Ecografía en el diagnóstico de la incontinencia urinaria femenina

Cidre, Miguel Ángel Jiménez; Lavalle, Luís López-Fando; Dorado, C. Quicios; Guérin, C; Poblador, Agustín Fraile; Dehesa, Teodoro Mayayo

doi:10.4321/s0004-06142006000400012

Cited by 8 publications

(3 citation statements)

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“…Access of the PDO threads to the vaginal urethral space was monitored and performed under trans perineal ultrasound vision and control (Figure 7). 17 It is important to highlight that the elaboration of the PDO wire mesh in the vaginal urethral space, corroborated by the transvaginal probe of the ultrasound equipment, provides safety and only confirms that its elaboration is located in the same place where the mesh slides during the procedure. To treat urinary incontinence, transvaginal obturator tape (TOT) is used.…”

Section: Discussionmentioning

confidence: 95%

Stress Urinary Incontinence: Treatment With Platelet-Rich-Plasma Injection and Placement of Polydioxanone Threads—A Pilot Study

Luksenburg¹,

Barcia

Sergio

et al. 2021

Am J Cosmet Surg

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Stress urinary incontinence is an important clinical problem that affects millions of women worldwide. The aim of this article was the evaluation of a minimally invasive procedure as an alternative treatment for mild urinary stress incontinence in women, using platelet-rich-plasma (PRP) injections and polydioxanone (PDO) threads. A total of 23 patients with mild urinary incontinence, mean age 46, were evaluated with detailed history, examination, urinary diary, complete laboratory tests, ultrasonography, urodynamic studies, and completion of International Consultation on Incontinence Questionaire–Urinary Incontinence Short Form (ICIQ-UI SF). Under local anesthesia, PRP was injected through the anterior vaginal wall, PDO threads placed in paraurethral, suburethral, and lateral urethrovaginal spaces, using instruments developed for safe and effective performance. Patients were analyzed at 1, 2, 4, 8 weeks and 6 months posttreatment. A total of 10 patients were biopsed preoperatively and 60 days after treatment. Symptoms and ICIQ-UI SF score were significantly improved. Postoperative urodynamic studies were normal in all cases. Biopsies after treatment showed a dense connective tissue tridimensional mesh. No complications or adverse effects were observed. All patients declared satisfaction with results, will have the procedure again, and will recommend it. The minimally invasive technique presented here results in strengthening of the paraurethral, suburethral, and lateral urethrovaginal spaces and the mucosa of the anterior vaginal wall. The combination of PRP injections and the placement of PDO threads creates a fibrotic and absorbable mesh-like structure, aimed to increase the urethral resistance, so that under effort the intravesical pressure does not overcome the urethral pressure. These results suggest that the procedure is safe and a cost-effective alternative in patients with mild urinary incontinence, reducing the need for invasive surgical procedures. Larger studies are needed to confirm the results of this study.

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Section: Discussionmentioning

confidence: 95%

Stress Urinary Incontinence: Treatment With Platelet-Rich-Plasma Injection and Placement of Polydioxanone Threads—A Pilot Study

Luksenburg¹,

Barcia

Sergio

et al. 2021

Am J Cosmet Surg

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“…Access of the PCL threads to the vaginal urethral space was monitored and performed under trans perineal ultrasound vision and control. 18 It is important to highlight that the elaboration of the PCL wire mesh in the vaginal urethral space, corroborated by the transvaginal probe of the ultrasound equipment, provides safety.…”

Section: Discussionmentioning

confidence: 99%

New Insights in the Treatment of Urinary Incontinence: The Luksenburg System

Luksenburg¹,

Barcia

Gaviria³

et al. 2022

Am J Cosmet Surg

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Introduction: Urinary incontinence (UI) is an important clinical problem which affects millions of women worldwide. We describe the Luksenburg system, a minimally invasive procedure for the treatment of UI in women, using platelet-rich plasma (PRP) injections and polycaprolactone (PCL) threads. Material & Methods: A total of 302 patients with UI, mean age 52, were evaluated with detailed history, examination, urinary diary, complete laboratory tests, ultrasonography, urodynamic studies, and completion of International Consultation on Incontinence Questionnaire-Urinary Incontinence Short Form (ICIQ-UI SF). Under local anesthesia, PRP was injected through the anterior vaginal wall, and PCL threads were placed in paraurethral, suburethral, and lateral urethrovaginal spaces, using instruments developed for safe and effective performance. Patients were analyzed at 1, 2, 4, 8 weeks and 6 months posttreatment. Twenty patients were biopsied preoperatively and 60 days after treatment. Results: Symptoms, ICIQ-UI SF score, and postoperative urodynamic studies were significantly improved in 95% of patients with UI grade I, 92% of patients with UI grade II, and in 30% of UI grade III. Biopsies after treatment showed a dense connective tissue 3-dimensional mesh. No complications or adverse effects were observed. All patients declared satisfaction with results, will have the procedure again, and will recommend it. Discussion: The Luksenburg system results in strengthening of the paraurethral, suburethral, and lateral urethrovaginal spaces and the mucosa of the anterior vaginal wall. The combination of PRP injections and the placement of PCL threads create a fibrotic and absorbable mesh-like structure, aimed to increase the urethral resistance, so that under effort the intravesical pressure does not overcome the urethral pressure. Conclusions: These results support that the Luksenburg system is safe and a cost-effective alternative in patients with all grades of UI, reducing the need for invasive surgical procedures.

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“…It also provides a good correlation with surgical exploration since tapes and materials are easily observed when generating a hyperechogenic image, facilitating assessments of post-surgical complications. Pelvic floor ultrasound assesses the urethral path, urethral hypermobility, and post-surgical changes in anti-incontinence surgeries by visualizing the slings [ 12 , 13 ]. Being a dynamic test allows physicians to assess the sling at rest and in Valsalva, and thus to determine its functionality and observe post-surgical complications such as surgical obstruction, the presence of hematomas, extrusion of the mesh, or the presence of other concomitant problems such as pelvic organ prolapses.…”

Section: Introductionmentioning

confidence: 99%

Construction of a Prognostic Score for Ultrasound Evaluation of the Transobturator Sling for Stress Urinary Incontinence

Cristina

Sabonet

Rita

et al. 2022

JCM

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Currently, pelvic floor ultrasound allows us to correctly visualize the synthetic material used in stress urinary incontinence surgery. The objective of this study is the construction of a score and its correlation with the SUU clinic. During the study period, 81 patients with transobturator slings were studied using ultrasound. Through multivariate analysis, the statistically significant variables were the distance from the sling to the urethral wall (p = 0.004), the shape of the sling at rest (p = 0.003), and the symmetry of the mesh (p = 0.016). Through these variables, the construction of a score was carried out. Once the model was constructed, its internal validation was carried out to determine the discrimination capacity of patients who present clinical stress and those who do not, with an area under the curve of 0.848 (95% CI (0.72–0.97), p < 0.001). This simple score using three ultrasound variables serves to adequately and objectively discriminate patients who have successful surgery and absence of clinical effort.

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Ecografía en el diagnóstico de la incontinencia urinaria femenina

Cited by 8 publications

References 0 publications

Stress Urinary Incontinence: Treatment With Platelet-Rich-Plasma Injection and Placement of Polydioxanone Threads—A Pilot Study

Stress Urinary Incontinence: Treatment With Platelet-Rich-Plasma Injection and Placement of Polydioxanone Threads—A Pilot Study

New Insights in the Treatment of Urinary Incontinence: The Luksenburg System

Construction of a Prognostic Score for Ultrasound Evaluation of the Transobturator Sling for Stress Urinary Incontinence

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