No abstract

). Ambas as técnicas foram concebidas com o intuito de evitar a passagem no espaço retropúbico, reduzindo assim o número de complicações. Conclusão: As taxas de cura para as abordagens transobturadoras oscilam entre 80 e 95%. A taxa de cura aumenta quando o mecanismo responsável pela incontinência urinária de esforço é a hipermobilidade da uretra, contudo não é alterada quando são realizadas concomitantemente outras cirurgias vaginais. Palavras-chave: Incontinência Urinária de Esforço; Slings Suburetrais. ABSTRACTIntroduction: Stress urinary incontinence affects about 20-40% of women. Treatment with transobturator mid-urethral slings is consensually accepted nowadays. The goal of this study was to evaluate the success rate and most frequent complications of surgical treatment with transobturator mid-urethral slings in stress urinary incontinence. Material and Methods:This study evaluated 363 patients who underwent correction of stress urinary incontinence with a transobturator tape in Hospitais da Universidade de Coimbra between January 1st 2008 and July 1st 2010. Results:The mean age of patients was 56 . In 13.5% of women, the correction of stress urinary incontinence was associated with other vaginal surgery. The majority of these women (95.3%) had urethral hypermobility. Only 0.8% of women suffered of perioperative complications, 5.2% of immediate postoperative complications and 15.7% of late postoperative complications. The global success rate was 93.7%. The success rate in patients with fixed urethra was lower (77.8%) comparing with the results of those with urethral hypermobility, being successful in 94.5% (p = 0.02). The success rate was similar in patients with or without vaginal surgeries. Discussion: Treatment with transobturator mid-urethral slings has high success rates and it became the first treatment chosen to stress urinary incontinence, even if they were treated with the technique outside-in (TOT. Both techniques were conceived to avoid passing through the retropubic space, decreasing the complicate matters number. Conclusions: The cure rates for the transobturator surgical approach range between 80 and 95%. The cure rate increases when the mechanism responsible for the urinary incontinence is urethral hypermobility, although it is not modified when are performed other vaginal surgeries concomitantly.

This case presents a unique scenario of muscle and skin infection after sling placement without any mesh exposure or vaginal involvement. The occurrence of the infection only after chemotherapy may indicate that immunosuppression had participation on its development. Care should be taken when exposing this mesh in contaminated perineal areas.

No abstract