<?xml version="1.0" encoding="ISO-8859-1"?><article xmlns:mml="http://www.w3.org/1998/Math/MathML" xmlns:xlink="http://www.w3.org/1999/xlink" xmlns:xsi="http://www.w3.org/2001/XMLSchema-instance">
<front>
<journal-meta>
<journal-id>2007-4085</journal-id>
<journal-title><![CDATA[Revista mexicana de urología]]></journal-title>
<abbrev-journal-title><![CDATA[Rev. mex. urol.]]></abbrev-journal-title>
<issn>2007-4085</issn>
<publisher>
<publisher-name><![CDATA[Sociedad Mexicana de Urología]]></publisher-name>
</publisher>
</journal-meta>
<article-meta>
<article-id>S2007-40852021000100002</article-id>
<article-id pub-id-type="doi">10.48193/revistamexicanadeurologa.v81i1.708</article-id>
<title-group>
<article-title xml:lang="es"><![CDATA[Reajuste de Sling TOT: ¿vale la pena?]]></article-title>
<article-title xml:lang="en"><![CDATA[TOT sling adjustment: is it worth it?]]></article-title>
</title-group>
<contrib-group>
<contrib contrib-type="author">
<name>
<surname><![CDATA[Malizia-Reynoso]]></surname>
<given-names><![CDATA[Enzo Andrea]]></given-names>
</name>
<xref ref-type="aff" rid="Aff"/>
</contrib>
<contrib contrib-type="author">
<name>
<surname><![CDATA[Olmedo]]></surname>
<given-names><![CDATA[José Javier]]></given-names>
</name>
<xref ref-type="aff" rid="Aff"/>
</contrib>
<contrib contrib-type="author">
<name>
<surname><![CDATA[Racca]]></surname>
<given-names><![CDATA[María Laura]]></given-names>
</name>
<xref ref-type="aff" rid="Aff"/>
</contrib>
<contrib contrib-type="author">
<name>
<surname><![CDATA[Quintero]]></surname>
<given-names><![CDATA[Leandro Marcos]]></given-names>
</name>
<xref ref-type="aff" rid="Aff"/>
</contrib>
<contrib contrib-type="author">
<name>
<surname><![CDATA[Dellavedova]]></surname>
<given-names><![CDATA[Tristán]]></given-names>
</name>
<xref ref-type="aff" rid="Aff"/>
</contrib>
<contrib contrib-type="author">
<name>
<surname><![CDATA[Minuzzi]]></surname>
<given-names><![CDATA[Susana]]></given-names>
</name>
<xref ref-type="aff" rid="Aff"/>
</contrib>
</contrib-group>
<aff id="Af1">
<institution><![CDATA[,Fundación Urológica Córdoba para la Docencia e Investigación Médica  ]]></institution>
<addr-line><![CDATA[Córdoba ]]></addr-line>
<country>Argentina</country>
</aff>
<pub-date pub-type="pub">
<day>00</day>
<month>02</month>
<year>2021</year>
</pub-date>
<pub-date pub-type="epub">
<day>00</day>
<month>02</month>
<year>2021</year>
</pub-date>
<volume>81</volume>
<numero>1</numero>
<copyright-statement/>
<copyright-year/>
<self-uri xlink:href="http://www.scielo.org.mx/scielo.php?script=sci_arttext&amp;pid=S2007-40852021000100002&amp;lng=en&amp;nrm=iso"></self-uri><self-uri xlink:href="http://www.scielo.org.mx/scielo.php?script=sci_abstract&amp;pid=S2007-40852021000100002&amp;lng=en&amp;nrm=iso"></self-uri><self-uri xlink:href="http://www.scielo.org.mx/scielo.php?script=sci_pdf&amp;pid=S2007-40852021000100002&amp;lng=en&amp;nrm=iso"></self-uri><abstract abstract-type="short" xml:lang="es"><p><![CDATA[Resumen  Introducción:  Desde su introducción, el sling TOT se instaló rápidamente como una opción segura y efectiva para el tratamiento de la incontinencia de orina de esfuerzo (IOE) femenina. Con el desarrollo del sling TOT reajustable, se adquirió la posibilidad de reacomodarlo si los resultados funcionales no hubieran sido óptimos (persistencia de IOE).  Objetivos:  Analizar los resultados globales de nuestra serie de casos en términos de éxito funcional y complicaciones postquirúrgicas; y analizar la relación entre el reajuste de sling y el desarrollo de obstrucción miccional postquirúrgica, erosión de prótesis, dolor pelviano e insatisfacción con astas de prótesis.  Materiales y Métodos: Se realizó un análisis retrospectivo comparativo entre 2006 y 2016 de pacientes sometidas a colocación de sling TOT reajustable y se analizaron como subgrupo aquellas donde se hubiese realizado un reajuste de sling como segundo procedimiento. El análisis incluyó: presencia de reajuste de sling, erosión de malla, complicaciones relacionadas con astas de prótesis, desarrollo de obstrucción miccional postquirgica, y éxito funcional de la cirugía.  