KMID : 0877720050090010040
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Journal of Korean Continence Society 2005 Volume.9 No. 1 p.40 ~ p.45
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Management of Voiding Dysfunction after Surgical Treatment of Female Stress Urinary Incontinence
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Han Dong-Seok
Gil Geon Shin Ju-Hyun So Seong-Min Yuk Seung-Mo Kim Yong-Woong Lim Jae-Sung Kim Hong-Sik Sul Chong-Koo Na Yong-Gil
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Abstract
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Purpose:: We studied the voiding dysfunction after surgical treatment of female stress urinary incontinence and diagnosis and treatment.
Materials and Methods: Three hundred women with stress urinary incontinence underwent surgical procedure between January 1998 and December 2004. Ninety two patients(30.6%) experienced the postoperative voiding dysfunction. As the primary procedure for the management of postoperative voiding dysfunction alpha-blockers medication and clean intermittent catheterization(CIC) were performed. Then, hegar dilation and urethral pull-down procedure were performed as a secondary measure. For the patients who showed persistent obstructed symptoms, cutting of mesh or sling materials were performed.
Results: In 57 patients, symptoms improved by alpha-blockers medication and CIC. The others were received hegar dilation and urethral pull-down procedure, and 29 patients were improved. 6 patients were not controlled by conservative treatment, of which 3 patients underwent cutting of mesh or sling. De novo urgency was developed in 12 patients. Anticholinergics were taken, symptoms were diminished in 10 patients after 5 months of medication.
Conclusion: Most voiding dysfunction after surgery may be effectively managed by conservative treatment. In cases of failure, hegar dilation and urethral pull-down procedure may be useful within postoperative first weak. Finally, cutting of mesh or sling must be considered in patient whose the secondary measure is failed.
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KEYWORD
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voiding dysfunction, Surgery, Treatment, Stress urinary incontinence
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