Malla suburetral retropúbica (TVT): experiencia clínica y análisis de datos en el Hospital El Carmen de Maipú / Retropubic suburethral mesh (TVT): clinical experience and data analysis at the Hospital El Carmen de Maipú

La incontinencia urinaria de esfuerzo es la pérdida involuntaria de orina durante una maniobra de esfuerzo físico, ejercicio, estornudo o tos. Afecta aproximadamente al 15% de las mujeres de 30-60 años y su prevalencia es del 30-41%. Aunque existen terapias conservadoras para su manejo, muchas pacientes terminarán necesitando cirugía para su resolución. Las mallas suburetrales son alternativas para el manejo quirúrgico, existiendo dos vías de instalación, la transobturadora (TOT o TVT-O) y la retropúbica (del inglés tension-free vaginal tape o TVT), siendo esta última la que presenta mejores resultados y menos complicaciones posoperatorias. Objetivo: evaluar la tasa de efectividad y las complicaciones de la TVT en la Unidad de Piso Pélvico Femenino del Hospital El Carmen de Maipú entre los años 2015 y 2020. Materiales y Métodos: Se obtuvieron 715 registros de pacientes que fueron sometidas a TVT y se logró contactar telefónicamente con el 60,69% de ellas. Resultados: Los resultados muestran una tasa de efectividad del 94,8% y una tasa de complicaciones del 2,3%. Conclusión: Este estudio aporta evidencia local de los resultados posoperatorios en la IOE en pacientes que requirieron la instalación de una malla suburetal retropúbica, demostrando ser una cirugía altamente efectiva y segura.

Stress urinary incontinence is the involuntary loss of urine during physical exertion, exercise, sneezing, or coughing. It affects approximately 15% of women aged 30-60, with a prevalence of 30-41%. Although there are conservative therapies for its management, many patients will eventually require surgery for resolution. Suburethral sling are considered for surgical management, and there are two installation alternatives, transobturator (TOT or TVT-O) and retropubic (tension-free vaginal tape or TVT), with the latter presenting better results and fewer postoperative complications. Objetive: to evaluate effectiveness rate and complications of the TVT in the Female Pelvic Floor Unit of Hospital El Carmen de Maipú between 2015 and 2020. Materials and Methods: A total of 715 patient records were obtained for those who underwent TVT, and 60.69% of them were successfully contacted by telephone. Results: The results show an effectiveness rate of 94.8% and a complication rate of 2.3%. Conclusion: This study provides local evidence for the results of stress urinary incontinence that required the placement of a retropubic suburethral sling, proving to be a highly effective and safe surgery.

Comparison between hematological and biochemical changes caused by conventional and metronomic chemotherapies in the treatment of canine transmissible venereal tumor / Comparação entre as alterações hematológicas e bioquímicas ocasionadas pela quimioterapia convencional e quimioterapia metronômica no tratamento do tumor venéreo transmissível canino

This study aimed to report the hematological and biochemical changes caused by conventional and metronomic chemotherapies, using vincristine sulfate to treat canine Transmissible Venereal Tumor (TVT). Twelve dogs were selected, six of them for the group receiving conventional chemotherapy (G1), and six dogs for the group receiving metronomic chemotherapy (G2). The G1 group received vincristine sulfate once a week at the dose of 0.75mg/m² until the tumor had disappeared with treatment, and the G2 group was treated with vincristine sulfate three times a week at the dose of 0.25mg/m2 until the tumor had disappeared. Before and after chemotherapy treatment, hematological and biochemical blood tests were performed to evaluate the main alterations caused by both chemotherapeutic models. Dogs undergoing conventional chemotherapy had significant leukocyte changes (p<0.05), causing neutropenia and leukopenia. In dogs undergoing metronomic chemotherapy, leukocytes remained within the reference range. Half of the dogs in group G1 had normochromic, normocytic anemia. The only biochemical alteration observed was the increase of urea in group G2. Thus, metronomic chemotherapy for the treatment of TVT with vincristine sulfate proved to be an excellent method for treatment, with fewer adverse effects, especially in maintaining the leukogram of dogs within normal range and reducing the number of anemia in animals during treatment.(AU)

Esta pesquisa teve como objetivo relatar as alterações hematológicas e bioquímicas causadas pelo tratamento quimioterápico convencional e pela quimioterapia metronômica, utilizando-se sulfato de vincristina para o tratamento do tumor venéreo transmissível canino(TVTC). Foram selecionados 12 cães, sendo seis para o grupo que recebeu quimioterapia convencional (G1) e seis cães para o grupo que recebeu quimioterapia metronômica (G2). O grupo G1 recebeu sulfato de vincristina, uma vez por semana, na dose de 0,75mg/m2, até o desaparecimento do tumor e o grupo G2 foi tratado com sulfato de vincristina, três vezes por semana, na dose de 0,25mg/m2, até o desaparecimento do tumor. Antes e após o tratamento quimioterápico foram realizados exames hematológicos e bioquímicos sanguíneos para avaliação das principais alterações causadas pelos dois modelos quimioterápicos. Os cães submetidos à quimioterapia convencional tiveram alterações leucocitárias significativas (p<0,05), causando uma leucopenia por neutropenia enquanto nos cães, submetidos à quimioterapia metronômica, os leucócitos mantiveram-se dentro do intervalo de referência. A metade dos cães do grupo G1 tiveram uma anemia do tipo normocítica normocrômica. A única alteração bioquímica observada foi o aumento da ureia no grupo G2. Desta forma, a quimioterapia metronômica para o tratamento do TVT com sulfato de vincristina, demonstrou ser um excelente método para a cura do animal, com menores reduções de efeitos adversos, sobretudo, na manutenção do leucograma dos cães e na redução de animais com anemia.(AU)

