ABSTRACT
Stress incontinence is a very common complaint in women and as there is a social aspect to the problem the satisfaction of the patient after surgery could be part of the successful rate of any kind of treatment. This study aim to compare the cure rate after surgery using subjective and objective measures to those who underwent to artificial sling operation to treat their urinary stress incontinence in Maternity Hospital at Damascus University. This prospective study started the 1[st] of January 2009 till 1/1/2010. 33 patients were involved in the study who had had surgery using TVT technique to treat urinary stress incontinence. Many items were used to put the diagnosis include; history, medical examination, bony test, urinalysis and culture and urodynamic study. All patients had a repeated urodynamic studies and the cure rate were compared with the cure using the subjective measures were the satisfaction of the patient is an important element. Using the subjective measures the cure rate was 94% while it was 73% by using the objective measures and there were a failure rate in 3%. despite what is accepted generally that the urodynamic studies is a fundamental measure to evaluate the cure rate after the surgery Such objective measures, however, are not always indicative of a patient's perception of cure, nor their satisfaction with the treatment and the improved quality of life.
Subject(s)
Humans , Female , Hospitals, Maternity , Prospective Studies , UrodynamicsABSTRACT
Stress incontinence is a very common complaint in women specially in preimenopausal area. They do not always come to the Gyn. Clinic complaining of this problem due to their embarrassment, thinking that ageing process is a coexistent to this problem. This study aim to highlight and focus on the bad result of the anterior colporrhaphy as a surgical procedure to treat urinary stress incontinence .which had been used and still from some colleagues. This study aim to focus on the very good result of the new technique [TVT] to treat urinary stress incontinence where it could be the standards technique to be used to solve this problem. The study started the 1[st] of March 2009 till 1/3/2010. 50 patients were involved in the study suffering from different degree of stress incontinence. 14 of them had been submitted to anterior colporrhaphy with Kelly sutures. Many items were used to put the diagnosis include; history, medical examination, bony test, urinalysis And culture and Urodynamic study. All 50 patients had been submited to the new technique of surgery and the results were compared with the result of the old surgery. For the 14 patients treated with anterior colporrhaphy with Kelly sutures the study revealed immediate failure rate 57% of cases[8 patients] while 43% [6 patients] remained without complaint for an average period of 5 years and at the end all patients need another surgery to treat the relapsed stress [TVT] [the new technique] with a good result in the majority of cases. The study revealed tension free vaginal tape [TVT] has a very good result to treat stress incontinence comparing with anterior colporrhaphy which has a high failure rate and advice not to use this old technique in the future to treat urinary stress incontinence
ABSTRACT
A study of cervical cancer took place at the Maternity Hospital of Damascus University from 1990 to 1995. A total of 102 patients were treated, the mean age was 46.6 years, 55% of patients were 40-59 years old. 30.4% were less than 40 years old and 14.6% were older than 60 years old. Vaginal bleeding was the main symptom especially post menopausal bleeding 31.4% and postcoital bleeding 27.5%. 85.2% of the cases were stage I and stage II of cancer cervix. 88.2% of all cases of cancer cervix were squamous cell carcinoma and 10.2% were adenocarcinoma. The most common among squamous cell carcinoma was large cell non keratinizing 54.7, then large cell keratinzing 26.6%, and at the end small cell 18.8%. The incidence of pelivc nodes metastases were high in small cell squamous cell carcinoma 75%, while it was 31.4% in non keratinzing large cell and 17.6% in large cell keratinizing. The dominating treatment modality for cervix carcinoma in our hospital was surgery 78.5% alone or combined with radiotherapy. Surgery alone was adequate in 41.2% of cases. During follow up of 83 patients with cancer cervix, there were 26.5% deaths of cancer, 19.3% patients were lost, and survival rate 53%. The survival rate after surgery was the highest among all other kinds of treatment. The stage of cervical cancer has been shown to be an important prognostic indication, the incidence of nodal metastases for stage I, II were 20% and 35.7% respectively. The incidence of positive vaginal margins was 6.7% for stage I and l6.7% for stage II