Tehran University Medical Journal

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In order to determine the frequency rate of urinary stress incontinence (S.I) after delivery and related factors a longitudinal study carried on primiparous women in Arash Hospital in 1379. Through a non probability sampling, 400 eligible women were recruited from available population. Patient with complain of urinary stress incontinence on third day after delivery, were examined and undergone for required diagnostic tests. After stabilizing the diagnosis of urinary stress incontinence, they were followed on 6th week, 3th month and the first year after delivery. The mean of maternal age was 23.5±4.3 years and the mean of gestational age was 37.9±2.1 weeks. The vaginal delivery and cesarean section rates were 83.7 percent and 16.3 percent respectively. From the cases, 50 women (12.5 percent) had S.I on third day after delivery, which 28 of them had this problem from their pregnancy (grup A), and in 22 patients (5.5 percent), S.I were began after delivery (group B). On first year after delivery, only 6 patients (1.5 percent) had complaint of S.I, totally. All patients with S.I had a vaginal delivery and no cases of S.I had found in cesarean section group (65 women). This difference was significant (P=0.019). Comparison of 3 groups A, B and C (including 285 women without S.I after vaginal delivery) had represented that the mean of maternal age and gestational age were significantly higher in group B than other two groups (P=0.0001 and P=0.0009 respectively).

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Normal 0 false false false EN-US X-NONE AR-SA MicrosoftInternetExplorer4 Background: Stress incontinence is the most common type of urinary incontinence which has been treated by different surgical techniques. The objectives of our study were to compare the laparoscopic Burch colposuspension with Trans- obturator Tape (TOT) procedure.
Methods: This randomized clinical trial was conducted on 40 patients with stress incontinence referred to Arash hospital from 2007 to 2009. All patients were randomly divided in two groups (laparoscopic Burch and TOT). Patient information was using obtained demographic, I-QOL (Which contained 22 questions), UDI-6 (urinary symptoms), ISI (Severity of urinary incontinence) questionnaires and urodynamic test.
Results: The data collected from 19 patients in TOT group and 16 patients in laparoscopic Burch groups. The objective cure rate which was determined by no urinary leakage during stress and were analyzed urodynamic evaluation was 75% in laparoscopic and 84.2% in TOT (p=0.53). Result of ISI questionnaire with showing the subjective cure rate following surgery had no significant difference between two groups (p=0.23). UDI-6 questionnaire was used to compare the result of both groups before and after surgery and showed that the improvement in Urgency was significant in TOT in compare to Burch (p=0.04). I-QOL score significantly increased in both groups after six months of operation (p<0.05). But the differences were not statistically significant.
Conclusion: Based on our results subjective and objective cure rate were not significantly different between TOT and laparoscopic Burch colposuspension.

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Normal 0 false false false EN-US X-NONE AR-SA MicrosoftInternetExplorer4 Background: Stress urinary incontinence is a major confounding factor which impairs health quality in women. Some procedures cannot resolve it&aposs impact on life quality. This study aims to assess a less common and newly method use of transobturator tension- free vaginal tapes (TOT) in regard to short- term and long-term morbidity and impact on patient&aposs quality of life (QOL).

Methods: Fifty four patients diagnosed with urinary stress incontinence, underwent a transobturator tension free vaginal tape procedure with or whitout prolapse surgery. Pre and post operative quality of life assessed with Incontinence- specific Quality of Life questionnaire (I-QOL), and objective and subjective cure rate according to patients signs and symptoms before operation, early and late surgical complications like hemorrhage, Injury and/ or perforation of bladder, intestine, urethra and infection were mentioned.

Results: The overall intraoperative and early post-operative complication rates were 5.5% and 3.7%, respectively. No case of hematoma, bladder or bowel injury was seen.   I-QOL scores were significantly higher after surgery. The mean I-QOL score were 23.6 and 64 before and after surgery respectively (p<0.0001). This improvement was independent of the concomitant pelvic floor repair surgery, menopause, underlying diseases, number of parity, body mass index (BMI) and age. The global rate of objective cure was 94.4% (p<0.0001). The majority of women were satisfied with the outcome. (subjective cure was 90.7%- p<0.001).

Conclusions: This study demonstrates that the TOT approach in the treatment of stress urinary incontinence is a safe and effective procedure which promotes health quality of life.