Comparison between hematological and biochemical changes caused by conventional and metronomic chemotherapies in the treatment of canine transmissible venereal tumor

ABSTRACT: This study aimed to report the hematological and biochemical changes caused by conventional and metronomic chemotherapies, using vincristine sulfate to treat canine Transmissible Venereal Tumor (TVT). Twelve dogs were selected, six of them for the group receiving conventional chemotherapy (G1), and six dogs for the group receiving metronomic chemotherapy (G2). The G1 group received vincristine sulfate once a week at the dose of 0.75mg/m² until the tumor had disappeared with treatment, and the G2 group was treated with vincristine sulfate three times a week at the dose of 0.25mg/m2 until the tumor had disappeared. Before and after chemotherapy treatment, hematological and biochemical blood tests were performed to evaluate the main alterations caused by both chemotherapeutic models. Dogs undergoing conventional chemotherapy had significant leukocyte changes (p 0.05), causing neutropenia and leukopenia. In dogs undergoing metronomic chemotherapy, leukocytes remained within the reference range. Half of the dogs in group G1 had normochromic, normocytic anemia. The only biochemical alteration observed was the increase of urea in group G2. Thus, metronomic chemotherapy for the treatment of TVT with vincristine sulfate proved to be an excellent method for treatment, with fewer adverse effects, especially in maintaining the leukogram of dogs within normal range and reducing the number of anemia in animals during treatment.

RESUMO: Esta pesquisa teve como objetivo relatar as alterações hematológicas e bioquímicas causadas pelo tratamento quimioterápico convencional e pela quimioterapia metronômica, utilizando-se sulfato de vincristina para o tratamento do tumor venéreo transmissível canino(TVTC). Foram selecionados 12 cães, sendo seis para o grupo que recebeu quimioterapia convencional (G1) e seis cães para o grupo que recebeu quimioterapia metronômica (G2). O grupo G1 recebeu sulfato de vincristina, uma vez por semana, na dose de 0,75mg/m2, até o desaparecimento do tumor e o grupo G2 foi tratado com sulfato de vincristina, três vezes por semana, na dose de 0,25mg/m2, até o desaparecimento do tumor. Antes e após o tratamento quimioterápico foram realizados exames hematológicos e bioquímicos sanguíneos para avaliação das principais alterações causadas pelos dois modelos quimioterápicos. Os cães submetidos à quimioterapia convencional tiveram alterações leucocitárias significativas (p 0,05), causando uma leucopenia por neutropenia enquanto nos cães, submetidos à quimioterapia metronômica, os leucócitos mantiveram-se dentro do intervalo de referência. A metade dos cães do grupo G1 tiveram uma anemia do tipo normocítica normocrômica. A única alteração bioquímica observada foi o aumento da ureia no grupo G2. Desta forma, a quimioterapia metronômica para o tratamento do TVT com sulfato de vincristina, demonstrou ser um excelente método para a cura do animal, com menores reduções de efeitos adversos, sobretudo, na manutenção do leucograma dos cães e na redução de animais com anemia.

Clinical assessment of tension-free vaginal tape surgery for the treatment of recurrent stress urinary incontinence in women / 中华老年医学杂志

Objective:To analyze the clinical efficacy and safety of the retropubic tension-free vaginal tape(TVT)procedure for postoperative recurrent urinary incontinence in women.Methods:Retrospective analysis was conducted on twenty-two patients who had developed recurrent urinary incontinence after mid-urethral sling(MUS)surgery and received the retropubic TVT procedure via the middle urethra from January 2016 to June 2020.Patients were between 44 and 74 years old, with a mean age of 61.2±10.2.They were initially treated with the TVT and inside-out trans-obturator(TVT-O)procedures and were followed up by using the International Consultation on Incontinence Questionnaire-Short Form(ICI-Q-SF). Then statistical analysis was performed.Results:No bladder or urethral puncture wounds were observed in the 22 patients during cystoscopy.No pain, sling, vaginal or urethral erosion, or postoperative sling infection was found in any of the patients during a long-term follow-up.Considerable improvement was achieved in frequency of leakage[pre-operation: 4(4, 5) vs.post-operation: 1(1, 2), P<0.001], urine leakage volume[pre-operation: 6(4, 6)ml vs.post-operation: 2(2, 2)ml, P<0.001], impact on quality of life[pre-operation: 10(8, 10) vs. post-operation: 2(1, 3), P<0.001]and ICI-Q-SF[pre-operation: 20(18, 21) vs. post-operation: 5(3, 7), P<0.001]after TVT. Conclusions:TVT is safe and effective for the treatment of recurrent urinary incontinence after MUS surgery.

Tratamientos alternativos en tumor venéreo transmisible en caninos / Alternative treatments in transmissible venereal tumor in canines / Tratamentos alternativos em tumor venéreo transmissível em caninos

Resumen El Tumor Venéreo Transmisible (TVT), es una neoplasia común de la especie canina, se localiza principalmente en la mucosa de los genitales; es altamente contagiosa y es la única que puede ser transmisible mediante el trasplante celular por contacto directo. Se diagnostica por estudio citológico y su tratamiento es la quimioterapia con sulfato de vincristina, fármaco de elección por tener un alto porcentaje de efectividad y baja recidiva; sin embargo, se han descrito efectos adversos como trastornos digestivos, hemáticos y nerviosos por parte de la población tratada. El objetivo de este trabajo es dar a conocer la efectividad y comportamiento de otras alternativas para el tratamiento de TVT; primero con un protocolo de autohemoterapia y el otro mediante la inmunoterapia con ácido yatrénico mas caseína, que actúan sobre el sistema inmunológico del animal, haciendo que sea el mismo organismo quien realice la eliminación del tumor.

