Efficaciousness of the new surgical technique in the treatment of the female urinary incontinence, based on hammock theory, compared by transvaginal needle suspension
D.Tomić, I.Gilja, M.Kordić, M.Tipurić, D.Zalihić, J.Baranik, V.Bekavac, M.Ignatkov, K.Pavlović,
Klinika za urologiju, SKB Mostar, F BiH
Efficaciousness of the new surgical technique in the treatment of the female urinary incontinence, based on hammock theory, compared by transvaginal needle suspension. Surgical treatment is the standard approach for women with SUI who have failed conservative management strategies such as lifestyle changes, physical therapies, scheduled voiding regimes, and behavioral therapies (211). Although hundreds of different surgical procedures have been reported, the ideal surgical technique that is, a procedure that is simple, inexpensive, easy to learn and perform, minimally invasive, with high and durable efficiacy, and without long-term morbidity and functional sequelae, does not yet exist (212).
In according to those facts, our main aim was to describe the new surgical technique,which is designed and suggested by Ivan Gilja, based on Hammock theory (200, 204). The 60 female patients over the 35 years old is treated by the new surgical technique during the period oft he three years. Control group was the 30 female patients treated by transvaginal needle suspension by Raz, modified by Gilja (200, 204), also during the period of the three years. All the patients had signs and symptoms of SUI, urodynamicaly
evidence of leakage in effort and urethrovesical hypermobility.
For the clinical evaluation and compare for the two differrent surgical way used for the treatment of the SUI, before the surgical treatment, half a year after the treatment and one and three years after the surgical treatment, we used two modullar questionnairies suggested by EAU, and ICS (International Continence Society) and ICIQ (International Consultation on Incontinence Modular Questionnaire), ICIQ-SF and ICIQ-FLUTS. (202)
After the period of the three years after the surgical treatment, in according to main aim of the investigations and results we get some conclusions after the statistical analysis of the results. At the testing of the differencies between the results of the two surgical techniques, it is noticed that transvaginal needle suspension had a higher cure rate (90,00 %), but at the same time had about 10,00 % female patients with a bad cure results.
New surgical technique based on the hammock theory had a 86,27 % fully cure rate, and 13,73 % patients as successfully cure. From the data at the tables which are show us the results of the treatment is clear that low risk procedure is the surgical technique based on the hammock theory, in according to the definition of the cure-rates, because all the patients treated with this surgical technique had a fully cure rate or successfully treated.
At the follow up period of the first year after the surgical treatment, on the radiologicaly measuring the urethrovesical mobility at the cystography both of the methods showing the very small middle value of the urethrovesical mobility. That shows that the both methods has a good and stable position of the vesical neck and urethra, which is the main aim for the those surgical techniques.
The new surgical technique, based on hammock theory, which is described is simple, safe, minimally invasive, inexpensive, easy to learn and perform, with a good and durable efficiacy, without long term functional sequelae.