array:23 [ "pii" => "S2173578610700147" "issn" => "21735786" "doi" => "10.1016/S2173-5786(10)70014-7" "estado" => "S300" "fechaPublicacion" => "2010-01-01" "aid" => "70014" "copyright" => "AEU" "copyrightAnyo" => "2010" "documento" => "article" "crossmark" => 0 "subdocumento" => "fla" "cita" => "Actas Urol Esp. 2010;34:82-7" "abierto" => array:3 [ "ES" => false "ES2" => false "LATM" => false ] "gratuito" => false "lecturas" => array:2 [ "total" => 559 "formatos" => array:3 [ "EPUB" => 6 "HTML" => 104 "PDF" => 449 ] ] "itemSiguiente" => array:18 [ "pii" => "S2173578610700159" "issn" => "21735786" "doi" => "10.1016/S2173-5786(10)70015-9" "estado" => "S300" "fechaPublicacion" => "2010-01-01" "aid" => "70015" "copyright" => "AEU" "documento" => "article" "crossmark" => 0 "subdocumento" => "fla" "cita" => "Actas Urol Esp. 2010;34:88-94" "abierto" => array:3 [ "ES" => false "ES2" => false "LATM" => false ] "gratuito" => false "lecturas" => array:2 [ "total" => 364 "formatos" => array:3 [ "EPUB" => 5 "HTML" => 81 "PDF" => 278 ] ] "en" => array:10 [ "idiomaDefecto" => true "titulo" => "<span class="elsevierStyleItalic">De novo</span> urological neoplasms in kidney transplant patients: Experience in 1751 patients" "tienePdf" => "en" "tieneTextoCompleto" => 0 "tieneResumen" => array:2 [ 0 => "en" 1 => "es" ] "paginas" => array:1 [ 0 => array:2 [ "paginaInicial" => "88" "paginaFinal" => "94" ] ] "titulosAlternativos" => array:1 [ "es" => array:1 [ "titulo" => "Neoplasias urológicas de novo en pacientes trasplantados renales: experiencia en 1.751 pacientes" ] ] "contieneResumen" => array:2 [ "en" => true "es" => true ] "contienePdf" => array:1 [ "en" => true ] "autores" => array:1 [ 0 => array:2 [ "autoresLista" => "C. di Capua Sacoto, S. Luján Marco, P. Bahilo Mateu, A. Budía Alba, J.L. Pontones Moreno, J.F. Jiménez Cruz" "autores" => array:6 [ 0 => array:2 [ "nombre" => "C." "apellidos" => "di Capua Sacoto" ] 1 => array:2 [ "nombre" => "S." "apellidos" => "Luján Marco" ] 2 => array:2 [ "nombre" => "P." "apellidos" => "Bahilo Mateu" ] 3 => array:2 [ "nombre" => "A." "apellidos" => "Budía Alba" ] 4 => array:2 [ "nombre" => "J.L." "apellidos" => "Pontones Moreno" ] 5 => array:2 [ "nombre" => "J.F." "apellidos" => "Jiménez Cruz" ] ] ] ] ] "idiomaDefecto" => "en" "EPUB" => "https://multimedia.elsevier.es/PublicationsMultimediaV1/item/epub/S2173578610700159?idApp=UINPBA00004N" "url" => "/21735786/0000003400000001/v1_201304251550/S2173578610700159/v1_201304251550/en/main.assets" ] "itemAnterior" => array:18 [ "pii" => "S2173578610700135" "issn" => "21735786" "doi" => "10.1016/S2173-5786(10)70013-5" "estado" => "S300" "fechaPublicacion" => "2010-01-01" "aid" => "70013" "copyright" => "AEU" "documento" => "article" "crossmark" => 0 "subdocumento" => "fla" "cita" => "Actas Urol Esp. 2010;34:78-81" "abierto" => array:3 [ "ES" => false "ES2" => false "LATM" => false ] "gratuito" => false "lecturas" => array:2 [ "total" => 307 "formatos" => array:3 [ "EPUB" => 5 "HTML" => 89 "PDF" => 213 ] ] "en" => array:10 [ "idiomaDefecto" => true "titulo" => "Extracorporeal lithotripsy in children. The efficacy and long-term evaluation of renal parenchyma damage by <span class="elsevierStyleSup">99m</span>Tc-DMSA scintigraphy" "tienePdf" => "en" "tieneTextoCompleto" => 0 "tieneResumen" => array:2 [ 0 => "en" 1 => "es" ] "paginas" => array:1 [ 0 => array:2 [ "paginaInicial" => "78" "paginaFinal" => "81" ] ] "titulosAlternativos" => array:1 [ "es" => array:1 [ "titulo" => "Litotricia extracorpórea en niños. Eficacia y evaluación a largo plazo de la lesión del parénquima renal mediante gammagrafía con DMSA-<span class="elsevierStyleSup">99m</span>Tc" ] ] "contieneResumen" => array:2 [ "en" => true "es" => true ] "contienePdf" => array:1 [ "en" => true ] "autores" => array:1 [ 0 => array:2 [ "autoresLista" => "L.O. Reis, E.L. Zani, O. Ikari, A. Gugliotta" "autores" => array:4 [ 0 => array:2 [ "nombre" => "L.O." "apellidos" => "Reis" ] 1 => array:2 [ "nombre" => "E.L." "apellidos" => "Zani" ] 2 => array:2 [ "nombre" => "O." "apellidos" => "Ikari" ] 3 => array:2 [ "nombre" => "A." "apellidos" => "Gugliotta" ] ] ] ] ] "idiomaDefecto" => "en" "EPUB" => "https://multimedia.elsevier.es/PublicationsMultimediaV1/item/epub/S2173578610700135?idApp=UINPBA00004N" "url" => "/21735786/0000003400000001/v1_201304251550/S2173578610700135/v1_201304251550/en/main.assets" ] "en" => array:14 [ "idiomaDefecto" => true "titulo" => "Three-years results of transvaginal cystocele repair with polypropylene mesh using a tension-free technique" "tieneTextoCompleto" => 0 "paginas" => array:1 [ 0 => array:2 [ "paginaInicial" => "82" "paginaFinal" => "87" ] ] "autores" => array:1 [ 0 => array:4 [ "autoresLista" => "Y. El Harrech, A. Ameur, A. Janane, K. Moufide, M. Ghadouane, M. Abbar" "autores" => array:6 [ 0 => array:4 [ "nombre" => "Y." "apellidos" => "El Harrech" "email" => array:1 [ 0 => "ylg79@hotmail.com" ] "referencia" => array:1 [ 0 => array:2 [ "etiqueta" => "<span class="elsevierStyleSup">*</span>" "identificador" => "cor0005" ] ] ] 1 => array:2 [ "nombre" => "A." "apellidos" => "Ameur" ] 2 => array:2 [ "nombre" => "A." "apellidos" => "Janane" ] 3 => array:2 [ "nombre" => "K." "apellidos" => "Moufide" ] 4 => array:2 [ "nombre" => "M." "apellidos" => "Ghadouane" ] 5 => array:2 [ "nombre" => "M." "apellidos" => "Abbar" ] ] "afiliaciones" => array:1 [ 0 => array:1 [ "entidad" => "Servicio de Urología, Hospital Militar Mohammed V, Rabat, Morocco" ] ] "correspondencia" => array:1 [ 0 => array:3 [ "identificador" => "cor0005" "etiqueta" => "*" "correspondencia" => "Author for correspondence." ] ] ] ] "titulosAlternativos" => array:1 [ "es" => array:1 [ "titulo" => "Resultados a los tres años de la reparación de un cistocele transvaginal con malla de propileno usando una técnica sin tensión" ] ] "pdfFichero" => "main.pdf" "tienePdf" => true "fechaRecibido" => "2009-03-25" "fechaAceptado" => "2009-07-23" "PalabrasClave" => array:2 [ "en" => array:1 [ 0 => array:4 [ "clase" => "keyword" "titulo" => "Keywords" "identificador" => "xpalclavsec85596" "palabras" => array:4 [ 0 => "Cystocele" 1 => "Synthetic mesh" 2 => "Transvaginal approach" 3 => "Tension free" ] ] ] "es" => array:1 [ 0 => array:4 [ "clase" => "keyword" "titulo" => "Palabras clave" "identificador" => "xpalclavsec85595" "palabras" => array:4 [ 0 => "Cistocele" 1 => "Malla sintética" 2 => "Abordaje transvaginal" 3 => "Sin tensión" ] ] ] ] "tieneResumen" => true "resumen" => array:2 [ "en" => array:2 [ "titulo" => "Abstract" "resumen" => "<span class="elsevierStyleSectionTitle">Objectives</span><p id="spar0005" class="elsevierStyleSimplePara elsevierViewall">To evaluate the long term efficacy and safety of transvaginal implantation of a non-resorbable synthetic prosthesis (Gynemesh®) for the treatment of cystocele using transvaginal free tension technique.