Paravaginal defect 및 stress urinary incontinence를 동반하는 환자에서 modified six-corner suspension의 유용성

Abstract

Objective: The purpose of our study is to evaluat the effectiveness of modified six-corner suspension in patients with paravaginal defect and stress urinary incontinence(SUI) by observing changes in POP(Pelvic Organ Prolapse)stage, substage, and cure rates of SUI.

Method: Twenty-one women patients with paravaginal defect and stress urinary incontinence were treated by the modified six-corner suspension at urogynecology clinic, Yonsei University Medical Center between January, 1999 to March, 2000. Each patient underwent a complete physical examination and a standardized urogynecologic interview including age, hormone replacement, parity, urinary symptom and previous gynecologic surgery.

Result: Out of 21 patients who underwent the operation, 10 patients with 1-year follow-up were included in the study. Changes from Stage Ⅲ (n=6, 60%) to stage Ⅰ (n=2, 33.3%) or stage 0 (n=4, 66.6%) was observed 3months after surgery and no further change was observed up to 1 year except in one case. Changes from Stage Ⅳ (n=4) to stage 0 (n=1, 25%) or stage Ⅰ (n=2, 50%) or stage Ⅱ (n=2, 50%) was observed 3 months after surgery and no further change was observed up to 1 year. Changes from substage Aa(+2, +3) to -3 (n=9, 90%) and from substage Ba(+2, +3, +4, +5, +6, +7) to -3 (n=9, 90%) were observed 3 months after surgery, and then no further change was observed up to 1 year. The average length of genital hiatus was initially 4.95㎝ and 2.5㎝ 3 month after surgery. Little change (2.6㎝) was observed up to 1 year. When assessed clinically by questioning and physical examination, no patients had urinary leakage symptoms up to 1 year after operation. All patients had excellent functional results with no postoperative complaints of stress urinary incontinence.

Conclusion: We experienced that modified six-corner suspension was surprisingly effective in patients with paravaginal defect and stress urinary incontinence.