Abstract Transmissible Venereal Tumor (TVT) is a common canine neoplasia; it is mainly located in the genital mucosa. This pathology is highly contagious and can be transmitted by direct contact cell transplantation from a diseased to a non-diseased mucosa. It is primarily diagnosed by cytology and its treatment is chemotherapy being the vincristine sulfate the medicine of choice. The Vincristine has a high rate of effectiveness and low recidivism; however, this alternative has important side effects. The treatment with Vincristine could cause primarily digestive upset, hematological, and nervous diseases. The objective of this work is to determine the efficacy and performance of alternative therapies for the treatment of TVT, firstly, with an autohemoterapy protocol, and using an immunotherapy treatment with yatrenic acid and casein, which acts in the animal's immune system and causes the same organism to eradicate the tumor.

Resumo O Tumor Venéreo Transmissível (TVT), é uma neoplasia comum da espécie canina, localiza-se principalmente na mucosa dos genitais; é altamente contagioso e é o único que pode ser transmitido por transplante de células de contato direto. É diagnosticado por estudo citológico e seu tratamento é a quimioterapia com sulfato de vincristina, a droga de escolha por apresentar alto percentual de eficácia e baixa recorrência; entretanto, efeitos adversos como distúrbios digestivos, sanguíneos e nervosos foram relatados na população tratada. O objetivo deste trabalho é apresentar a eficácia e o comportamento de outras alternativas para o tratamento do TVT; a primeira com um protocolo de auto-hemoterapia e a outra por meio de imunoterapia com ácido yatrênico mais caseína, que atuam no sistema imunológico do animal, fazendo com que o mesmo organismo realize a retirada do tumor.

Analysis on long-term complications and sexual function improvement of TVT surgery and AjustTM sling for treatment of female stress urinary incontinence / 重庆医学

Objective To investigate the long-term complications of TVT surgery and AjustTM sling for treating female stress urinary incontinence and its influence on sexual function.Methods Forty-five female cases of stress urinary incontinence treated in the hospital from January 2013 to December 2015 were retrospectively analyzed,including 27 cases in the TVT group and 18 cases in the AjustTM sling group.The follow-up time lasted for 0.5-2.5 years and the follow up contents included the treatment effects and sexual function improvement.Results Twenty cases among 27 cases in the TVT group and 18 cases in the AjustTM sling group obtained satisfactory followed up.Four cases in the TVT group appeared the long term complications with the occurrence rate of 20.0 ％;there were 2 cases of long term complications in the AjustTM sling group with the occurrence rate of 11.1 ％,the difference between the two groups was statistically significant(P＜0.05),the aspect of sexual function improvement was increased compared with before operation(P＜0.05).Conclusion The occurrence rate of long term complications in the AjustTM sling group is less than that in the TVT group.

Tumor venéreo transmisible canino de presentación atípica. reporte de caso clínico / Canine transmissible venereal tumor of atypical presentation. clinical case report

RESUMEN Se describe el caso de un paciente canino macho entero, raza Bóxer, de ocho años de edad y 30 kg de peso vivo, que ingresó a consulta en el hospital Clínico Veterinario de la Universidad Santo Tomás, sede Santiago, por un aumento de volumen en el ojo derecho, signo clínico con un curso de dos meses de evolución que no respondió al tratamiento con prednisona oral (0,7 mg/kg, dos veces al día (BID), ni a dexametasona y tobramicina en ungüento oftálmico (1 gota, tres veces al día, TID). Al examen físico se observó una masa en el tercer párpado que desplazaba el ojo lateralmente, además de una masa que se palpaba en la base lateral del pene. Se realizó una ecografía ocular que indicó la presencia de una masa de aspecto irregular con parénquima heterogéneo y características neoplásicas en la zona medial del globo ocular derecho y una ecografía abdominal que permitió detectar una masa dorsal a la vejiga. Al realizar citología ecoguiada de las masas intraabdominal y ocular, bajo sedación, se constató una inflamación supurativa, necrosis y displasia epitelial en la masa periorbitaria sugerente de neoplasia, la cual no se pudo diagnosticar fehacientemente; por su parte, la citología de la masa intraabdominal indicó la presencia de Tumor Venéreo Transmisible (TVT). El tratamiento se inició con vincristina (ocho aplicaciones i.v. de 0,7 mg/m2 cada 7 días) lográndose remisión parcial. Ante una posible resistencia al efecto de la quimioterapia, se decidió modificar la terapia a doxorrubicina (30 mg/m2) la cual tuvo respuesta positiva alcanzando remisión completa con una aplicación única.

ABSTRACT An 8 years old, 30 kg live weight, intact male, Boxer breed, was presented at the Santo Tomas Veterinary Teaching Hospital because of a volume increase in his right eye of 2 months of duration; which didn't respond to oral prednisone (0.7 mg/kg, twice a day (BID), or dexamethasone and tobramycin in ophthalmic ointment (1 drop, three times a day, TID). On physical exam, a mass in the third eyelid and another on the base of the penis were noted. Besides that, ocular ultrasonography showed an irregular mass with neoplastic characteristics in the medial area of the eyeball and abdominal ultrasound indicated a mass dorsal to the bladder. Fine needle aspiration of the eye and abdomen masses were done under sedation; cytology of the tumor in the abdomen was compatible with transmissible venereal tumor (TVT) and in the eye the results were suppurative inflammation, necrosis and epithelial dysplasia. Neoplasia couldn't be rule out or confirmed. Initial treatment was started with vincristine (8 applications i.v of 0.7 mg/m2 every 7 days) obtaining a parcial remission; so, considering a possible resistance of the cells to this drug, doxorrubicin (30 mg/rrr2) was used. The patient had a positive response to doxorrubicin achieving complete remission with a single aplication.

