긴장성 요실금과 골반장기 탈출증간의 연관성

Abstract

Objective: We investigated objective coexisting rate of stress urinary incontinence and pelvic organ prolapse and also, compared the treatment outcomes in patients with both conditions treated by correcting operation performed based on precise preoperative evaluation to those by previous procedures.

Methods: We reviewed 97 cases who underwent urodynamic studies and evaluations of prolapse according to Pelvic Organ Prolapse Quantifivaiton(POP-Q) system among patients admitted with either stress urinary incontinence or pelvic organ prolapse. Either Burch urethropexy or modified six-corner suspension to correct stress urinary incontinence and additional operations to correct prolapse, of which stage was more than Ⅱ, were done, Postoperatively, the patients were evaluated on stress urinary incontinence and degree of prolapse on every visit. Results: In 19 of 30(63.3%) cases admitted with stress urinary incontinence, pelvic organ prolapse coexisted, anterior vaginal wall prolapse consisting the most. In 42 of 67(62.7%) cases admitted with pelvic organ prolapse, stress urinary incontinence coexisted. Total 61 cases with both conditions were followed up during 12 months postoperatively. Recurrence rate of stress urinary incontinence and prolapse(of which all stages were Ⅱ) were 3.3% and 18.0%, respectively, It was noted that higher the preoperative stage, higher the recurrence rate of prolapse(stage Ⅱ: 4.35%, stage Ⅲ: 25.0%, stage Ⅳ: 33.6%).

Conclusion: Coexisting rate of pelvic organ prolapse were both high. Therefore, preoperative evaluation concerning both conditions should be done simultaneously and by correcting operations based on this evaluation, recurrenct rates of both conditions could be lowered.