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Complicaciones de la cirugía de incontinencia urinaria femenina con minicintas

DOI: 10.4321/S0210-48062010001000014

Keywords: urinary incontinence, complications, mini-slings.

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Abstract:

objective: to evaluate the complications of urinary incontinence (ui) surgery with mini-sling system. describe its diagnosis and management. material and method: we make a descriptive analysis of the complications of the surgery in a group of 155 women with ui surgically treated with minisling system (50 tvt-secur and 105 miniarc) from october 2006 to november 2008. all patients were evaluated with clinical history, physical examination and two questionnaires of qol (iciq-sf and eq-5d). when urethral obstruction was suspected, we included urineculture, post-void residual urine measurement and urodinamycs. the complications were grouped into three cathegories: intraoperatory, early (within de first month after surgery) and late complications (after a month). we use the spss program (v 14.0) for statistical analysis of the results. results: the average age was 56 years (range 33-82) and 180 days for the following-up (range 26-817). we had a complication rate of 20% (22% tvt-secur, 17% miniarc). we reported one intraoperatory complication corresponding to a bladder perforation (0.64%), managed conservatively with catheterization. all early complications were reported in the miniarc group: one obturator fossa hematoma (0.64%) spontaneously resolved, groin pain in 4 patients (2.5%) successfully treated with nsaids and one urethral obstruction (0.64%) that required mesh cutting. late complications included: 8 vaginal erosions (5%), 4 required tape excison and vaginal wall closure; 2 were treated with vaginal estrogens, and the other 2 were asymptomatic so we did nothing. 6 patients (3.8%) showed urethral obstruction: we performed mesh cutting in 5, whereas one patient improved with intermittent catheterization. urge symptoms were reported in 10 patients (6.45%) and successfully managed with anticholinergic agents. 2 patients suffered from recurrent infections (1.3%) confirmed by antibiogram, treating isolated episodes.

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