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Eine neue Annäherungsweise im transvaginalen Nadelsuspensionsverfahren nach Raz

Technik und langfristige Ergebnisse

A new approach to the transvaginal needle suspension technique after Raz

Technique and long-term results

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Zusammenfassung

Ziele

Beschreibung der chirurgischen Technik und Bewertung der langfristigen Ergebnisse.

Material und Methoden

Bei 53 Patientinnen mit Stressinkontinenz wurde ein transvaginales Raz-Nadelsuspensionsverfahren mit der Einführung eines Mesh-Polypropylenbandes (15×1,5–2cm) in die Suspensionsfäden durchgeführt. Die Suspensionsfäden befinden sich auf der endopelvinen Faszie, um den Blasenhals zu heben und die Funktion des Trägers des Mesh-Polypropylenbandes zu erfüllen. Das Mesh-Polypropylenband nimmt nicht an der Hebung des Blasenhalses teil. Die 53 konsekutiven Operationen wurden alle von demselben Urologen durchgeführt. Die klinische Bewertung erfolgte 6 Monate, 1 Jahr und 5 Jahre nach der Operation.

Ergebnisse

Nach 6 Monaten gaben 51 (96,2%) Frauen an, nach einem steigenden intraabdominalen Druck trocken zu bleiben, während 2 (3,7%) nach wie vor die Symptome einer Stressinkontinenz hatten. Nach dem 1. und 5. Jahr waren 47 (88,6%) der Patientinnen trocken und hatten eine normale Miktion (spontanes Verschwinden von nächtlichem Einnässen [Enuresis; n=2] und chirurgische Behandlung einer subvesikalen Obstruktion [n=1]).

Schlussfolgerung

Unsere Ergebnisse zeigen, dass die Einführung eines Mesh-Polypropylenbandes in die Suspensionsfäden beim transvaginalen Nadelsuspensionsverfahren gute langfristige Ergebnisse bei der Behandlung von Patientinnen mit einer Stressinkontinenz erzielen.

Abstract

Aim

Our aim is to describe the surgical technique and to present a long-term evaluation of the results.

Materials and methods

A total of 53 patients with stress incontinence underwent a Raz transvaginal needle suspension operation with the introduction of a polypropylene mesh strip (15×1.5–2 cm) pulled under the suspension threads. The suspension threads occur on the endopelvic fascia in order to support the bladder neck and to permit the function of the polypropylene mesh strip, which, however, does not take part in supporting the bladder neck. The same urologist carried out 53 consecutive operations with clinical evaluation at 6 months, 1 and 5 years after surgery.

Results

After 6 months, 51 of the patients (96.2%) reported remaining dry after increasing intra-abdominal pressure. Two (3.7%) still had stress incontinence symptoms. After 1 and 5 years, 47 (88.6%) were dry and urinated normally, with spontaneous disappearance of nightly enuresis in two and surgery for subvesicular obstruction in one.

Conclusions

The introduction of a polypropylene mesh strip in the suspension threads in cases using the trasvaginal suspension technique has good, long-term results for the treatment of patients with stress incontinence.

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Authors and Affiliations

  1. Abteilung für Urologie, Allgemeines Krankenhaus „Heiliger Geist“ (Sveti Duh), Zagreb, Kroatien

    I. Gilja, R. Deban & P. Bokarica

  2. Geburts- und Gynäkologieabteilung, Allgemeines Krankenhaus „Heiliger Geist“ (Sveti Duh), Zagreb, Kroatien

    A. Klobučar

  3. Abteilung für Urologie, Chirurgieabteilung, Klinikkrankenhaus Mostar, Bosnien und Herzegowina

    D. Tomić

  4. Universitätsfrauenklinik J.J. Strossmeyer, Osijek, Kroatien

    Z. Hrgovic

  5. Kaiserstraße 15, 60311, Frankfurt am Main

    Z. Hrgovic

Authors
  1. I. Gilja
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  2. R. Deban
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  3. P. Bokarica
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  4. Z. Hrgovic
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  5. D. Tomić
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  6. A. Klobučar
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Correspondence to Z. Hrgovic.

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Gilja, I., Deban, R., Bokarica, P. et al. Eine neue Annäherungsweise im transvaginalen Nadelsuspensionsverfahren nach Raz. Urologe 45, 202–208 (2006). https://doi.org/10.1007/s00120-005-0892-7

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  • DOI: https://doi.org/10.1007/s00120-005-0892-7

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