and mesh-associated complications at suprapubic fixation. Conclusion. The study confirms that the installation of suburethral meshes by the method of suprapubic fixation of mesh is associated with a higher incidence of complications and should be performed only in the target group of patients who are not suitable for surgical correction in safer ways.

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