¿Existen diferencias entre la vía transobturadora y retropúbica en la resolución de la incontinencia de orina de esfuerzo? / Are there differences between transobturator and retropubic sling in the resolution of stress urinary incontinence?

PROPÓSITO: Comparar la eficacia y complicaciones de la vía retropúbica (TVT o RP) y la vía transobturadora (TVT-O) en el tratamiento quirúrgico de la incontinencia de orina de esfuerzo (IOE). MÉTODOS: Estudio retrospectivo de pacientes con diagnóstico de IOE operadas entre Julio 2004 y Julio 2014 en el Hospital Clínico de la Universidad de Chile. Se evaluaron los datos demográficos, antecedentes médicos, síntomas y examen físico tanto preoperatorio como post operatorio y seguimiento post quirúrgico. RESULTADOS: De un total de 715, se analizaron los datos de 383 pacientes operada durante la fecha. 59,7% (n= 229) fueron sometidas a TVT-O y 40,3% (n=154) a TVT. Un 4,8% (n=11) de las pacientes en que se realizó cinta transobturadora tenían antecedente de cirugía previa de incontinencia versus un 14,29% (n=22) de las pacientes en que se realizó cinta retropúbica (P 0,006). Los datos post operatorios fueron ajustados según el dato anterior. En el seguimiento post operatorio se presentaron diferencias significativas en la disfunción del vaciamiento vesical [OR 0,28, (95%IC 0,10-0,74), p = 0,011]; y en el dolor inguinal post operatorio [OR 0,19 (95%IC 0,06-0,56), p = 0,003); siendo ambos más frecuentes en el grupo transobturador. No hubo diferencias significativas en el éxito subjetivo de la resolución de la IOE así como en otro tipo de complicaciones postoperatorias. CONCLUSIONES: Si bien ambas técnicas presentan tasas similares de éxito subjetivo en la resolución de la IOE, en nuestra experiencia, la vía transobturadora presenta mayor riesgo de disfunción del vaciamiento vesical y dolor inguinal postoperatorio.

PURPOSE: To compare the efficacy and complications of the retropubic sling (TVT or RP) and the transobturator sling (TVT-O or TOT) for the surgical treatment of stress urinary incontinence (SUI). METHODS: Retrospective study including patients diagnosed with SUI who had surgery between July 2004 and July 2014 at the Clinical Hospital of the University of Chile. Demographics, medical history, symptoms and physical examination (preoperative, postoperative and post-surgical follow-up) were evaluated. RESULTS: From a total of 715 operated during this period, the data from 383 patients was analyzed. 59.7% (n = 229) were submitted to TVT-O and 40.3% (n = 154) to TVT. 4.8% (n = 11) of patients in the transobturator sling group had previously had an incontinence surgery versus 14.29% (n = 22) of patients that had a retropubic sling (P 0.006). The postoperative data was adjusted according to this data. At the postoperative follow-up there were significant differences in bladder emptying dysfunction [OR 0.28 (95% CI 0.10 to 0.74), p = 0.011]; and postoperative groin pain [OR 0.19 (95% CI 0.06 to 0.56), p = 0.003); both being more frequent in the transobturator group. There were no significant differences in subjective success of the resolution of the SUI as well as other postoperative complications. CONCLUSIONS: Although both techniques have similar rates of subjective success in solving the SUI, in our experience, the transobturator approach has increased risk of bladder emptying dysfunction and postoperative groin pain.

The long-term effectiveness analysis of retropubic and transobturator tension-free vaginal tape in the treatment of female stress urinary incontinence / 中华泌尿外科杂志

Objective To compare the long-term outcomes of the retropubic tension-free vaginal tape (TVT) versus the transobturator tension-free vaginal tape (TVT-O) for women with stress urinary incontinence (SUI).Methods From July 2001 to June 2011,data of 120 female patients with SUI were retrospectively reviewed,of which 45 patients received TVT treatment,while 75 patients received TVT-O.The median age in TVT group was 45.1 years (range 35-72 years),and the median age in TVT-O group was 50.5 years (range 39-76 years).We retrospectively analyzed the long-term subjective effect,objective effect and the rate of complications in the two groups.Results Median follow-up period was 121 months (range 72-192 months).The complete satisfaction rate was 89％ (40/45) in TVT group,and 92％(69/75) in TVT-O group,with no statistical difference between the two groups.The negative rate of cough test was 84.4％ (38/45) in TVT group,and 76.0％ (57/75)in TVT-O group,with a statistically significant difference.The rate of urinary tract injury was 8.9％ (4/45) in TVT group,and 4.0％ (3/75) in TVT-O group.The rate of thigh pain was 0 in TVT group,and 6.7％ (3/45) in TVT-O group.The rate of micturition frequency and urinary incomplete emptying after operations was 6.7％ (5/75) in TVT group,and 5.3％ (4/75) in TVT-O group.Conclusions The long-term subjective effect between TVT and TVT-O groups was similar.The objective effect in TVT group was better.There was no statistical difference in complication rate between the two groups,which showed different types of complications in different procedures.

