Uraco-cistopexia: nueva técnica de cisto-suspensión asociada al burch para el tratamiento del cistocele e incontinencia urinaria de esfuerzo, seguimiento a largo plazo / Urachus cystopexy: New technique for bladder suspension associated to the Burch`s technique in the treatment of cystocele and stress urinary incontinence. Long-term follow-up
Arch. esp. urol. (Ed. impr.)
; 62(1): 34-41, ene.-feb. 2009. ilus, tab
Article
en Es
| IBECS
| ID: ibc-59999
Biblioteca responsable:
ES1.1
Ubicación: BNCS
RESUMEN
OBJETIVO: Comparar la eficacia y morbilidad a largo plazo de pacientes con incontinencia urinaria de esfuerzo a las que se realizó uretro-cervico-suspensión tipo Burch versus el procedimiento de Burch más uraco-cistopexia.MÉTODOS: Se realizó un análisis de cohorte retrospectivo, longitudinal, comparativo y observacional. De enero de 1994 a marzo 2005 se incluyeron 129 pacientes con incontinencia urinaria de esfuerzo (IUE) o incontinencia urinaria mixta (IUM). Cincuenta y cuatro pacientes fueron sometidas a procedimiento de Burch (grupo B) y 75 pacientes a procedimiento de Burch asociado a uraco-cistopexia (grupo BU). La severidad de la incontinencia fue valorada mediante el número de apósitos utilizados durante 24 hrs. La cura se consideró cuando el paciente no requirió ningún dispositivo para la pérdida urinaria; la mejoría como una disminución a una toalla al día y fracaso el uso de más de 1 apósito en 24 horas. En la IUM, el componente de incontinencia urinaria de urgencia (IUU) se evaluó por separado(AU)
ABSTRACT
OBJECTIVES: To compare long term efficacy and morbidity in patients with stress urinary incontinence treated using Burchs colpopexy versus Burchs colpopexy plus urachus-cystopexy.METHODS: Retrospective, longitudinal comparative, observational study in 129 patients with stress urinary incontinence (SUI) or mixed urinary incontinence (MUI). Fifty four patients underwent Burchs colpopexy (group B) and 75 patients underwent Burchs colpopexy and urachus-cystopexy (group B U). These patients completed inclusion criteria from January 1994 to March 2005.The severity of SUI was evaluated by means of the number of pads used in 24 hours. Cure was defined as patients not using any pad for urinary leakage; improvement, when the number of pads used decreased to one pad a day; and failure when the patients used more than 1 pad in 24 hours. In MUI the urge urinary incontinence (UUI) component was evaluated separately.RESULTS: After 12 months of follow-up, 47 patients of group B and 67 patients of group BU were evaluated analyzing cure/improvement. Either one were observed in 74.4% (29/6) and 97% (58/7) respectively (p= 0.001). At 24 months follow up, in 35 patients of group B and 42 of group BU, a rate of 65.7% (22/3) and 97.6% (37/4) was observed respectively (p=0.014). MUI was present in 53.7% of group B and 58.6% patients of group BU. An independent analysis was made on urge urinary incontinence (UUI) in these patients at 12 months; 53.1 % of group B and 19.4 % of group BU had UUI (p= 0.000). At 24 months, 50% of patients of group B and 26.19% of group BU had UUI (p= 0.029). De novo UUI was present in 19.4% of group B and 5.97% of group BU (p= 0.000) at12 months follow-up, and in 17.64% of patients of group B and 13.95% of group BU (p= 0.005) at 24 months. Complications related to urachus-cystopexy presented trans-operatively: vesical injury in 3 of the initial cases, solved with bladder closure in two layers and vesical catheter for 7 days approximately(AU)
Texto completo:
1
Colección:
06-national
/
ES
Base de datos:
IBECS
Asunto principal:
Procedimientos Quirúrgicos Urológicos
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Uraco
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Incontinencia Urinaria de Esfuerzo
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Urodinámica
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Cistocele
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Dispositivos de Fijación Quirúrgicos
Tipo de estudio:
Observational_studies
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Risk_factors_studies
Límite:
Female
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Humans
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Male
Idioma:
Es
Revista:
Arch. esp. urol. (Ed. impr.)
Año:
2009
Tipo del documento:
Article