Resultados: Fueron seleccionadas 70 pacientes a quienes se les colocó un sling TOT reajustable (curación de IOE 84.3%; obstrucción postquirúrgica 22.8%), a 11 (15.7%) de las cuales se les realizó reajuste de prótesis por resultados funcionales adversos en las cuales la tasa de curación de IOE ascendió a 92.8% y la tasa de obstrucción post reajuste al 28.5%. Se encontró una asociación significativa entre el reajuste y el desarrollo de dolor pelviano (36% vs 10%, p=0.02) y no existieron diferencias significativas entre los grupos en el desarrollo de obstrucción miccional postquirúrgica (p=0.23), erosión a vagina (p=0.78), erosión a vejiga (p=0.39) e insatisfacción con las astas de la prótesis (p=0.9).  Conclusión:  La posibilidad de elevar el éxito funcional de una primera cirugía en pocos minutos, con anestesia local, y sin diferencias significativas en la mayoría de las complicaciones analizadas, permiten colocar este procedimiento como un complemento útil para el tratamiento de la incontinencia de orina de esfuerzo, lo que no es posible con los slings convencionales.]]></p></abstract>
<abstract abstract-type="short" xml:lang="en"><p><![CDATA[Abstract  Introduction:  Since its introduction, the TOT sling rapidly became a safe and effective option for the treatment of stress urinary incontinence (SUI) in women. The development of the adjustable TOT sling enabled the tape to be repositioned, in cases with suboptimum results (persistent SUI).  Objectives:  To analyze the overall results of our case series, in terms of functional success and postoperative complications, as well as the relation between sling adjustment and the development of postoperative urinary obstruction, mesh erosion, pelvic pain, and dissatisfaction with the tape&#8217;s silicone columns.  Materials and Methods: A comparative, retrospective analysis was carried out on patients that underwent adjustable TOT sling placement, within the time frame of 2006 and 2016, assessing a subgroup of patients that had sling repositioning as a second procedure. The variables analyzed were sling adjustment, mesh erosion, complication related to the tape&#8217;s silicone columns, development of postoperative urinary obstruction, and functional success of the surgery.  Results: Seventy patients that underwent adjustable TOT sling placement were selected (SUI cured in 84.3%; postoperative obstruction in 22.8%). Slings were repositioned in 11 (15.7%) patients due to adverse functional results, raising the SUI cure rate to 92,8% and the post-adjustment obstruction rate to 28.5%. There was a significant association between sling adjustment and the development of pelvic pain (36% vs 10%, p=0.02) and no significant differences between groups, regarding the development of postoperative urinary obstruction (p=0.23), erosion into the vagina (p=0.78), erosion into the bladder (p=0.39), and dissatisfaction with the tape&#8217;s silicone columns (p=0.9).  Conclusion:  The possibility of increasing the functional success of a first surgery, within a few minutes and with local anesthesia, together with the fact that there were no significant differences in the majority of the complications analyzed, make tape adjustment a useful complement in the treatment of SUI, which is not possible with conventional slings.]]></p></abstract>
<kwd-group>
<kwd lng="en"><![CDATA[Stress urinary incontinence]]></kwd>
<kwd lng="en"><![CDATA[Adjustable sling]]></kwd>
<kwd lng="en"><![CDATA[Safyre]]></kwd>
<kwd lng="en"><![CDATA[Postoperative urinary obstruction]]></kwd>
<kwd lng="es"><![CDATA[Incontinencia de Orina de Esfuerzo]]></kwd>
<kwd lng="es"><![CDATA[Sling ajustable]]></kwd>
<kwd lng="es"><![CDATA[Safyre]]></kwd>
<kwd lng="es"><![CDATA[Obstrucción miccional postquirúrgica]]></kwd>
</kwd-group>
</article-meta>
</front><back>
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