The long-term effectiveness analysis of retropubic and transobturator tension-free vaginal tape in the treatment of female stress urinary incontinence / 中华泌尿外科杂志

Objective To compare the long-term outcomes of the retropubic tension-free vaginal tape (TVT) versus the transobturator tension-free vaginal tape (TVT-O) for women with stress urinary incontinence (SUI).Methods From July 2001 to June 2011,data of 120 female patients with SUI were retrospectively reviewed,of which 45 patients received TVT treatment,while 75 patients received TVT-O.The median age in TVT group was 45.1 years (range 35-72 years),and the median age in TVT-O group was 50.5 years (range 39-76 years).We retrospectively analyzed the long-term subjective effect,objective effect and the rate of complications in the two groups.Results Median follow-up period was 121 months (range 72-192 months).The complete satisfaction rate was 89％ (40/45) in TVT group,and 92％(69/75) in TVT-O group,with no statistical difference between the two groups.The negative rate of cough test was 84.4％ (38/45) in TVT group,and 76.0％ (57/75)in TVT-O group,with a statistically significant difference.The rate of urinary tract injury was 8.9％ (4/45) in TVT group,and 4.0％ (3/75) in TVT-O group.The rate of thigh pain was 0 in TVT group,and 6.7％ (3/45) in TVT-O group.The rate of micturition frequency and urinary incomplete emptying after operations was 6.7％ (5/75) in TVT group,and 5.3％ (4/75) in TVT-O group.Conclusions The long-term subjective effect between TVT and TVT-O groups was similar.The objective effect in TVT group was better.There was no statistical difference in complication rate between the two groups,which showed different types of complications in different procedures.

A control study on the clinical outcome of tension-free vaginal tape-obturator and modified tension-free vaginal tape-obturator for female stress urinary incontinence / 西安交通大学学报(医学版)

ABSTRACT:Objective To evaluate the curative effect of tension-free vaginal tape-obturator (TVT-O)and modified TVT-O in treating female stress urinary incontinence (SUI).Methods We selected 1 1 3 female patients diagnosed with SUI from January to December 2013 in our department and divided them into standard TVT-O group (group A,5 6 cases)and modified TVT-O group (group B,5 7 cases).We evaluated prospectively the safety,short-term efficacy and complications of operation in the two groups.Results The length from bilateral obturator membrane to the puncture point in the skin was greater in group A than in group B.The average intraoperative blood loss was more in group A than in group B.The median NRS score of postoperatie thigh pain in group A was higher than in group B (P0.05).Conclusion Both TVT-O and modified TVT-O techniques are effective in treating female SUI.Modified TVT-O has a short path to get through the adductor muscles and less intraoperative blood loss;therefore,it can significantly reduce the complications such as postoperative pain to enhance the quality of life after operation. 

Tension-free vaginal tape-Abbrevo procedure for female stress urinary incontinence: a prospective analysis over 22 months

<p><b>INTRODUCTION</b>We aimed to study the efficacy and safety of the tension-free vaginal tape (TVT)-Abbrevo procedure for female stress urinary incontinence (SUI).</p><p><b>METHODS</b>This was a prospective cohort study that aimed to determine the subjective and objective cure, improvement of SUI and incidence of complications among women who underwent TVT-Abbrevo for SUI during a period of 22 months from September 2011 to June 2013.</p><p><b>RESULTS</b>A total of 76 patients, with a mean age of 48.2 ± 8.1 years, underwent TVT-Abbrevo during the study period. Among them, 86.8% had vaginal delivery and 5.3% had instrumental delivery. Mean parity was 2.3 ± 0.8 and mean body mass index was 27.0 ± 5.0 kg/m. 11 (14.5%) patients had previously tried physiotherapy. Mean follow-up duration was 12.3 ± 5.6 months. The subjective cure rate for SUI at one-month, six-month and one-year follow-up was 95.7%, 90.8%, and 90.6%, respectively. Among the nine patients who completed the two-year follow-up, 88.9% reported either cure or improvement of SUI. At six months, the proportion of patients with objective cure was 86.8%, and the rates of postoperative groin pain and complications were low. In addition, overactive bladder symptoms disappeared in 76.3% of patients.</p><p><b>CONCLUSION</b>Our results are comparable with those of other studies, although long-term results remain to be seen.</p>

Estudo da variação neutropênica pelo sulfato de vincristina em cães com tvt tratados em um hospital veterinário do noroeste paulista / Neutropenic variation by vincristine sulfate in tvt dogs treated in a veterinary hospital in northwestern são paulo / Estudio de la variación neutropénica por sulfato de vincristina en perros con tvt tratados en el hospital veterinario del noroeste paulista

O presente estudo avaliou dados epidemiológicos de neutropenia induzida por sulfato vincristina em cães com Tumor Venéreo Transmissível (TVT), num Hospital Veterinário do Noroeste paulista. Para tanto, trata-se de um estudo do tipo retrospectivo de protocolos eletrônicos e formulários manuais de dados digitalizados de 51 casos de TVT. O atendimento ambulatorial e de internação desses animais foi realizado no período de setembro de 2006 a dezembro de 2009. Dentre os resultados, destaca-se que 51 animais foram diagnosticados com TVT, sendo 37 fêmeas (73%) e 14 (27%) machos; 46 animais (90,2%) foram tratados exclusivamente com sulfato de vincristina. Os cães Sem Raça Definida-SRD (n=28) foram os maiores acometidos com 54,9%; seguidos pelos Poodles com quatro cães (7,84%). Os animais com idade entre 37 e 84 meses obtiveram a maior porcentagem de acometimento pelo TVT com 20 casos (39,22%). Em doze animais (23,52%) foi observada neutropenia (valores entre 390 a 1927 cél/µL). Conclusão: a possível toxicidade medular induzida pela vincristina foi verificada pela descrição da neutropenia. Dessa forma, a identificação de quadros neutropênicos, por meio da realização de hemogramas semanais, é considerada obrigatória e de extrema relevância devido à prevalência de mielotoxicidade secundária à utilização deste quimioterápico.

