The efficacy and safety of urethral injection therapy for urinary incontinence in women: a systematic review

To evaluate the efficacy and safety of different bulking agents for treating urinary incontinence in women, a systematic review including only randomized controlled trials was performed. The subjects were women with urinary incontinence. The primary outcomes were clinical and urodynamic parameters. The results were presented as a weighted mean difference for non-continuous variables and as relative risk for continuous variables, both with 95% confidence intervals. Initially, 942 studies were identified. However, only fourteen eligible trials fulfilled the prerequisites. Altogether, the review included 1814 patients in trials of eight different types of bulking agents, and all studies were described and analyzed. The measured outcomes were evaluated using a large variety of instruments. The most common complications of the bulking agents were urinary retention and urinary tract infection. Additionally, there were certain major complications, such as one case of death after use of autologous fat. However, the lack of adequate studies, the heterogeneous populations studied, the wide variety of materials used and the lack of long-term follow-up limit guidance of practice. To determine which substance is the most suitable, there is a need for more randomized clinical trials that compare existing bulking agents based on standardized clinical outcomes.

A new proposal to evaluate the healing of open skin wounds: volumetry / Nova proposta para avaliar cicatrização de ferida cutânea aberta: volumetria

PURPOSE: To present a new proposal to evaluate the healing of an open subcutaneous and skin wound, which we termed "volumetry". METHODS: A total of 32 circular wounds were performed in the subcutaneous tissues and skin of four feet of pigs (8 each). Each wound had about 1 cm in diameter and was 0.2 cm deep. Volume was calculated from the wound filled with saline and mass Xantopren. With the aid of a magnifying glass and local lighting, the liquid was dripped with a micropipette inside the wound until complete fullness. Volume repletion was calculated in microliters, corresponding to the volume of the wound. The mass of Xantopren was placed inside the wound to obtain a mold of the lesion. Mold volume was calculated using the formula of the volume of a cylinder closest resembling a geometric figure with mold. RESULTS: The calculation of wound volume was possible with both Xantopren and mold techniques. Volume as calculated by micropipette was 119.37 ± 30.87 microliters while the volume calculated by mold was 122.41 ± 33.90 mm3 (p=0.79). CONCLUSIONS: Volumetry in pig feet is simple and reproducible. Volumetry perfomed with saline did not differ from the volumetry with mass Xantopren. This method may be a useful tool to help evaluate the healing of open skin wounds in experimental and clinical research.

OBJETIVO: Apresentar nova proposta para avaliar a cicatrização de uma ferida cutânea aberta, denominada "volumetria." MÉTODOS: Foram provocadas 32 feridas circulares cutâneas, com cerca de 1 cm de diâmetro e 0.2 cm de profundidade, em quatro patas de suíno. O volume da ferida foi calculado com solução salina e massa de xantopren. O líquido foi gotejado com uma micropipeta no interior da ferida até sua completa repleção, o que foi auxiliado com uma lupa de aumento e iluminação local. O volume de repleção foi calculado em microlitros e correspondeu ao volume da ferida. A massa de xantopren foi colocada no interior da ferida para se obter um molde da lesão. O volume do molde foi calculado utilizando-se a fórmula do volume de um cilindro que foi a figura geométrica mais parecida com o molde. RESULTADOS: O cálculo do volume da ferida foi possível com as duas técnicas propostas. O volume calculado pela micropipeta foi 119.37 ± 30.8693 microlitros e o volume calculado pelo molde foi 122.4088 ± 33.8997 mm³ (p=0.79). CONCLUSÕES: A volumetria realizada em patas de suíno é um método simples, reprodutível. A volumetria realizada com líquido não diferiu da volumetria realizada com massa de Xantopren. Esse método poderá ser útil para auxiliar na análise da cicatrização da ferida cutânea aberta em trabalhos clínicos e experimentais.

Polidimetilsiloxano(PDMS) como contraste radiológico no ROLL / Polydimethilsiloxane (PDMS) as radiological contrast in the ROLL

Na marcação estereotáxica para o ROLL (radioguided occult lesion localisation) utiliza-se contrasteiodado não-iônico para confirmação do posicionamento do MAA-99mTc (tecnécio pertecnetatoassociado à albumina humana) no tecido mamário. A alergia ao iodo constitui um dos fatoreslimitantes deste passo técnico. A informação de posicionamento incorreto, previamente ao atooperatório, também pode impedir retirada cirúrgica inadequada. Em uma paciente sabidamentealérgica ao contraste iodado, utilizou-se PDMS (polidimetilsiloxano) como contraste radiológicono ROLL, o que permitiu a correta retirada da lesão suspeita, sem interferências nos processamentoscintilográfico, histológico e imunohistoquímico.

For stereotactic marking of the ROLL (Radioguided Occult Lesion Localisation), non-ionic iodized contrastis used for confirmation of the MAA-99mTc (Technetium-99m Pertecnetate Human Serum AlbuminMacroaggregated) positioning in the mammary tissue. The allergy to iodine constitutes one ofthe difficulties of this technical step. Pre-surgery incorrect information may lead to inadequate surgicalwithdrawal. In a patient allergic to iodized contrast, PDMS (polydimethilsiloxane) was used as radiologicalcontrast in the ROLL, which enabled to correct lesion withdrawal without interferences in thescintigraphic, histological and imunehistochemical processings.