</p> <span class="elsevierStyleSectionTitle">Materials and methods</span><p id="spar0010" class="elsevierStyleSimplePara elsevierViewall">Prospective study of patients that have been submitted to correction of cystocele between April 2004 and July 2007. A prolene mesh was cut to an appropriate size to cover the whole cystocele leaving two tabs on each side. The two tabs of the mesh were then placed in paravaginal spaces, tension free, without stitches. Mesh was used in 31 patients. All patients had a symptomatic cystocele ≥<span class="elsevierStyleHsp" style=""></span>2 according to Baden-Walker halfway classification. Patients were reviewed initially at 1and 3 month and then every 6 months.</p> <span class="elsevierStyleSectionTitle">Results</span><p id="spar0015" class="elsevierStyleSimplePara elsevierViewall">The mean age of the patients was 58 years (range: 47–70 years). Mean parity was 5.8 (range 1–11), and mean weight was 75<span class="elsevierStyleHsp" style=""></span>kg (range 60–82<span class="elsevierStyleHsp" style=""></span>Kg). All women were postmenopausal. The operation was combined with vaginal hysterectomy in 2 patients, Posterior colporraphy in 2 patients, Perineorrhaphy in 1 patient, Sacrospinous fixation in 2 patients, transobturator tape for stress urinary incontinence in 7 women. Average time of surgery was 23 minutes for cystocele. There were no major complications, such as trauma to the bladder, urethra, bowels, or large vessels in the patient group treated. There was no immediate postoperative complications (up to 7 days) recorded. No hematoma or infection was observed in the operative area. Mesh erosion was detected in one patient. It was treated by excision of the eroded part of the mesh.</p><p id="spar0020" class="elsevierStyleSimplePara elsevierViewall">Mean follow-up was 36.4 months (18 to 52 months). Using our definition of success based on both anatomic and functional outcomes, the overall cure rate was 74.19% (asymptomatic with no or grade 1 cystocele). The improvement rate (asymptomatic with a grade 2 cystocele) was 19.35% and the overall failure rate (symptomatic or with a grade 3 or 4 cystocele) was only 6.4% (2 women).</p> <span class="elsevierStyleSectionTitle">Discussion and conclusions</span><p id="spar0025" class="elsevierStyleSimplePara elsevierViewall">The interposition of a sub-vesical transversal tension-free polypropylene mesh by the vaginal route seems to be an excellent procedure in the definitive surgical treatment of anterior vaginalwall prolapse. This procedure is simple, mini-invasive, reproducible and efficient with low morbidity and good tolerance. The results seem to be stable after three years of follow up.</p>" ] "es" => array:2 [ "titulo" => "Resumen" "resumen" => "<span class="elsevierStyleSectionTitle">Objetivos</span><p id="spar0030" class="elsevierStyleSimplePara elsevierViewall">Evaluar la eficacia y la seguridad a largo plazo de la implantación transvaginal de una prótesis sintética no absorbible (Gynemesh®) para el tratamiento del cistocele mediante una técnica vaginal sin tensión.