[Retropubic and transobturator sling in treatment of stress urinary incontinence].

OBJECTIVE: To compare the results of retropubic and transobturator slings for surgical treatment of female stress urinary incontinence (SUI). METHODS: We randomized thirty patients with SUI, ten of whom underwent transobturator sling surgery and ten retropubic sling surgery. Patients were assessed before treatment and 1, 6 and 12 months after treatment on the basis of clinical history, physical examination, quality of life questionnaire (King's Health Questionnaire), pad test and urodynamic evaluation. The groups were homogenous prior to surgery. RESULTS: One year after surgery, incontinence and quality of life parameters had improved significantly in both groups and there were no differences between them. There was a significant reduction in pad test weights in both groups. According to the urodynamic evaluation, 12 months after surgery cure rates were 84.2% for the transobturator group and 88.8% for the retropubic group. Subjective cure rates were 85% in the transobturator group and 88.8% in the retropubic group. No statistical difference was observed in complication rates. CONCLUSION: Retropubic and transobturator slings were effective for treatment of women with SUI at 12-month follow-up. Both techniques had significant cure rates and improved quality of life with low complication rates.

"Sling" retropúbico e transobturatório no tratamento da incontinênca urinária de esforço: [revisão] / Retropubic and transobturator sling in treatment of stress urinary incontinence: [review]

OBJETIVO: Comparar resultados das técnicas de "sling" retropúbico e transobturador para o tratamento de mulheres com incontinência urinária de esforço (IUE). MÉTODOS: Foram randomizadas 30 pacientes, sendo que 20 se submeteram ao sling retropúbico e 10 ao transobturador. As pacientes foram avaliadas antes e após o tratamento com um, seis e 12 meses, por meio de história clínica, exame físico, questionário de qualidade de vida ("King's Health Questionnaire"), teste do absorvente e avaliação urodinâmica. Os grupos foram homogêneos no pré-operatório. RESULTADOS: Houve melhora significante na avaliação da qualidade de vida em ambos os grupos após a terapêutica, sem diferença entre os grupos. Houve diminuição no peso do absorvente para os dois grupos. As taxas de cura pela avaliação urodinâmica em 12 meses foram de 84,2 por cento para o grupo transobturador e 88,8 por cento para o retropúbico. Da mesma forma, a cura subjetiva foi de 85 por cento e 88,8 por cento, respectivamente. Não observamos diferenças entre os grupos consoante as complicações. CONCLUSÃO: As cirurgias deste sling, pelas vias retropúbica e transobturadora, foram eficazes para o tratamento de mulheres com IUE, no seguimento de 12 meses. Observamos elevada taxa de cura e melhora da qualidade de vida com baixos índices de complicações.

OBJECTIVE: The aim of this study was to compare results of retropubic and transobturator sling for surgical treatment of female stress urinary incontinence (SUI). METHODS: Thirty randomized patients with SUI were divided in two groups, twenty who underwent the transobturator sling and ten the retropubic sling procedure. .Patients were assessed before and after one, six and twelve months of treatment by clinical history, physical examination, quality of life questionnaire (King's Health Questionnaire), pad test and urodynamic parameters. At preoperative both groups were homogenous. RESULTS: One year after surgery, incontinence and quality of life questionnaire parameters had improved significantly in both groups and there was no difference between them. There was significant reduction in the pad test in both groups. Concerning urodynamic evaluation, one year after surgery cure rates were 84.2 percent for the transobturator group and 88.8 percent for the retropubic,. Subjective cure rate was 85 percent in the transobturator group and 88.8 percent in the retropubic. No statistical difference was found in complications rates. CONCLUSION: Retropubic and transobturator slings were effective in treatment of female SUI at one-year follow-up. Both techniques had significant cure rates and improved the quality of life with few complications.