Efectividad de la cirugía con cinta mediouretral transobturadora según su localización documentada por ecografía transperineal en mujeres con incontinencia urinaria de esfuerzo en una población de Bogotá, Colombia.

dc.contributorCortés Díaz, Daniel
dc.contributorSánchez Angarita, Jacinto
dc.creatorLópez Silva, Hugo Alfonso
dc.date.accessioned2020-01-29T20:04:11Z
dc.date.available2020-01-29T20:04:11Z
dc.date.created2020-01-29T20:04:11Z
dc.date.issued2019-12-17
dc.date.issued2019-12-17
dc.identifierhttps://repositorio.unal.edu.co/handle/unal/75537
dc.description.abstractObjetivo: Establecer la cura subjetiva y objetiva de la incontinencia urinaria de esfuerzo en mujeres sometidas a cirugía con cinta mediouretral transobturadora según su localización documentada por ecografía transperineal. Metodología: Estudio observacional prospectivo tipo Cohorte de expuestos en mujeres con incontinencia urinaria de esfuerzo, atendidas en un Hospital público de Bogotá en el periodo comprendido entre enero y octubre de 2019 que fueron sometidas a cirugía de incontinencia (cistouretropexia con cinta mediouretral transobturadora). La cura se evaluó con la prueba de tos y con el test de severidad de Sandvik antes y después de la cirugía. La ubicación de la cinta se determinó con ecografía transperineal tres meses después del procedimiento quirúrgico. Resultados: Participaron en este estudio 30 pacientes de las cuales 27 (90%) tuvieron continencia urinaria en el posoperatorio después de tres meses. En 26 (86.6%) de los casos de continencia urinaria la ubicación de la cinta TOT fue en el tercio medio, y 1(3.3%) en el tercio proximal. De las 3(10%) pacientes con IUE que persistió después del posoperatorio 2 tenían la cinta TOT en el tercio distal de la uretra y 1 en el tercio proximal. En cuanto a la cura subjetiva se encontró 26 (86.7%) pacientes con cura subjetiva. 3(10%) con IUE leve y 1(3.3%) grave. en cuanto a la efectividad de la cirugía según la ubicación de la cinta se observó que el 96.1% de las pacientes con cura subjetiva y objetiva tenían ubicada la cinta TOT en el tercio medio, por otro lado las pacientes 2(6.7%) con ubicación distal de la cinta TOT presentaron IUE en ambos casos. La paciente que presentó la ubicación de la cinta TOT en el tercio proximal, 1(3.3%) tuvo cura subjetiva. La efectividad de la cirugía en cuanto a cura objetiva fue del 90%, mientras que con relación a la cura subjetiva su efectividad fue del 86.6%. Conclusiones: La colocación de la cinta mediouretral transobturadora en el tercio distal de la uretra parece estar asociada con una mayor tasa de recurrencia de incontinencia urinaria de esfuerzo. Los pacientes con cintas ubicadas en la uretra proximal y media tuvieron las mejores tasas de continencia postquirúrgica. Palabras clave: incontinencia urinaria de esfuerzo, Cabestrillo Suburetral, ecografía.
dc.description.abstractObjective: To establish the subjective and objective cure of stress urinary incontinence in women undergoing surgery with transobturator mediourethral tape according to its location documented by transperineal ultrasound. Methodology: Cohort prospective observational study of exposed, in women with stress urinary incontinence, treated at a public hospital in Bogotá in the period between January and October 2019 who underwent incontinence surgery (cystouretropexy with transobturator mediourethral sling). The cure was evaluated with the cough test and the Sandvik severity test, before and after surgery. The location of the tape was determined with transperineal ultrasound three months after the surgical procedure. Results: Thirty patients participated in this study, of which 27 (90%) had urinary continence in the postoperative period after three months. In 26 (86.6%) of the cases of urinary continence the location of the TOT sling was in the middle third, and 1 (3.3%) in the proximal third. Of the 3 (10%) patients with SUI that persisted after the postoperative period 2 had TOT sling in the distal third of the urethra and 1 in the proximal third. Regarding the subjective cure, 26 (86.7%) patients with subjective cure were found. 3 (10%) with mild SUI and 1 (3.3%) severe. Regarding the effectiveness of the surgery according to the location of the tape, it was observed that 96.1% of the patients with subjective and objective cure had the TOT tape located in the middle third, on the other hand, patients 2 (6.7%) with location TOT tape distally presented SUI in both cases. The patient who presented the location of the TOT tape in the proximal third, 1 (3.3%) had a subjective cure. The effectiveness of the surgery in terms of objective cure was 90%, while in relation to the subjective cure its effectiveness was 86.6%. Conclusions: The placement of the transobturator mediourethral tape in the distal third of the urethra appears to be associated with a higher rate of recurrence of stress urinary incontinence. Patients with slings located in the proximal and middle urethra had the best rates of post-surgical continence. Keywords: urinary stress incontinence, Midurethral Sling, Ultrasonography.
dc.languagespa
dc.publisherUniversidad Nacional de Colombia - Sede Bogotá
dc.relationBibliografía
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dc.titleEfectividad de la cirugía con cinta mediouretral transobturadora según su localización documentada por ecografía transperineal en mujeres con incontinencia urinaria de esfuerzo en una población de Bogotá, Colombia.
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