Comparative Study of Tension-free Vaginal Tape and Burch Colposuspension in the Surgical Management of Female Stress Urinary Incontinence / 대한산부인과학회잡지

OBJECTIVE: The purpose of this study was to compare the effectiveness, easiness, postoperative complications between tension-free vaginal tape (TVT) and Burch colposuspension (BC) in the surgical management of female genuine stress urinary incontinence. METHODS: A retrospective study of 77 cases with stress urinary incontinence at Department of Obstetrics and Gynecology and Urology, Pochon CHA University Medical College from January 2000 to December 2002, followed up more than 6 months. All of 77 cases were above grade 2 genuine stress urinary incontinence, 37 cases were performed tension-free vaginal tape, 40 cases were performed Burch colposuspension. RESULTS: Cure rate was 91.4% in the tension-free vaginal tape (TVT) group, 90% in the Burch colposuspension group. The mean operative time for TVT was 23.4 minutes and for Burch colposuspension was 47.2 minutes. The mean hospital stay in TVT was 1.8 days and in Burch colposuspension was 5.2 days. The incidence and severity of postoperative complication is similar in both groups. CONCLUSION: The cure rates of TVT were comparable with Burch colposuspension in the surgical management of female genuine stress urinary incontinence. And the incidence and severity of postoperative complication is similar in both groups. Moreover TVT is simple procedure more than Burch colposuspension.

Comparative Study of Tension-free Vaginal Tape and Burch Colposuspension in the Surgical Management of Female Stress Urinary Incontinence / 대한산부인과학회잡지

OBJECTIVE: The purpose of this study was to compare the effectiveness, easiness, postoperative complications between tension-free vaginal tape (TVT) and Burch colposuspension (BC) in the surgical management of female genuine stress urinary incontinence. METHODS: A retrospective study of 77 cases with stress urinary incontinence at Department of Obstetrics and Gynecology and Urology, Pochon CHA University Medical College from January 2000 to December 2002, followed up more than 6 months. All of 77 cases were above grade 2 genuine stress urinary incontinence, 37 cases were performed tension-free vaginal tape, 40 cases were performed Burch colposuspension. RESULTS: Cure rate was 91.4% in the tension-free vaginal tape (TVT) group, 90% in the Burch colposuspension group. The mean operative time for TVT was 23.4 minutes and for Burch colposuspension was 47.2 minutes. The mean hospital stay in TVT was 1.8 days and in Burch colposuspension was 5.2 days. The incidence and severity of postoperative complication is similar in both groups. CONCLUSION: The cure rates of TVT were comparable with Burch colposuspension in the surgical management of female genuine stress urinary incontinence. And the incidence and severity of postoperative complication is similar in both groups. Moreover TVT is simple procedure more than Burch colposuspension.

A Case of Sirenomelia In One Fetus of Twin Pregnancy / 대한산부인과학회잡지

Sirenomelia is a lethal congenital malformation characterized by single or fused lower limbs associated with other severe genitourinary and lower gastrointestinal tract anomalies. Associated anomalies include malformation of vertebrae and pelvis, oligohydroamnios, renal agenesis, imperforate anus, internal and external genital anomaly and single umbilical artery. Recently, sirenomelia is diagnosed by ultrasound at first trimester or early second trimester. Termination of pregnancy is recommended as soon as diagnosis is made. We report a case of sirenomelia in a monoamniotic twin gestation detected at IUP at 12 weeks which was maintained till IUP at 37 weeks and delivered by cesarean section. On autopsy, typical finding of sirenomelia was noted, whereas the contralateral twin showed no abnormalities.

Acute Leukemia and Myelodysplasitc Syndrome During Pregnancy A Single Institutional Experience of 4 Cases / 대한산부인과학회잡지

We have reviewed the medical records of 4 pregnant patients with concomitant acute leukemia at our institution in conjunction with determining the delivery process in order to reduce complications associated with the delivery. Of the 4 patients, three cases were diagnosed as acute leukemia and the other as myelodysplastic syndrome. One experienced an incomplete abortion at gestational age of 10 weeks, after remission induction chemotherapy. The remaining three patients made delivery at full term by Cesarean section. Our observation indicated that Cesarean delivery was advisable for these three patients. Most of the patients had thrombocytopenia or anemia. Before the Cesarean section or dilatation or evacuation, transfusion was undertaken to prevent hemorrhage or severe anemia. In the cases of refractoriness to blood transfusion, a greater amount was transfused. After Cesarean section, some complications were reported such as fever, delayed wound repair, and vaginal bleeding. Based on the our observations, we are of the opinion that pregnant women with acute leukemia or myelodysplastic syndrome can be managed even in those cases where the state of leukemia is not in complete remission or chemotherapy-induced cytopenia is. And the proper measures are timely undertaken to prevent complications associated with delivery.

Massive Gastrointestinal Bleeding Following Intracranial Lesion

"Stress ulceration" of the stomach and duodenum is a nonspecific term used to cover a wide variety of different entities. It has been known for many years that there is an association between gastrointestinal bleeding and intracranial lesion. This is not a common clinical problem, but it has been noted to be increasing over the recent years, possibly due to the increased survival of severe injured neurosurgical patients and neurosurgical procedures. Clinically recongnition of gastrointestinal bleeding or ulceration can be difficult, partcularly in the unconscious patient and prevention of this complication has not been successful. The treatment of that has been the subject of considerable controversy. Prognosis depends on a prevention of hemorrhagic shock or sepsis and promptly proper management. The authors analyzed the 21 cases of massive gastrointestinal bleeding in neurosurgical patients, who were admitted to the department of neurosurgery of National Medical Center from 1978 to 1980.