Comparison of the transvaginal procedure and retropubic procedure for stress incontinence / 대한비뇨기과학회지

ABSTRACT

For the successful surgical treatment of genuine stress urinary uncontinence many procedures have been applied. We report on 36 cases of stress incontinence surgically treated by the tansvaginal procedure (19 cases) and retropubic procedure(17 cases) during the period from November, 1981 to October, 1991. The patient varied in age from 34 to 65 years in the transvaginal procedure and 26 to 68 years in the retropubic procedure(total mean age was 47.2 years). The surgical procedures were performed by Pereyra`s method 17 cases. Stamey`e method 2 cases. MMK's method 11 cases. Montague`s method 1 case. Burch`s method 5cases. Clinical symptom classification (grade I - Grade IV)of stress incontinence reported by Ball was used. There were symptom distribution of Grade I, 3 cases ; Grade II, 14 cases; Grade III, 2 cases in the transvaginal procedure. Grade I, 3 cases; Grade II, 11 cases Grade III, 3 cases were done by the retropubic procedures. The success rate was 84% in the trensvaginal procedure and 89% in the retropubic procedure with minimum follow up of six months. Postoperative complications were urinary retention 8 cases, bladder perforation 1 case, vaginitis 1 case (total 59%) in the transvaginal procedures, while urinary retention10 cases. wound infection 1 case (total 70%) in the retropubic procedures. The values of post-operative days on catheter, operative time and postoperative hospitalization in the transvaginal procedures were 6.8+/-2.1 days. 91.6+/-23.2 minutes and 7.2+/-0.5 days, and in the retropubic procedures 6.9+/-3.2, 123.5+/-21.5 and 7.8+/-0.6 respectively (p<0.01). On the basis of the results we concluded that the transvaginal procedure had advantages including operative simplicity, extensive indication, rarer postoperative complication, compared with retropubic procedures.