The present study aims to assess epidemiological data on neutropenia induced by vincristine sulfate among dogs with Canine Transmissible Venereal Tumor (CTVT) at a veterinary hospital in the Northwestern region in the São Paulo State. Methodology: This is a retrospective study of electronic protocols and digitalized data from manually filled form from 51 CTVT cases. These animals were treated in an outpatient care clinic and hospitalization took place from September 2006 to December 2009. Results: 51 animals were diagnosed with CTVT; among these, 37 were female (73%) and 14 were male (27%). From these, 46 animals (90.2%) were treated exclusively with vincristine sulfate. Among them, mongrels (n=28) were the most common, with 54.9%, followed by Poodles, with 4 dogs (7.84%). Animals aged from 37 and 84 months were the largest age group, with 20 cases (39.22 %). Neutropenia (390 to 1927 cells/µL) was observed in 12 animals. Conclusion: possible vincristine-induced marrow toxicity was verified by the description of neutropenia. Thus, neutropenia identification through weekly blood count cells is considered extremely important and mandatory due to the prevalence of myelotoxicity following treatment with this chemotherapeutic drug.

Este estudio busca evaluar datos epidemiológicos de neutropenia inducida por sulfato vincristina en perros con Tumor Venéreo Transmisible (TVT), en un Hospital Veterinario del Noroeste Paulista. Es un estudio del tipo retrospectivo de protocolos electrónicos y formularios manuales de datos digitalizados de 51 casos de TVT. El atendimiento de ambulatorio y de internación de esos animales se realizó en el período de septiembre de 2006 a diciembre de 2009. Entre los resultados, se destaca que 51 animales fueron diagnosticados con TVT, siendo 37 hembras (73%) y 14 (27%) machos; 46 animales (90,2%) fueron tratados exclusivamente con sulfato de vincristina. Los perros Sin Raza Definida ? SRD (n=28) fueron los más acometidos con 54,9%; seguidos por los Poodles con cuatro perros (7,84%). Los animales con edad entre 37 y 84 meses obtuvieron mayor porcentaje de acometimiento por TVT, con 20 casos (39,22%). En doce animales (23,52%0 se ha observado neutropenia (valores entre 390 a 1927 cél/µL). Conclusión: la posible toxicidad medular inducida por vincristina se ha verificado por la descripción de la neutropenia. Así, la identificación de cuadros neutropénicos por medio de realización de hemogramas semanales, es considerada obligatoria y de extrema relevancia debido a la prevalencia de mielotoxicidad secundaria a la utilización de este quimioterápico.

Estudo da variação neutropênica pelo sulfato de vincristina em cães com tvt tratados em um hospital veterinário do Noroeste Paulista / Neutropenic variation by vincristine sulfate in tvt dogs treated in a veterinary hospital in northwestern São Paulo / Estudio de la variación neutropénica por sulfato de vincristina en perros con tvt tratados en el hospital veterinario del Noroeste Paulista

O presente estudo avaliou dados epidemiológicos de neutropenia induzida por sulfato vincristina em cães com Tumor Venéreo Transmissível (TVT), num Hospital Veterinário do Noroeste paulista. Para tanto, trata-se de um estudo do tipo retrospectivo de protocolos eletrônicos e formulários manuais de dados digitalizados de 51 casos de TVT. O atendimento ambulatorial e de internação desses animais foi realizado no período de setembro de 2006 a dezembro de 2009. Dentre os resultados, destaca-se que 51 animais foram diagnosticados com TVT, sendo 37 fêmeas (73%) e 14 (27%) machos; 46 animais (90,2%) foram tratados exclusivamente com sulfato de vincristina. Os cães Sem Raça Definida-SRD (n=28) foram os maiores acometidos com 54,9%; seguidos pelos Poodles com quatro cães (7,84%). Os animais com idade entre 37 e 84 meses obtiveram a maior porcentagem de acometimento pelo TVT com 20 casos (39,22%). Em doze animais (23,52%) foi observada neutropenia (valores entre 390 a 1927 cél/µL). Conclusão: a possível toxicidade medular induzida pela vincristina foi verificada pela descrição da neutropenia. Dessa forma, a identificação de quadros neutropênicos, por meio da realização de hemogramas semanais, é considerada obrigatória e de extrema relevância devido à prevalência de mielotoxicidade secundária à utilização deste quimioterápico...

The present study aims to assess epidemiological data on neutropenia induced by vincristine sulfate among dogs with Canine Transmissible Venereal Tumor (CTVT) at a veterinary hospital in the Northwestern region in the São Paulo State. Methodology: This is a retrospective study of electronic protocols and digitalized data from manually filled form from 51 CTVT cases. These animals were treated in an outpatient care clinic and hospitalization took place from September 2006 to December 2009. Results: 51 animals were diagnosed with CTVT; among these, 37 were female (73%) and 14 were male (27%). From these, 46 animals (90.2%) were treated exclusively with vincristine sulfate. Among them, mongrels (n=28) were the most common, with 54.9%, followed by Poodles, with 4 dogs (7.84%). Animals aged from 37 and 84 months were the largest age group, with 20 cases (39.22 %). Neutropenia (390 to 1927 cells/µL) was observed in 12 animals. Conclusion: possible vincristine-induced marrow toxicity was verified by the description of neutropenia. Thus, neutropenia identification through weekly blood count cells is considered extremely important and mandatory due to the prevalence of myelotoxicity following treatment with this chemotherapeutic drug...

