Vaginal Doğum Sonrası Gelişen Fekal inkontinans Olgularında Geç Dönem Sfinkteroplasti Operasyonunun Etkinliğinin Değerlendirilmesi

Year 2015, Volume: 12 Issue: 1, 38 - 43, 15.04.2015

Yusuf Yücel , Ahmet Şeker , Abdullah Özgönül , Alpaslan Terzi Orhan Gözeneli , Adnan İncebıyık , Reşit Çiftçi Ali Uzunköy

Abstract

Amaç: Vaginal doğum sonrası fekal inkontinans gelişen olgularda geç dönemde yapılan overlapping
sfinkteroplasti ameliyatının etkinliğini değerlendirmektir.
Materyal ve Metod: 2010-2014 yılları arasında Harran Üniversitesi Tıp Fakültesi Genel Cerrahi Kliniğinde
fekal inkontinans tanısıyla ameliyat edilen 11 olgu retrospektif olarak analiz edildi. Hastaların dosya
kayıtlarından; demografik özelliklerinin yanı sıra, uygulanan cerrahi girişim, postoperatif komplikasyonlar
ve operasyonun başarı oranları not edildi.
Bulgular: Hastaların yaş ortalaması 39 yıl, ortalama doğum sayısı 7 idi. Yedi hastaya doğum sırasında
epizyotomi yapılırken, dört hastada ise epizyotomi işleminin yapılmadığı tespit edildi. Altı hastanın gaz-sıvı,
5 hastanın ise gaz-sıvı-katı gaita inkontinansı şikayeti ile başvuru yaptığı saptandı. Tüm hastalara fekal
inkontinansı gidermek amacıyla overlapping sfinkteroplasti işlemi uygulandı. Postoperatif komplikasyon
olarak hastaların 2'sinde yara enfeksiyonu, 2'sinde ise ameliyat sonrası şiddetli ağrı gelişti. Tüm hastalarda
ameliyat sonrası erken dönemde katı ve sıvı gaita inkontinansı kayboldu. Gaz inkontinansında bütün
hastalarda belirgin düzelme gözlendi. Jorge-Wexner inkontinans skoruna (JWİS) göre; hastaların ameliyat
öncesi inkontinas skoru ortalama 10.45 (8 -15), ameliyat sonrası ortalama 1.ayda 3.64 ( 3-5 ), 6.ayda 4.12 (4-
5), 12.ayda 4.25 (4-5) idi. Hastaların % 72. 5'i ameliyat sonrası sonucu mükemmel/iyi olarak tanımladı.
Sonuç: Doğum sonrası fekal inkontinans gelişen olgularda geç dönemde yapılan overlapping sfinkteroplasti
fekal inkontinans semptomlarının azalmasında ve hayat kalitesinin artmasında önemli katkı sağlayan basit,
etkin cerrahi bir yöntem olarak kabul edilebilir. 

Keywords

Fekal inkontinans, Vaginal doğum, Overlapping sfinkteroplasti

Evaluation of Effectiveness of the Late Term Sphincteroplasty Operation in Faecal Incontinence Cases that Growing After Vaginal Parturition

Abstract

Background:To evaluate the efficacy of the patients with faecal incontinence after vaginal parturition which
made overlapping sphincteroplasty surgery in the late period.
Material and Method:We analyzed the eleven patients retrospectively that operated between 2010 and
2014 with the diagnosis of faecal incontinence in Harran University School of Medicine, General Surgery
Clinic. From the records of patients; in addition to demographic characteristics; surgical intervention,
postoperative complications and success rate of the operation were noted.

Results: The mean age of the patients was 39 years, the average number of birth was 7. Episiotomy was
executed to seven patients during parturition, whereas was not executed four patients. It was detected that six
patients was admitted from gas and liquid, five patients was admitted from gas,liquid and solid incontinence.
All patients was performed overlapping sphincteroplasty procedure to eliminate faecal incontinence. It was
developed as postoperatively complication was wound infection in two patients, and developed severe pain
in two patients. Solid and liquid faecal incontinence disappeared in the early postoperative period in all
patients. Gas incontinence significantly improved in all patients. According to Jorge-Wexner incontinence
score; patients' average incontinence score before the operation was 10.45 (8-15); after the operation in first
month was 3.64 (3-5), 6th month was 4.12(4-5), 12th month was 4.25(4-5). 72.5% of patients described
excellent / good as a result of surgery.
Conclusion: Late term applied overlapping sphincteroplasty may be considered effective,simple surgical
procedure to reduce fecal incontinence symptoms and contributing to the improvement of quality of life from
developing fecal incontinence after parturition

Keywords

Fecal incontinence, vaginal parturition, overlapping sphincteroplasty

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