Cesarean section and burch colposuspensıon operatıons

Amaç

Investigation of efficiency and safety of Burch operation at the time of low segment transverse Caesarean section procedure in the cases diagnosed as genuine anatomical urinary stress incontinence prior than pregnancy.

Yöntem

Four cases who were diagnosed as genuine anatomical urinary stress incontinence prior than pregnancy by means of previous investigations (history, Q tip, stress test and urodynamical examination) and underwent bilateral tubal ligation and Burch colposuspension procedures at the time of Caesarean section for macrosomic tetus were included in the descriptive type study program. For clinical parameters, the age, gravida, parity, macrosomic fetus history, preoperative stress incontinence duration, postoperative analgesic intake need, total operation duration, intraoperative blood loss, the amount of fluid discharge via hemovac catheter placed in Retzius space, day of hospitalization were recorded. For laboratory parameters, preoperative and postoperative hemoglobin values were idenlified. All patients were followed up on their postoperative 1, and 3rd days and at 1.5 ,6, and 12th months. Descriptive statistical analyses of the patients were executed with SPSS 9.0 software. Findings: in all 4 patients were employed low segment During of Caesarean Section at terin bilateral tubal ligation and Burch colposuspension operations. Age of the patients was calculated as 31. 6± 3-5year (mean ± SD), urinary incontinence duration 33 ± 7.5 months, macrosomic fetus history 100%, pregnancy age 34.3 ± 0.6 weeks, total operation duration 37± 7 minutes, and blood loss 245 ± 23 ml, serosanguinous fluid discharge from Retzius 31± 36 ml, hospitalizalion duration 4± 0 days, newborn weight 4150± 218 g. Postoperative hemoglobin levels were measured 11± 0.4 g/dl. Postoperative pain which may require extraroutine supplemental therapy or intraoperative, early or late postoperative complications did not develop in any patient. Q tip and stress tests were found normal in the patients whose urinary incontinence symptoms have improved by postoperative follow ups.

Bulgular

Our approach is the first to be reported in the literature. Burch colposuspension employed during Cesarian Section does not increment the incidence of intraoperative morbidity and can be performed successfully, provided under the experienced hands. However future experiences on vast populations and long term results are yet needed.

Anahtar Kelimeler

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