ABSTRACT
Antecedentes: La Incontinencia Urinaria de Esfuerzo (IUE) es una patología frecuente y en ascenso entre las mujeres, produce un deterioro significativo en la calidad de vida de ellas. Objetivos: Evaluar los resultados en el tratamiento de la IUE mediante un TOT ambulatorio con ajuste intraoperatorio de la tensión de la malla. Método: Se realizó un estudio prospectivo, descriptivo en el que se evaluaron los resultados objetivos y subjetivos en el tratamiento de la IUE con TOT ambulatorio, con ajuste intraoperatorio de la tensión de la malla. Resultados: Se obtuvo continencia normal en el 93,3 por ciento de las pacientes, 87 por ciento se consideró "sana". No se presentaron complicaciones mayores ni sobrecorrección a los 24 meses de seguimiento. El 93 por ciento de las pacientes abandonó el hospital el mismo día de la cirugía. Conclusiones: El ajuste de la malla intrao-peratorio permitiría mejorar los resultados publicados de continencia en la cirugía de TOT ambulatorio, disminuyendo el riesgo de sobrecorrección de la IUE en forma segura y rápida. Consideramos que debiera ser un paso obligatorio en el TOT.
Background: Stress urinary incontinence (SUI) is a common condition and rising among women, with a significant deterioration of quality of life. Objectives: To evaluate the results in the treatment of SUI by ambulatory TOT with intraoperative adjustment of mesh tension. Methods: We performed a prospective descriptive study that evaluated the objective and subjective outcomes of the SUI treatment with ambulatory TOT intraoperative adjustment of mesh tension. Results: Normal continence was obtained 93.3 percent of patients, 87 percent were considered cured. There were no major complications or over correction at 24 months follow up. 93.3 percent were discharged on the day of surgery. Conclusions: The intraoperative adjustment of the mesh would improve continence results published in TOT outpatient surgery, reducing the risk of overcorrection of SUI safely and quickly. We believe it should be a mandatory step in the TOT.
Subject(s)
Humans , Female , Adult , Middle Aged , Suburethral Slings , Urinary Incontinence, Stress/surgery , Ambulatory Care , Prospective Studies , Follow-Up Studies , Treatment Outcome , Patient SatisfactionABSTRACT
PURPOSE: Using corneal reflex, we performed intraoperative adjustments in horizontal strabismus patients who had very poor visual acuities with good compliance and analyzed various aspects of intraoperative adjustment. METHODS: We retrospectively reviewed the records of patients with horizontal strabismus who underwent intraoperative adjustment using corneal reflex from May 1997 to April 2005. We evaluated various aspects of intraoperative adjustment. RESULTS: Fifty-five patients (40 exotropes, 15 esotropes) were included in our study. 11 of 40 extropes (27.5%) and 4 of 15 esotropes (26.7%) eventually underwent operations that were adjusted intraoperatively. Successful results were seen in 35 of 40 exotropes (87.5%) and 8 of 15 esotropes (53.3%). Fifteen patients (27.3%) received intraoperative adjustments, and of these patients 11 (20.0%) who had successful results would have experienced either undercorrection or overcorrection if their operation were performed as scheduled. Four patients underwent operation on one muscle rather than on the scheduled two muscles. All 4 of these patients (100%) would have experienced significantly large overcorrection had they not received intraoperative adjustment. CONCLUSIONS: Patients who would have had difficulty with fixation due to low visual acuity could avoid under- or overcorrection and are expected to have higher success rates because of intraoperative adjustment using corneal reflex.
Subject(s)
Humans , Compliance , Muscles , Reflex , Retrospective Studies , Strabismus , Visual AcuityABSTRACT
We evaluated the one-stage intraoperative adjustment strabismus surgery with adjustable suture under topical anesthesia. Medical records of the patients who had intraoperative adjustment surgery under topical anesthesia for horizontal or vertical strabismus in our hospital from March 1997 to March 2003 with follow-up of 6 months were analyzed retrospectively. Of the 71 patients, 48 patients had exotropia, 16 had esotropia, and 7 had hyper- or hypotropia. The overall success rates were 85.9% at 1 week, 83% at 1 month, 78.9% at 3 months, and 76.1% at 6 months after surgery. The procedure was not stopped in any patients, and no serious intra-operative or postoperative complications were noted. Intraoperative adjustment strabismus surgery under topical anesthesia is a simple, well-tolerated and effective procedure.
Subject(s)
Middle Aged , Male , Humans , Female , Adult , Adolescent , Treatment Outcome , Suture Techniques , Strabismus/surgery , Retrospective Studies , Ophthalmologic Surgical Procedures/methods , Intraoperative Period , Anesthetics, Local/administration & dosage , Administration, TopicalABSTRACT
The adjustable suture strabismus surgery has been used for the more accurate operation. In general adjustable surgery is a two-stage procedure, so it has many difficulties such as hospitalization, more chances of infection and more times. We performed one-stage intraoperative adjustment strabismus surgery under topical anesthesia and analyzed the result of surgery. 67 patients were included in this study. The patients ranged from 14 to 61 years of age, averaging 27.6 years of age and the follow-up period after operation ranged from 3 months to 58 months averaging 9.4 months. The overall success rate was 78% (52/67). The success rate of reoperation group which had previous one or more strabismus surgery was 63% (5/8). And the success rate of vertically deviated group was 63% (5/8).