</p> <span class="elsevierStyleSectionTitle">Materiales y métodos</span><p id="spar0035" class="elsevierStyleSimplePara elsevierViewall">Estudio prospectivo de pacientes sometidas a corrección de un cistocele entre abril de 2004 y julio de 2007. Se cortaba una malla de propileno al tamaño adecuado para cubrir todo el cistocele, dejando dos lengüetas a cada lado. Las dos lengüetas de la malla se colocaban después en los espacios paravaginales sin tensión ni suturas. Se utilizó la malla en 31 pacientes. Todas ellas tenían un cistocele sintomático de grado ≥ 2, según la clasificación del punto medio de Baden-Walker. Se les revisaba inicialmente al cabo de uno y tres meses, y después cada 6 meses.</p> <span class="elsevierStyleSectionTitle">Resultados</span><p id="spar0040" class="elsevierStyleSimplePara elsevierViewall">La edad media de las pacientes era de 58 años (límites: 47–70 años). La paridad media era de 5,8 (límites: 1–11) y el peso medio de 75<span class="elsevierStyleHsp" style=""></span>kg (límites: 60–82<span class="elsevierStyleHsp" style=""></span>kg). Todas las mujeres eran posmenopáusicas. La operación se combinó con histerectomía vaginal en dos pacientes, colporrafia posterior en dos, perineorrafia en una, fijación sacroespinosa en dos y cinta transobturadora para incontinencia urinaria de esfuerzo en 7 mujeres. La duración media de la cirugía del cistocele fue de 23 minutos. En el grupo de pacientes tratadas no hubo complicaciones importantes como traumatismo de vejiga, uretra, intestino o grandes vasos. No se registraron complicaciones en el postoperatorio inmediato (hasta los 7 días). No se observó hematoma ni infección en la zona quirúrgica. En una paciente se detectó erosión de la malla, que se trató mediante extirpación de la parte erosionada de la misma.</p><p id="spar0045" class="elsevierStyleSimplePara elsevierViewall">El seguimiento medio fue de 36,4 meses (de 18 a 52). Según nuestra definición de éxito, basada en los resultados anatómico y funcional, la tasa de curación global fue del 74,19% (asintomática sin cistocele o con cistocele de grado 1). La tasa de pacientes con mejoría (asintomáticas con cistocele de grado 2) fue del 19,35% y la de fracasos globales (sintomáticas o con cistocele de grado 3 o 4) de sólo el 6,4% (dos mujeres).</p> <span class="elsevierStyleSectionTitle">Comentario y conclusiones</span><p id="spar0050" class="elsevierStyleSimplePara elsevierViewall">La interposición de una malla de polipropileno subvesical transversal, sin tensión, por la vía vaginal, parece ser un procedimiento excelente para el tratamiento quirúrgico definitivo del prolapso de la pared vaginal anterior. Se trata de un procedimiento simple, poco invasivo, reproducible y eficiente con baja morbilidad y bien tolerado. Los resultados parecen mantenerse estables a los tres años de seguimiento.</p>" ] ] "bibliografia" => array:2 [ "titulo" => "References" "seccion" => array:1 [ 0 => array:2 [ "identificador" => "bibs0005" "bibliografiaReferencia" => array:23 [ 0 => array:3 [ "identificador" => "bib1" "etiqueta" => "1." 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Journal Information
Three-years results of transvaginal cystocele repair with polypropylene mesh using a tension-free technique
Resultados a los tres años de la reparación de un cistocele transvaginal con malla de propileno usando una técnica sin tensión
Y. El Harrech
, A. Ameur, A. Janane, K. Moufide, M. Ghadouane, M. Abbar
Corresponding author
Servicio de Urología, Hospital Militar Mohammed V, Rabat, Morocco