Artículos de revistas
Tension-free Vaginal Tape (tvt): Minimally Invasive Technique For Stress Urinary Incotinence (sui)
Registro en:
International Braz J Urol. , v. 28, n. 5, p. 458 - 463, 2002.
16775538
2-s2.0-0036765868
Autor
Palma P.C.R.
Riccetto C.L.Z.
Dambros M.
Herrmann V.
Thiel M.
Netto Jr. N.R.
Institución
Resumen
Objective: The procedure o tension-free vaginal tape (TVT) was recently introduced in the therapeutic armamentarium of stress urinary incontinence (SUI). It is a pubovaginal sling applied in mid-urethra. The authors describe their experience with this technique. Materials and methods: During the period of May, 1999 to March, 2001, 110 patients (median age=53 years) were submitted to TVT implant for the treatment of stress urinary incontinence. Clinical exam and urodynamic studies were performed previously to surgery. All patients referred symptoms consistent with stress incontinence, and 35.7% complained of associated voiding urgency. Sixty-eight percent of the group reported previous continence procedure. Urethral hypermobility was diagnosed in 42% of patients (mean Valsalva leak point pressure under median effort of 110 cmH2O), and 58% had intrinsic sphincter deficiency (mean Valsalva leak point pressure under effort of 55 cmH2O). Results: Mean patient follow-up was 18 months. Ninety-two percent of the patients were submitted to anesthetic blockade and 8% to local anesthesia. Mean length of the procedure was 30 minutes. Dystopy correction, when present, was performed in the same procedure. Mean hospital stay was 24 hours. There was bladder perforation in 13% of cases of TVT. There was no urethral or vaginal erosion. Twenty patients (18%) developed urgency symptoms during post-operative period, and 5 (4.5%) presented urge incontinence. During this follow-up period, 81% remained continent, 9% referred improvement of the symptoms compared to before the procedure and 10% were not satisfied. Conclusion: Our data allow us to conclude that TVT procedure is safe, rapid and promoting adequate levels of continence in mean term. 28 5 458 463 Norris, J.P., Breslin, D.S., Staskin, D.R., Use of synthetic material in sling surgery: A minimally invasive approach (1996) J. Endourol., 10, pp. 227-230 Palma, P.C.R., Ikari, O., D'Ancona, C.A.L., Netto N.R., Jr., Alça pubovaginal sintética no tratamento da incontinência urinária de esforço (1992) J. Bras. Urol., 18, pp. 202-204 Ulmsten, U., Henriksson, L., Johnson, P., Varhos, G., An ambulatory surgical procedure under local anesthesia for treatment of female urinary incontinence (1996) Int. Urogynecol. J., 7, pp. 81-86 Petros, P., Ulmsten, U., An integral theory and its method for the diagnosis and management of female urinary incontinence (1993) Scand. J. Urol. Nephrol., 153, pp. 1-93 Ulmstem, U., Falconer, C., Johnson, P., Jomaa, M., Lannér, L., Nilsson, C.G., A multicenter study of tension-free vaginal tape (TVT) for surgical treatment of stress urinary incontinence (1998) Int. Urogynecol. J., 9, pp. 210-213 Carlin, B.I., Klutke, J.J., Klutke, C.G., The tension-free vaginal tape procedure for the treatment of stress incontinence in the female patient (2000) Urology, 5 (SUPPL. 6), pp. 28-31 Klutke, J.J., Carlin, B.I., Klutke, C.G., The tension-free vaginal procedure: Correction of stress incontinence with minimal alteration in proximal urethral mobility (2000) Urology, 55, pp. 512-514 Jimenez, C.J., Hualde, A.A., De Garibay, A.S.G., Uruñuela, F.L., Cárdenas, A.P., Paul, M.P., TVT (tension-free tape). New surgical technique in the treatment of stress urinary incontinence (2000) Arch. Esp. Urol., 53, pp. 9-13 Wang, A.C., Lo, T.S., Tension-free vaginal tape. A minimally invasive solution to stress urinary incontinence (1998) J. Reprod. Med., 43, pp. 429-434