"Sling" retropúbico e transobturatório no tratamento da incontinênca urinária de esforço

Abstract

Objective. To compare the results of retropubic and transobturator slings for surgical treatment of female stress urinary incontinence (SUI). MethOds. We randomized thirty patients with SUI, ten of whom underwent transobturator sling surgery and ten retropubic sling surgery. Patients were assessed before treatment and 1, 6 and 12 months after treatment on the basis of clinical history, physical examination, quality of life questionnaire (King's Health Questionnaire), pad test and urodynamic evaluation. The groups were homogenous prior to surgery. Results. One year after surgery, incontinence and quality of life parameters had improved significantly in both groups and there were no differences between them. There was a significant reduction in pad test weights in both groups. According to the urodynamic evaluation, 12 months after surgery cure rates were 84.2% for the transobturator group and 88.8% for the retropubic group. Subjective cure rates were 85% in the transobturator group and 88.8% in the retropubic group. No statistical difference was observed in complication rates. cOnclusiOn. Retropubic and transobturator slings were effective for treatment of women with SUI at 12-month follow-up. Both techniques had significant cure rates and improved quality of life with low complication rates.

An overview of recently published medical papers in Brazilian scientific journals

“…In two previously discussed articles Gomes and da Silva1 described prevalence of stress urinary incontinence in women over 20 years of age, who participate in the Family Health Program in the city of Dourados, State of Mato Grosso do Sul, Brazil and conclude that prevalence is similar to that of other studies. Tanuri et al2 compared results of retropubic and transobturator sling for surgical treatment of female stress urinary incontinence which were effective at one-year follow-up. Oliveira et al72 evaluated risk factors related to occurrence of female urinary incontinence and found that independent risk factors include age, vaginal delivery, forceps delivery, and weight of largest infant and as a protective factor, cesarean section delivery.…”

Epidemiological profile and postoperative complications of women undergoing gynecological surgery in a reference center in the northern brazilian legal amazon

“…The major benign gynecological conditions with surgical indication are uterine myoma and urinary incontinence. While in specialized centers they are treated today with minimally invasive techniques, in centers distant from large capitals the conventional surgical treatments dominate 2,5 .…”

“…Urinary incontinence (UI), on its turn, represents about 10% of gynecological complaints [5][6][7][8][9][10] . The operative techniques of suburethral sling for correction of UI can use a wide variety of autologous and synthetic materials and consist of the use of a strip positioned inferiorly to the urethra or bladder neck without tension.…”

“…Their cure rates range between 61% and 93% 11,12 . The use of synthetic meshes in sling procedures reduces the operation time and eliminates the potential morbidity at the graft site extraction 5,13 .…”

I LIVRO DA ABLAC-BR: A Cirurgia Sob as Lentes das Ligas Acadêmicas

“…Alguns pontos são importantes para o correto diagnóstico da doença, tal como a coleta de uma história clínica detalhada, em que se investiga o grau de vazamento, o tempo de início, os detalhes da história pregressa cirúrgica e obstétrica da paciente, bem como as medicações em uso e as comorbidades sistêmicas que lhe acomete. Ao exame físico, deve-se analisar, em região ginecológica, a existência de alterações como lassidão do suporte pélvico, mobilidade de parede vaginal anterior, presença de algum grau de prolapso, cistocele, retocele, alterações tróficas relacionadas ao estímulo hormonal e status neurológico da pelve (distúrbios de sensibilidade ou hipotonias severas) (MCANINCH & LUE, 2014;TANURI et al, 2010).…”