Análisis comparativo entre la colocación medio-uretral de malla sintética (cinta vaginal sin tensión [TVT] y cinta a través del músculo obturador [TOT]); en el tratamiento quirúrgico de la incontinencia urinaria de esfuerzo en mujeres en un período de tie
Resumen
Introducción: la incontinencia urinaria de esfuerzo es la pérdida involuntaria de orina debido al aumento de presión intra- abdominal. El abordaje vaginal por cinta mediouretral es actualmente el método quirúrgico de elección para el tratamiento de IUE con las técnicas: cinta vaginal sin tensión (TVT) y cinta a través del músculo obturador (TOT). Objetivo: determinar la eficacia y complicaciones observadas after the placement of synthetic midurethral sling for the surgical treatment of urinary incontinence in a period of 3 years at HCAM. posterior a la colocación mediouretral de malla sintética TVT y TOT en el tratamiento quirúrgico de la incontinencia urinaria de esfuerzo en un período de 3 años en el HCAM. Materiales y métodos: se realizó un análisis retrospectivo en pacientes que fueron sometidas a cirugía con la colocación de malla mediouretral para IUE en el HCAM. 218 pacientes fueron estudiados, se registraron datos clínico-demográficos, perioperatorios, transoperatorios, y del seguimiento postoperatorio incluidas complicaciones y mejoría clínica de la IU para evaluar la eficacia y seguridad de los métodos. TVT en la apreciación subjetiva y objetiva de la mejoría clínica (87% vs 82% y 92% vs 90% respectivamente). La perforación vesical se presentó en el 14% en el grupo TVT vs 0.5% del grupo TOT. Complicaciones graves que llevaron a reoperación se presentaron mayoritariamente en el grupo TVT (4.8% vs 2.25% / p= 0.356). Conclusiones: comparativamente, ambas técnicas mostraron similar eficacia a través del tiempo de estudio. Sin embargo TOT tendría menos complicaciones, especialmente en referencia a la perforación vesical. Además, TVT requirió mayor tiempo operatorio, estancia hospitalaria.
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