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    The effect of the distance between mesh and the urethra on sexual function in patients who underwent transobturator tape
    (Galenos Yayınevi, 2024) Sahin, Fatih; Doğan, Ozan
    Objective: To evaluate the effect of mesh-urethra distance on sexual function in continent patients who underwent transobturator tape (TOT) surgery due to isolated stress urinary incontinence (SUI). Material and Methods: Continent patients who had undergone TOT surgery for SUI were eligible. Objective treatment for SUI was defined as the absence of urine leakage during a stress test. Translabial perineal ultrasound was performed six months after surgery. The successful surgical group was split into two subgroups based on the distance from the posterior of the urethra at the bladder neck to the nearest proximal edge of the tape: <5 mm and >5 mm. In addition to these, band percentile, the descent of bladder neck and urethra length measured by perineal ultrasound, pubo-urethral distance, urethral thickness, detrusor thickness, cystocele descent, rectal descent, and uterine descent were evaluated. Preoperative and postoperative results of the standardized and internationally valid incontinence questionnaires Incontinence Questionnaire Urinary Incontinence Short Form and Female Sexual Function Index (FSFI) were compared between groups. Results: Eighty-two patients were included. The postoperative FSFI scores for the >5 mm group were significantly lower than those of the <5 mm group, including the postoperative FSFI average, all subscales except lubrication, and average change scores due to the operation (p<0.001). There was no statistically significant relationship between the percentile occupied and postoperative FSFI score (p=0.553), and the FSFI preoperative-postoperative difference was not significant (p=0.905). Conclusion: Sexual functions are more affected in patients with a mesh-urethra distance >5 mm as measured by perineal ultrasound. (J Turk Ger Gynecol Assoc. 2024; 25: 124-31)
  • Küçük Resim Yok
    Öğe
    The effect of the distance between mesh and the urethra on sexual function in patients who underwent transobturator tape
    (Galenos Yayınevi, 25.11.2024) Sahin, Fatih; Doğan, Ozan
    Objective: To evaluate the effect of mesh-urethra distance on sexual function in continent patients who underwent transobturator tape (TOT) surgery due to isolated stress urinary incontinence (SUI). Material and Methods: Continent patients who had undergone TOT surgery for SUI were eligible. Objective treatment for SUI was defined as the absence of urine leakage during a stress test. Translabial perineal ultrasound was performed six months after surgery. The successful surgical group was split into two subgroups based on the distance from the posterior of the urethra at the bladder neck to the nearest proximal edge of the tape: <5 mm and >5 mm. In addition to these, band percentile, the descent of bladder neck and urethra length measured by perineal ultrasound, pubo-urethral distance, urethral thickness, detrusor thickness, cystocele descent, rectal descent, and uterine descent were evaluated. Preoperative and postoperative results of the standardized and internationally valid incontinence questionnaires Incontinence Questionnaire Urinary Incontinence Short Form and Female Sexual Function Index (FSFI) were compared between groups. Results: Eighty-two patients were included. The postoperative FSFI scores for the >5 mm group were significantly lower than those of the <5 mm group, including the postoperative FSFI average, all subscales except lubrication, and average change scores due to the operation (p<0.001). There was no statistically significant relationship between the percentile occupied and postoperative FSFI score (p=0.553), and the FSFI preoperative-postoperative difference was not significant (p=0.905). Conclusion: Sexual functions are more affected in patients with a mesh-urethra distance >5 mm as measured by perineal ultrasound. (J Turk Ger Gynecol Assoc. 2024; 25: 124-31)
  • Küçük Resim
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    Total knee arthroplasty postsurgical chronic pain, neuropathic pain, and the prevalence of neuropathic symptoms: a prospective observational study in Turkey
    (DOVE MEDICAL PRESS LTD, 2021) Sahin, Fatih; Beyaz, Serbülent Gökhan; Karakus, Nazim; Inanmaz, Mustafa Erkan
    Purpose: Chronic post-surgical pain (CPSP) is a detrimental condition that persists at least two months after surgical procedures and seriously affects patients' quality of life. Although its incidence varies according to operation types and definitions, its prevalence is between 3% and 85%. The purpose of this study is to evaluate the prevalence of CPSP and neuropathic pain in patients undergoing TKA for osteoarthritis. Patients and Methods: In this study, patients who had undergone total knee arthroplasty (TKA) were examined prospectively and observationally. 42 patients were included in the study. Numeric rate scale (NRS) for developing chronic pain, Douleur Neuropathique 4 (DN-4) questionnaire to evaluate neuropathic pain and symptoms, and von Frey filaments to evaluate mechanical hyperesthesia and alladony. Results: NRS scores were 1 or higher for all patients. Twenty-seven patients constituted the mild pain group (NRS: 1-4), and 15 patients constituted the moderate pain group (NRS: 4-7). The number of patients defined as having "neuropathic pain," according to DN-4 scores, was 17 (40.4%; DN-4 >= 4). The moderate pain group reported greater severity of neuropathic symptoms on average than the mild pain group (p = 0.039). When patients knees affected by TKA were divided into suprapatellar, patellar, and infrapatellar regions and evaluated with von Frey filaments, a significant difference was found between the three regions (p < 0.05). Conclusion: In this study, we showed-unlike other studies-that the rate of neuropathic pain was higher among CPSP patients, and all patients had neuropathic symptoms. In evaluating patients knees with von Frey filaments, we showed that the neuropathic component of patients' pain occurred mostly in the knee's infrapatellar region. Although the incidence of CPSP and neuropathic pain in these patients was higher than expected, we think CPSP, its diagnosis, and its treatment present an important issue that requires further examination.