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A Comparative Study of T.O.T and Kelly Operation in the Management of Stress Urinary Incontinence Experienced by Women

دراسة مقارنة بين T.O.T و طريقة كيلي في تدبير سلس البول الجهدي عند النساء

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 Publication date 2014
  fields Medicine
and research's language is العربية
 Created by Shamra Editor




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The study contains 70 patients , who were divided into two groups: A: 52 patients, who have been managed with T.O.T for stress urinary incontinence in women. B: 18patient s , who have been managed with Kelly for stress urinary incontinence in women. Age: 76.7% of the patients were more than 40 years old. 77,83% of them were multipare (more than 3 children). Complication : Bleeding was the most common complication with both groups (A=9.61% , B=5.5%). Residual Urine(0-25ml) was 51.9% with group A, while it was 66.6%in group B. Relapse: relapse rate was 13.46% in group A, while it was 11.3 % in group B. Hospitalization: 77.9% of group A stayed at for three days or less, while 94.17% of group B stayed for just one day. Time of Procedure : (less1\ 2 h)in group A 13.4 %, while it was 72.2% in group B.


Artificial intelligence review:
Research summary
تتناول هذه الدراسة مقارنة بين طريقتين جراحيتين لعلاج سلس البول الجهدي عند النساء: طريقة كيلي وطريقة T.O.T (الشريط عبر الثقبة السادة). شملت الدراسة 70 مريضة تم تقسيمهن إلى مجموعتين: المجموعة A التي تم علاجها بطريقة كيلي (52 مريضة) والمجموعة B التي تم علاجها بطريقة T.O.T (18 مريضة). أظهرت النتائج أن النزف كان الاختلاط الأكثر شيوعًا في كلا المجموعتين، لكن كان أقل في المجموعة B. كما كانت مدة الاستشفاء أقصر في المجموعة B، حيث مكثت معظم المريضات يومًا واحدًا فقط مقارنة بثلاثة أيام في المجموعة A. أما بالنسبة للنكس، فقد كانت نسبته أقل في المجموعة B (11.2%) مقارنة بالمجموعة A (13.46%). خلصت الدراسة إلى أن طريقة T.O.T تعتبر أكثر فعالية وأقل اختلاطًا مقارنة بطريقة كيلي، وأوصت بإجراء دورات تدريبية للجراحين النسائيين على طريقة T.O.T.
Critical review
دراسة نقدية: على الرغم من أن الدراسة تقدم مقارنة شاملة بين طريقتين جراحيتين لعلاج سلس البول الجهدي، إلا أنها تحتوي على بعض النقاط التي يمكن تحسينها. أولاً، حجم العينة صغير نسبيًا، مما قد يؤثر على دقة النتائج. ثانياً، لم يتم ذكر تفاصيل كافية حول المتابعة الطويلة الأمد للمريضات بعد الجراحة، مما يجعل من الصعب تقييم النتائج على المدى البعيد. ثالثاً، كان من الممكن تضمين المزيد من المتغيرات مثل جودة الحياة بعد الجراحة لتقديم صورة أكثر شمولية. وأخيراً، كان من الأفضل تضمين تكلفة كل طريقة جراحية بشكل مفصل لتقديم تقييم اقتصادي أكثر دقة.
Questions related to the research
  1. ما هي نسبة النزف في كل من المجموعتين A و B؟

    كانت نسبة النزف في المجموعة A 9.61% بينما كانت في المجموعة B 5.5%.

  2. كم كانت مدة الاستشفاء في كل من المجموعتين؟

    مكثت 76.9% من المريضات في المجموعة A لمدة ثلاثة أيام أو أقل، بينما مكثت 94.17% من المريضات في المجموعة B ليوم واحد فقط.

  3. ما هي نسبة النكس في كل من المجموعتين؟

    كانت نسبة النكس في المجموعة A 13.46% بينما كانت في المجموعة B 11.2%.

  4. ما هي التوصيات التي خرجت بها الدراسة؟

    أوصت الدراسة بإجراء عمليات T.O.T للمريضات اللواتي يعانين من سلس البول الجهدي، خاصة عندما لا يترافق مع هبوط مثانة، وكذلك بإجراء دورات تدريبية للجراحين النسائيين على هذه الطريقة.


References used
DARAI, E;FROBERT,J. Functional results after the sub urethral sling procedure for stress urinary incontinence: a prospective randomized multicenter study comparing the retropubic and Transobturator routes. Eur Urol 2009;51:795-802
JHON , A ; HOWARD,W. Telinde’s Operative Gynecology.10ed, Amega-Lippincott Williams and Wilkins,London,2008,1472
DEBODINANCE, P. Transobturator urethral sling for surgical correction of female stress urinary incontinence: outside-in (Monarc) versus inside-out T.V.T-O .)Are both ways safe? Gynecol obstet Biol Repord(Paris) 2006;35:571-7
DELROME , E. Transobturator urethral suspension: mini- invasive procedure in the treatment of stress urinary incontinence in women. 2008,22-53
LAURIKAINEN, E; KIVELA, A. Retro pubic compared with Transobturator tape placement in treatment of urinary incontinence: randomized controlled trial. Obstet Gynecol 2007,10-11
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