1 / 9

Annual meeting of the International Continence

Annual meeting of the International Continence Society (ICS) and International Urogynecological Association (IUGA) 23-27 August, 2010,Toronto,Canada. Schierlitz L, Dwyer P, Rosamilia A, Murray C, Thomas E, Fitzgerald E, Hiscock R, De Souza A

lilah-melendez
Download Presentation

Annual meeting of the International Continence

An Image/Link below is provided (as is) to download presentation Download Policy: Content on the Website is provided to you AS IS for your information and personal use and may not be sold / licensed / shared on other websites without getting consent from its author. Content is provided to you AS IS for your information and personal use only. Download presentation by click this link. While downloading, if for some reason you are not able to download a presentation, the publisher may have deleted the file from their server. During download, if you can't get a presentation, the file might be deleted by the publisher.

E N D

Presentation Transcript

  1. Annual meeting of the International Continence Society (ICS) and International Urogynecological Association (IUGA) 23-27 August, 2010,Toronto,Canada.

  2. Schierlitz L, Dwyer P, Rosamilia A, Murray C, Thomas E, Fitzgerald E, Hiscock R, De Souza A Mercy Hospital for Women, Australia, Monash Medical Centre, Australia A RANDOMIZED CONTROLLED STUDY TO COMPARE TENSION FREE VAGINAL TAPE (TVT) AND MONARC TRANS-OBTURATOR TAPE IN THE TREATMENT OF WOMEN WITH URODYNAMIC STRESS INCONTINENCE (USI) AND INTRINSIC SPHINCTER DEFICIENCY (ISD): THE THREE YEAR FOLLOW UP. • Prospectivo, Randomizado • IOE + ISD ( LPP < 60 / UCP < 20 cm H2O ) • Outcome primario: Necesidad de reoperación

  3. A RANDOMIZED CONTROLLED STUDY TO COMPARE TENSION FREE VAGINAL TAPE (TVT) AND MONARC TRANS-OBTURATOR TAPE IN THE TREATMENT OF WOMEN WITH URODYNAMIC STRESS INCONTINENCE (USI) AND INTRINSIC SPHINCTER DEFICIENCY (ISD): THE THREE YEAR FOLLOW UP. • 162 Pacientes , 82 por rama • Seguimiento promedio 37 meses (23,3 - 47,9) • Outcome primario: TVT 1,2% (1/82) vs Monarc 18,3% (15/82) • R.R. de falla 1,2 para Monarc • Tiempo medio a reoperación 15,6 vs 43,7 meses • Sin diferencias significativas en encuestas

  4. CONCLUSIONES A RANDOMIZED CONTROLLED STUDY TO COMPARE TENSION FREE VAGINAL TAPE (TVT) AND MONARC TRANS-OBTURATOR TAPE IN THE TREATMENT OF WOMEN WITH URODYNAMIC STRESS INCONTINENCE (USI) AND INTRINSIC SPHINCTER DEFICIENCY (ISD): THE THREE YEAR FOLLOW UP. • NNT 6 • Las pacientes con IOE + ISD tienen menor riesgo de requerir una nueva cirugía anti incontinencia de esfuerzo si se les realiza un TVT vs. Monarc • TVT es la técnica de elección en IOE + ISD

  5. RE-ANALYSIS OF A RANDOMIZED TRIAL OF THREE METHODS OF ANTERIOR COLPORRHAPHY USING MORE CLINICALLY RELEVANT DEFINITIONS OF SUCCESS Chmielewski L, Walters M, Weber A, Barber M Cleveland Clinic • Weber , et al 2001 reportan tasas de éxito de un 30% al 47% plastías anteriores • Éxito definido como Ba < -2 • Población general 35% estadio 2 • 98% de las pacientes con prolapso hasta el introito es asintomática

  6. NUEVOS CRITERIOS DE ÉXITO RE-ANALYSIS OF A RANDOMIZED TRIAL OF THREE METHODS OF ANTERIOR COLPORRHAPHY USING MORE CLINICALLY RELEVANT DEFINITIONS OF SUCCESS • Ausencia de síntomas de tumor genital • Prolapso no sobrepase el introito • No reoperación

  7. RE-ANALYSIS OF A RANDOMIZED TRIAL OF THREE METHODS OF ANTERIOR COLPORRHAPHY USING MORE CLINICALLY RELEVANT DEFINITIONS OF SUCCESS • 114 pacientes operadas entre Junio 1996 y Mayo 1999 • Randomizadas: 38 PA / 38 Paravaginal / 38 PA + Vycril • POP-Q y Encuestas 0, 6, 12 y 24 meses

  8. RE-ANALYSIS OF A RANDOMIZED TRIAL OF THREE METHODS OF ANTERIOR COLPORRHAPHY USING MORE CLINICALLY RELEVANT DEFINITIONS OF SUCCESS • No hay Diferencia en los score promedio del POP-Q • Ba promedio en -1 • 90% no tiene prolapso >0 • 95 % asintomaticas • 1% reoperaciones a los 29 meses

  9. RE-ANALYSIS OF A RANDOMIZED TRIAL OF THREE METHODS OF ANTERIOR COLPORRHAPHY USING MORE CLINICALLY RELEVANT DEFINITIONS OF SUCCESS • La tasa de éxito de la plastía anterior depende del criterio utilizado; utilizando un criterio anatómico estricto es mala. • Usando criterios contemporáneos y clínicamente relevantes, el éxito de la plastía anterior es considerablemente mejor con sólo un 10% de recidiva más allá del introito, 5% de recurrencia sintomática y sin pacientes que requieran reintervenciones al año de seguimiento

More Related