14 aug. 2008 CONSIDERATII PRIVIND CONDUITA MEDICO-CHIRURGICALA A INCONTINENTEI URINARE LA EFORT IN MENOPAUZA
N.G. Saba, Elisaveta Maior, G. Banceanu, Maria Ocrim
Clinica Obstetrică Ginecologie Polizu, UMF „Carol Davila”, Bucureşti
Rezumat
Intre anii 1990-2006 in spitalul Clinic Polizu dintr-un total de 1635 de cazuri operate pentru incontinenta urinara la efort (IUE) in 1475 varsta a fost cuprinsa intre 45-65 ani corespunzator perioadei menopauzale au fost abordate chirurgical:1323 prin uretrocistopexie directa procedeu Dan Alessandrescu (Grupa I), 152 prin uretrocistopexie indirecta (Grupa II).
Postoperator eficienta terapeutica a procedeului chirurgical s-a obiectivat prin evaluarea lungimii uretrei cat si prin cistografie mictionala.
Reevaluarea postoperatorie a evidentiat pentru Uretrocistopexia directa Dan Alessandrescu in conditiile respectarii riguroase a succesiunii timpilor operatori: suspensia directa a jonctiunii uretro-vezicale, fixarea jonctiunii la nivel tisular independent hormonal characteristic menopauzei si alungirea uretrei, micsorarea calibrului, repunerea jonctiunii in incinta manometrica uretro-vezicale. Dupa aplicabilitatea acestui procedeu vindecarile s-au situate la 95% din cazuri.
Abstract – CONSIDERATION REGARDING THE MANAGEMENT MEDICO – SURGICAL OF THE STRESS INCONTIENCE IN MENOPAUSE CONSIDERATION REGARDING THE MANAGEMENT MEDICO – SURGICAL OF THE STRESS INCONTIENCE IN MENOPAUSE
Between 1990 – 2006 in Polizu Clinical Hospital out of 1635 cases operated on for stress incontinence, in 1475, the age was 45-65, corresponding to menopausal period. Cases surgically approached were as follows:, 1323 by direct urethrocistopexy D. Alessandrescu procedure (group I), 152 by indirect urethrocistopexy (group II ).
Post operatory, the therapeutically efficiently of either procedures was objectified by evaluating both the urethral length and by myctional cystography.
For D. Alessandrescu direct cystopexy (groupI) the post-operator re-evaluation while rigorously following the succession of the operatory steps pointed out:the direct suspension of the vesico-urethral junction by re-positioning it within manometric situs together with its fixation at tissular level hormonally independent, a beneficial aspect in menopause otherwise. By this procedure the cure situated at 95% of cases.