Does the design of mini slings anchoring systems really matter? A biomechanical comparison between Mini Arc™ and Ophira™. / ¿El diseño de sistemas de anclaje mini cabestrillo realmente importa? Una comparación biomecánica entre Mini Arc™y Ophira™.

INTRODUCTION AND HYPOTHESIS: Currently, a sling implant is the standard treatment for stress urinary incontinence in women. To be effective, they require an adequate anchoring system. The aim of this study is compare biomechanical features of fixation systems of two mini slings models available on the market (Ophira™ and Mini Arc™) through a tensile test. MATERIALS AND METHODS: Anchoring devices of each sling were surgically implanted in abdominal wall of 15 rats divided into three groups of five animals which were arranged according to the date of post implant euthanasia on 7, 14 and 30 days. Abdominal walls of rats were extracted on bloc containing the anchoring system and were submitted to a tensile strength test to measure the maximum load and elongation until device avulsion from the tissue. The results were compared using Student test t and a 5% cut off was considered significant. RESULTS: The Ophira™ mini sling fixation system demanded a greater maximum load and developed a longer stretch for avulsion from the implanted site at all moments evaluated (p value less than 0.05). CONCLUSION: There were significant differences in fixation patterns of the anchoring systems, which were exclusively related to their designs. The Ophira™ mini sling fixation device provided better fixation to the abdominal wall of rats compared to the Mini Arc™ device, even in the late post implant period.

The effect of ovariectomy and estradiol replacement on collagen and elastic fibers in the bladder of rats.

The authors quantified the collagen and elastic fibers in the bladder wall of ovariectomized rats with and without estradiol replacement. This study was conducted on 60 3-month-old Wistar rats. Group 1 remained intact; group 2 underwent bilateral ovariectomy and were sacrificed after 30 days; group 3 were sham operated and sacrificed after 30 days; group 4 had a bilateral ovariectomy and after 30 days were started on subcutaneous injections of 17beta-estradiol (10 microg/kg body weight) for 90 days; group 5 were sham operated and after 30 days were on started subcutaneous sesame oil replacement (0.2 ml/day) for 90 days; group 6 had a bilateral ovariectomy and after 30 days were started on subcutaneous sesame oil replacement (0.2 ml/day) for 90 days. Sirius red and Weigert's resorcin-fuchsin were used to stain collagen and elastic fibers on paraffin-embedded rat bladder sections. The M-42 grid system was used to quantitatively analyze the fibers. Ovariectomy had no effect on the volumetric density and absolute volume of the collagen and elastic fibers in the bladder wall of rats, or on the weight of the bladder. Estradiol replacement in castrated animals did not demonstrate any significant difference in the stereological parameters compared to the castrated group without hormonal replacement.

Endourologic approach of ureteral gunshot lesion.

We report a case which demonstrates that to approach an ureteral gunshot lesion endourologically may be an alternative to surgical intervention. We believe that drainage of a damaged ureter should, in selected cases, constitute the first option. This procedure often is successful, but may not be feasible in all cases. We do not believe that simple catheter drainage should replace standard surgical procedures. However, it presents a less invasive treatment alternative which still adheres to conventional surgical principles if a proper patient selection is made.