Este estudio busca evaluar datos epidemiológicos de neutropenia inducida por sulfato vincristina en perros con Tumor Venéreo Transmisible (TVT), en un Hospital Veterinario del Noroeste Paulista. Es un estudio del tipo retrospectivo de protocolos electrónicos y formularios manuales de datos digitalizados de 51 casos de TVT. El atendimiento de ambulatorio y de internación de esos animales se realizó en el período de septiembre de 2006 a diciembre de 2009. Entre los resultados, se destaca que 51 animales fueron diagnosticados con TVT, siendo 37 hembras (73%) y 14 (27%) machos; 46 animales (90,2%) fueron tratados exclusivamente con sulfato de vincristina. Los perros Sin Raza Definida – SRD (n=28) fueron los más acometidos con 54,9%; seguidos por los Poodles con cuatro perros (7,84%). Los animales con edad entre 37 y 84 meses obtuvieron mayor porcentaje de acometimiento por TVT, con 20 casos (39,22%). En doce animales (23,52%0 se ha observado neutropenia (valores entre 390 a 1927 cél/µL). Conclusión: la posible toxicidad medular inducida por vincristina se há verificado por la descripción de la neutropenia. Así, la identificación de cuadros neutropénicos por medio de realización de hemogramas semanales, es considerada obligatoria y de extrema relevancia debido a la prevalencia de mielotoxicidad secundaria a la utilización de este quimioterápico...

Seguimiento a 6 meses de mujeres tratadas con cabestrillos mediouretrales para Incontinencia Urinaria de Esfuerzo entre 2007 y 2009, en la Clínica Universitaria Pontificia Bolivariana en la ciudad de Medellín (Colombia): cohorte histórica / Six months follow up of females treated with medium tension-free urethral slings for Urinary Stress Incontinence between 2007 and 2009 at the Pontificia Bolivariana teaching hospital in the city of Medellin, Colombia: historical cohort

Objetivo: describir las complicaciones intraoperatorias y tempranas, el estado de continencia posquirúrgica, así como la satisfacción posquirúrgica a los 6 meses de la cirugía para el manejo de la IUE con cabestrillos medio uretrales. Materiales y métodos: cohorte retrospectiva constituida por 231 pacientes, atendidas en la Clínica Universitaria Pontificia Bolivariana durante el período comprendido entre enero de 2007 a diciembre de 2009. Todas las pacientes fueron clasificadas con urodinamia, y en todas se utilizó material quirúrgico similar. Además se contó con el aval del comité de ética de la institución. Se describen las características sociodemográficas, clínicas, complicaciones intraoperatorias y tempranas, estado de continencia subjetiva y satisfacción posquirúrgica. Resultados: se realizó un total de 231 cirugías con cabestrillo mediouretral, en la Clínica Universitaria Bolivariana durante este período. Se evaluaron 181 pacientes en el posquirúrgico inmediato, de continencia luego de la cirugía; el 4,3% de las pacientes presentaron morbilidad intraoperatoria. Se evidenciaron 2 lesiones vesicales asociadas al TVT. A los 6 meses se encontró incontinencia leve en el 3,9%, moderada en el 2,4%, y severa en el 6,9% de las pacientes. Conclusiones: el tratamiento para la incontinencia urinaria de esfuerzo con cabestrillo mediouretral tiene bajos porcentajes de complicaciones intraoperatorias y tempranas secundarias a la técnica quirúrgica. El seguimiento a los 6 meses es satisfactorio para las pacientes y presenta bajas tasas de recurrencia de la IUE.

Objective: describing intraoperation and early complications and the state of post-surgical continence as well as post-surgery satisfaction 6 months after surgery for managing Urinary Stress Incontinence with medium tension-free urethral slings. Materials and methods: a retrospective cohort consisted of 231 patients who were attended at the Pontificia Bolivariana teaching hospital in Medellin from January 2007 to December 2009. All of them were classified by means of urodynamic tests and surgical treatment was done using similar material; the institution’s ethics committee approved the study. The sociodemographic and clinical characteristics were described, as were intraoperation and early complications, state of subjective continence and post-surgery satisfaction. Results: a total of 231 surgeries involving medium tension-free urethral sling were performed at the Bolivariana teaching hospital during this period. 181 patients were evaluated during the immediate post-surgery period and 97.3% were found to have become continent following such surgery and 4.3% of the patients presented intra-operation morbidity. There were 2 lesions of the bladder associated with tension-free vaginal tape (TVT). Slight incontinence was found in 3.9% of the patients’ after six months, moderate incontinence in 2.4% and severe incontinence in 6.9%. Conclusions: treating urinary effort incontinence with medium tension-free urethral sling resulted in a low percentage of intraoperation and early complications secondary to the surgical technique used. 6-month follow-up showed that patients were satisfied and low UEI recurrence rates were presented.

TVT versus TVTO: revisão bibliográfica para escolha e implantação da melhor técnica cirúrgica para correção de incontinência urinária de esforço em mulheres no Hospital do Campo Limpo

Objetivo: o presente estudo tem por objetivo comparar o melhor resultado terapêutico das cirúrgias TVT e TVTO para correção da incontinência urinária de esforço, levando em consideração a eficácia terapêutica, tempo cirúrgico e complicações no intra e pós operatórias. (...)

TVT versus TVTO: revisão bibliográfica para escolha e implantação da melhor técnica cirúrgica para correção de incontinência urinária de esforço em mulheres no Hospital do Campo Limpo / TVT versus TVTO: literature review the choice and implementation of best surgical technique for correction of stress urinary incontinence in women in the Hospital do Campo Limpo

Objetivo: o presente estudo tem por objetivo comparar o melhor resultado terapêutico das cirúrgias TVT e TVTO para correção da incontinência urinária de esforço, levando em consideração a eficácia terapêutica, tempo cirúrgico e complicações no intra e pós operatórias...

