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The authors retrospectively studied a database of 221 patients who underwent correction of stress urinary incontinence (SUI) through the implantation of a SAFYRE VS retropubic sling (96 women) or a homemade polypropylene retropubic sling -HMS (125 patients) between March 2005 and December 2007, comprising a median follow-up of 78.47 (± 38.69) months (1). The evaluation included a telephone call made by a blinded trained researcher for those patients who had completed at least one year of surgery. The HMS was made of a 75g/m 2 , 15mm-wide polypropylene mesh attached with polyglycolic acid sutures at its edges. Both HMS and SAFYRE VS groups presented significant improvements on International consensus on Incontinence -Urinary Incontinence Short Form questionnaire (ICIQ-UI SF) and there were no differences in satisfaction, subjective cure rates, ICIQ-UI SF, or complications between groups, but a significantly higher frequency of patients of SAFYERE VS group required indwelling urinary catheter over 24 hours ( 2.4% vs. 8.3%, p=0.061) as well as a higher frequency of bladder injury was observed in the SAFYRE VS group (0% vs. 4.2%, p=0.034).In the present study (1), the use of the SAFYRE VS was not advised for patients with severe or recurrent SUI or those with expected need of postoperative readjustment that are the primary population for which readjstuble sinthetic slings have been currently proposed (2, 3). In fact, authors disclosured that the allocation of patients for HMS or SAFYRE VS implant was exclusively conditioned to their availability at the time of surgery. Furthermore, no significant sociodemographic or clinical differences were detected between patients in both groups, which allowed for reasonable data comparison despite the retrospective and non randomized study design.In fact, there are few publications focused on both types of suburethral slings which were studied in the current series. The SAFYRE VS sling kit developed in Latin America, and together with REEMEX readjustable System (Neomedic Int, Spain) correspond to the only two slings that propose to allow an easy postoperative readjustment feature (4). However, publications on long-term follow-up are rare for both devices so the present series is a good reference on the performance of SAFYRE VS in longer follow--up periods than previously published (refer to article's references).Publications about homemade polypropylene slings are even rarer and much more difficult to evaluate, due to the biomechanical differences and the wide range of of the meshe's size resulted from the surgeon's tailoring. In addition, detailed descriptions of the procedures used for the primary adjustment and sling fixation are often missed in the publications (5), leaving no answer as to how it should be performed, i.e., if similar to the adjustment of a classic aponeurotic sling or as the same manner as used for polypropylene midurethral slings sets.
The authors retrospectively studied a database of 221 patients who underwent correction of stress urinary incontinence (SUI) through the implantation of a SAFYRE VS retropubic sling (96 women) or a homemade polypropylene retropubic sling -HMS (125 patients) between March 2005 and December 2007, comprising a median follow-up of 78.47 (± 38.69) months (1). The evaluation included a telephone call made by a blinded trained researcher for those patients who had completed at least one year of surgery. The HMS was made of a 75g/m 2 , 15mm-wide polypropylene mesh attached with polyglycolic acid sutures at its edges. Both HMS and SAFYRE VS groups presented significant improvements on International consensus on Incontinence -Urinary Incontinence Short Form questionnaire (ICIQ-UI SF) and there were no differences in satisfaction, subjective cure rates, ICIQ-UI SF, or complications between groups, but a significantly higher frequency of patients of SAFYERE VS group required indwelling urinary catheter over 24 hours ( 2.4% vs. 8.3%, p=0.061) as well as a higher frequency of bladder injury was observed in the SAFYRE VS group (0% vs. 4.2%, p=0.034).In the present study (1), the use of the SAFYRE VS was not advised for patients with severe or recurrent SUI or those with expected need of postoperative readjustment that are the primary population for which readjstuble sinthetic slings have been currently proposed (2, 3). In fact, authors disclosured that the allocation of patients for HMS or SAFYRE VS implant was exclusively conditioned to their availability at the time of surgery. Furthermore, no significant sociodemographic or clinical differences were detected between patients in both groups, which allowed for reasonable data comparison despite the retrospective and non randomized study design.In fact, there are few publications focused on both types of suburethral slings which were studied in the current series. The SAFYRE VS sling kit developed in Latin America, and together with REEMEX readjustable System (Neomedic Int, Spain) correspond to the only two slings that propose to allow an easy postoperative readjustment feature (4). However, publications on long-term follow-up are rare for both devices so the present series is a good reference on the performance of SAFYRE VS in longer follow--up periods than previously published (refer to article's references).Publications about homemade polypropylene slings are even rarer and much more difficult to evaluate, due to the biomechanical differences and the wide range of of the meshe's size resulted from the surgeon's tailoring. In addition, detailed descriptions of the procedures used for the primary adjustment and sling fixation are often missed in the publications (5), leaving no answer as to how it should be performed, i.e., if similar to the adjustment of a classic aponeurotic sling or as the same manner as used for polypropylene midurethral slings sets.
The papers came from many different countries such as Brazil, USA, Turkey, China, Belgium, Qatar and Colombia and as usual the editor´s comment highlights some of them.In the present issue we present a important reviews about Vesical Imaging Reporting and Data System (VI-RADS) in bladder cancer diagnosis. The paper about the group of Dr.Nicola and colleagues from USA and Brazil in page 609 shows a very complete narrative review about the topic (1). The authors shows that. the technological innovation of MR imaging has advanced the assessment of bladder cancer. MR findings can be incorporated to increase the accuracy of the traditional prediction models as the EORTC, CUETO, and EAU risk stratification. The authors conclude that the use and implication of VI-RADS will improve the communication in the diagnosis, staging and surveillance of patients with bladder cancer. The editor in chief would like to highlight the following works too:Dr. Bai and colleagues from China, presented in page 625 (2) a nice systematic review about the trifecta achievement in patients undergoing partial nephrectomy and conclude that the larger tumor size, medium and high PADUA score are associated with decreased probability of trifecta achievement.Dr. Qin and colleagues from China performed in page 637 (3) a interesting systematic review about the Comparison of mini percutaneous nephrolithotomy and standard percutaneous nephrolithotomy for renal stones >2cm and concluded that in the treatment of >2cm renal stones, mini-PCNL should be considered an effective and reliable alternative to standard-PCNL (30FR) with less blood loss, lower transfusion rate, and shorter hospitalization. However, the mini-PCNL does not show a significant advantage over the 24F standard-PCNL. On the contrary, this procedure takes a longer operation time.Dr. Terziotti and colleagues from Brazil performed in page 649 (4) an interesting retrospective study about the incontinence outcomes in women undergoing retropubic mid-urethral sling and conclude that both hand-made synthetic sling (HMS) and SafyreTM have similar satisfaction and subjective cure rates, with marked International Consultation on Incontinence Modular Questionnaire
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