Author/Editor		Kralj, Božo
Title		Izbira zdravljenja stresne urinske inkontinence pri ženskah
Translated title		The choice of treatment of stress urinary incontinence in women
Type		članek
Source		Zdrav Vestn
Vol. and No.		Letnik 72, št. Suppl 2
Publication year		2003
Volume		str. II-167-70
Language		slo
Abstract		Background. The important factors for successful treatment of female stress urinary incontinence (SUI) are described: type of urinary incontinence (UI), degree of UI, pelvic floor relaxation and associated diseases (genital and extragenital). Indications for conservative and operative treatment are presented. Methods. Conservative treatment: pelvic floor exercises - Kegel's exercises and functional electrical stimulation (FES) are proposed to female patients with mild and moderate degree of SUI. Separate indications for vaginal and retopubic operations are quoted. Results. With conservative treatment of SUI - pelvic floor exercises, 33.3% of female patients were cured and 36.7% were improved. With FES treatment of SUI, 50% of patients were cured and 23.4% were improved. Results of operative treatment of SUI: vaginal approach - our modification of vaginal operation with preparation ofpubovesico-cervical fascia and suburethral application - 97.5% of female patients were primary cured and recurrence after 2 years was found in 9% of female patients. In retropubic operation - Burch colposuspension - 99.1% of female patients were primary cured and recurrence after 2 years was found in 1.3% of female patients. Conclusions. Although the results of classical operations for SUI are favourable, trends for SUI operations are nowadays in miniinvasive surgery, especially in TVT operation.
Summary		Izhodišča. Opisani in analizirani so dejavniki, pomembni za izbiro uspešnega zdravljenja stresne urinske inkontinence (SUI) pri ženskah, kot so vrsta in stopnja urinske inkontinence (UI), spremembe statike ženskih genitalij in spremljajoče bolezni spolovil ali drugih bolezni. Navedene so indikacije za konzervativno oziroma operativno zdravljenje SUI. Metode. Konzervativno zdravljenje je smiselno pri bolnicah z blago in zmerno stopnjo SUI. Za tovrstno zdravljenje pri nas uporabljamo vaje za krepitev mišičja medeničnega dna (Keglove vaje) in funkcionalno električno stimulacijo (FES). Pri indikacijah za operativno zdravljenje SUI so ločene indikacije za vaginalno oziroma retopubično operacijo. Rezultati. Pri konzervativnem zdravljenju SUls Keglovimi vajami je ugotovljena 33,3-odstotna ozdravitev in 36,7-odstotno izboljšanje stanja, medtem ko je pri zdravljenju s FES ugotovljena 50-odstotna ozdravitev in 23,4-odstotno izboljšanje stanja. Pri operativnem zdravljenju SUI so navedeni rezultati vaginalne operacije - modifikacije z izprepariranjem pubo-veziko-cervikalne fascije in njeno suburetralno duplikaturo. Pri tej operaciji ugotavljamo primarno ozdravitev pri 97,5% bolnic in ponovitev bolezni po dveh letih pri 9% bolnic. Pri retopubični operaciji - kolposuspenzija po Burchu - ugotavljamo primarno ozdravitev pri 99,1% bolnice in ponovitev bolezni po dveh letih le pri 1,3% bolnic. Zaključki. Kljub ugodnim rezultatom obeh opisanih operacij je sodobni trend operacij pri SUI miniinvazivna kirurgija, predvsem operacija z nožničnim nenapetostnim trakom (TVT).
Descriptors		URINARY INCONTINENCE, STRESS ELECTROMYOGRAPHY PELVIC FLOOR EXERCISE THERAPY ELECTRIC STIMULATION THERAPY TREATMENT OUTCOME