Efficacy and safety of TVT-Secur procedure for treatment of female stress urinary incontinence / 中华泌尿外科杂志

Objective To evaluate the efficacy and safety of the TVT-Secur procedure for female stress urinary incontinence (SUI). Methods Analyze retrospectively the preoperative, intraoperative and postoperative complications and follow-up data of 27 SUI patients from October 2008 to May 2010. 20 cases were simple SUI, and 7 cases were mixed SUI. The average age was 56.1 ± 10.7 years (range, 35-77), the average parity was 2.8-±- 1.4 (range, 1-6), the average body mass index was 25.6±2.5, and the average course of the disease was 6.8±7.2 yeas (range, 1-30). Two cases had past history of pelvic surgery without any anti-incontinence surgery. Mashall-marchett test was positive in all patients, with an average abdominal leak point pressure (ALPP) of 60.9±27.5 cm H2O (range, 27- 120 cm H2O). The mean International Consultation on Incontinence-Short Form (ICIQ-SF) score was 11.2 ± 1.8 (range, 7- 14) before surgery. Results 27 patients underwent TVT-Secur procedure, of which 19 cases underwent "U" procedure, and 8 cases underwent "H" procedure. The mean operation time was 15.3±1.4min (range, 13- 19 min). There were no intraoperative bladder or urethral injury, and no obturator vessel or nerve damage. The blood loss was 10 to 50 ml, and the maximum urinary flow rate was 25. 4±13. 1 ml (range, 4-50 ml). Three eases had mild dysuria(11. 1%), and 3 cases had wound effusion(11. 1%). Followed up for 12. 6 ±6. 7 months (range, 3-21 months). 10 cases complained of bladder overactivity symptoms such as frequency, urgency, and urge incontinence, and no case had vaginal erosion. Therapeutic efficacy: 15 cases were cured (56%), 8 cases were improved (30%), and 4 cases were ineffective (15%). Conclusions TVT-Secur procedure is a simple, safe and minimally invasive surgery, while the cure rate is low. The long-term efficacy needs great amount of clinical data and long-term follow-up to prove.

Tumor venéreo transmisible con metástasis a un hemangioma esplénico en una perra / Transmissible venereal tumor with metastasis to a spleen hemangioma in a bitch

This report describes a case of transmissible venereal tumor (TVT) with metástasis to spleen in areas previously affected with a hemangioma in an adult mongrel stray bitch. In addition, the animal had seborrheic dermatitis associated with demodicosis, suggesting a deficient immune response. In Mexico, TVT is a common entity; however, metastases to internal organs are extremely rare. This is the first report of metastasis of TVT to an internal organ with a previous established tumour.

Este informe describe un caso del tumor venéreo transmisible (TVT) con metástasis en bazo y en áreas previamente afectadas con hemangioma en una perra adulta mestiza. Además, el animal tenía dermatitis seborreica asociada con dermodicosis, la cual sugería una respuesta inmune deficiente. En México, el TVT canino es una entidad común; sin embargo, las metástasis a los órganos internos son extremadamente raras. Este es el primer informe de metástasis de TVT a un órgano interno con un tumor previamente establecido.

Resultados de cirugía tipo TVT con un seguimiento mínimo de 6 años / Results of TVT-type surgery with a minimum follow-up of 6 years

Introducción: El objetivo de este trabajo es mostrar los resultados a largo plazo de la técnica TVT con un seguimiento mínimo de 6 años. Material y método: Con insumos de fabricación local y usando la técnica del TVT, 108 pacientes fueron operadas entre enero de 2002 y agosto de 2003. Los datos analizados fueron: edad, número de partos, cirugías previas, estado nutricional, tiempo de operación, de sonda uretro-vesical y estadía en hospital, residuo posmiccional, complicaciones y continencia urinaria. Resultados: Edad promedio 53 años (27-76). Tiempo de seguimiento promedio 80 meses (72-90). Índice masa corporal promedio 29, número de partos promedio 3,5. Tiempo quirúrgico promedio 33 minutos (15-70). Días promedio de hospitalización 1,09 (1-3).Residuo posmiccional promedio 39,3 cc. Complicaciones: Perforación vesical 14 (13 por ciento),retención urinaria 3 (3 por ciento), ITU aguda no complicada 1 (1 por ciento), infección de herida operatoria1 (1 por ciento). La tasa de continencia con pacientes secas sin uso de protectores fue de 83 por ciento. En 12 pacientes (11 por ciento) se desarrolló una urgencia miccional de novo, la que ha sido manejada en forma satisfactoria con anticolinérgicos. Discusión: Podemos concluir que la técnica de sling retropúbico es un procedimiento con buenos resultados a largo plazo, mínimamente invasiva y con una tasa de complicaciones aceptables que pueden habitualmente ser resueltas sin mayores problemas en la práctica clínica habitual del urólogo. Los resultados son además concordantes con otras series tanto nacionales como internaciones.

Introduction: The aim of this paper is to show the long-term results of TVT technique with minimal follow-up of 6 years. Materials and methods: With local manufacturing devices and using the technique of TVT, 108 patients were operated between January2002 and August 2003. The data analyzed were age, parity, previous surgery, nutritional status, surgical time, Foley catheter and hospital stay, post void residual urine, complications and urinary continence. Results: Median age 53 years (27-76). Mean follow-up time 80 months (72-90). Mean body mass index 29, mean parity 3.5. Mean operative time 33 minutes (15-70). Mean hospital days 1.09 (1-3). Mean post void residual urine 39.3 cc. Complications: bladder perforation 14 (13 percent), urinary retention, 3 (3 percent), uncomplicated urinary tract infection 1 (1 percent), wound infection 1 (1 percent). The continence rate with dry patients was 83 percent. 12 patients (11 percent) developed de novo urgency, which has been satisfactorily treated with anticholinergics. Discussion: We conclude that retropubic sling is a procedure with successful long-term results, minimally invasive, with acceptable complications that can usually be resolved without problems in clinical practice by urologist. The results are also consistent with other series both national and international.