Colocación de segunda cinta de uretra media en el manejo de incontinencia urinaria recurrente o persistente en contraste con otras opciones terapéuticas. Revisión sistemática de la literatura y meta-análisis

Introducción: La incontinencia urinaria femenina es una entidad con una prevalencia hasta del 40%. El manejo quirúrgico de primera línea es con cintas de uretra media en el caso de la incontinencia tipo esfuerzo, sin embargo, cuando dicho manejo falla, no se tiene claridad sobre cuál debe ser el man...

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Detalles Bibliográficos
Autores Principales: Vega-López, Johanna, Durán-Torres, Felipe, Sánchez-Moreno, David
Otros Autores: Palacios, Arlex Urial
Formato: Tesis de maestría (Master Thesis)
Lenguaje:Español (Spanish)
Publicado: Universidad del Rosario 2017
Materias:
TVT
TOT
Acceso en línea:http://repository.urosario.edu.co/handle/10336/13874
id ir-10336-13874
recordtype dspace
institution EdocUR - Universidad del Rosario
collection DSpace
language Español (Spanish)
topic Incontinencia urinaria
Cintas de uretra media
TVT
TOT
Manejo de segunda línea
Incontinencia urinaria recurrente o persistente
Enfermedades
Incontinencia Urinaria
Incontinencia Urinaria de Esfuerzo
Recurrent/persistent urinary incontinence
Urinary incontinence
Mid urethral tape
TVT
TOT
Second line management
spellingShingle Incontinencia urinaria
Cintas de uretra media
TVT
TOT
Manejo de segunda línea
Incontinencia urinaria recurrente o persistente
Enfermedades
Incontinencia Urinaria
Incontinencia Urinaria de Esfuerzo
Recurrent/persistent urinary incontinence
Urinary incontinence
Mid urethral tape
TVT
TOT
Second line management
Vega-López, Johanna
Durán-Torres, Felipe
Sánchez-Moreno, David
Colocación de segunda cinta de uretra media en el manejo de incontinencia urinaria recurrente o persistente en contraste con otras opciones terapéuticas. Revisión sistemática de la literatura y meta-análisis
description Introducción: La incontinencia urinaria femenina es una entidad con una prevalencia hasta del 40%. El manejo quirúrgico de primera línea es con cintas de uretra media en el caso de la incontinencia tipo esfuerzo, sin embargo, cuando dicho manejo falla, no se tiene claridad sobre cuál debe ser el manejo. Metodología: Revisión sistemática de la literatura con meta-análisis de proporciones, incluyendo estudios observacionales y de intervención, en los cuales se evaluaron los manejos de la incontinencia urinaria recurrente o persistente en mujeres con una cinta de uretra media. Resultados: Se identificaron y tamizaron 161 estudios en la búsqueda sistemática, se incluyeron 29 estudios en la síntesis cualitativa y 27 en la síntesis cuantitativa. Dada la alta heterogeneidad clínica y metodológica entre los estudios, se obtuvo una medida de proporción de curación y/o curación/mejoría combinada para cada uno de los tipos de manejo y no se realizó comparación entre ellos. Se estimó una proporción de curación total combinada en cintas ajustables de 86% (IC95%: 76,4%-92,1%), en segunda cinta de uretra media de 75,1% (IC95%: 68%-81,1%), en acortamiento de la cinta de uretra media previa de 62,3% (IC95%: 49,1%-73,9%) y en la implantación de agentes abultantes de 55,4% (IC95%: 43,2%-67%). No se encontraron pudo realizar con respecto a: sling pubovaginal, colposuspensión y terapia de piso pélvico, al igual que para los desenlaces secundarios. Conclusión: La evidencia encontrada no permite generar un grado de recomendación. Es importante tener en cuenta que estos resultados deben ser corroborados con ensayos clínicos aleatorizados colaborativos multicéntricos.
author2 Palacios, Arlex Urial
author_facet Palacios, Arlex Urial
Vega-López, Johanna
Durán-Torres, Felipe
Sánchez-Moreno, David
format Tesis de maestría (Master Thesis)
author Vega-López, Johanna
Durán-Torres, Felipe
Sánchez-Moreno, David
author_sort Vega-López, Johanna
title Colocación de segunda cinta de uretra media en el manejo de incontinencia urinaria recurrente o persistente en contraste con otras opciones terapéuticas. Revisión sistemática de la literatura y meta-análisis
title_short Colocación de segunda cinta de uretra media en el manejo de incontinencia urinaria recurrente o persistente en contraste con otras opciones terapéuticas. Revisión sistemática de la literatura y meta-análisis
title_full Colocación de segunda cinta de uretra media en el manejo de incontinencia urinaria recurrente o persistente en contraste con otras opciones terapéuticas. Revisión sistemática de la literatura y meta-análisis
title_fullStr Colocación de segunda cinta de uretra media en el manejo de incontinencia urinaria recurrente o persistente en contraste con otras opciones terapéuticas. Revisión sistemática de la literatura y meta-análisis
title_full_unstemmed Colocación de segunda cinta de uretra media en el manejo de incontinencia urinaria recurrente o persistente en contraste con otras opciones terapéuticas. Revisión sistemática de la literatura y meta-análisis
title_sort colocación de segunda cinta de uretra media en el manejo de incontinencia urinaria recurrente o persistente en contraste con otras opciones terapéuticas. revisión sistemática de la literatura y meta-análisis
publisher Universidad del Rosario
publishDate 2017
url http://repository.urosario.edu.co/handle/10336/13874
_version_ 1645141745560715264
spelling ir-10336-138742019-09-19T12:37:54Z Colocación de segunda cinta de uretra media en el manejo de incontinencia urinaria recurrente o persistente en contraste con otras opciones terapéuticas. Revisión sistemática de la literatura y meta-análisis Vega-López, Johanna Durán-Torres, Felipe Sánchez-Moreno, David Palacios, Arlex Urial Incontinencia urinaria Cintas de uretra media TVT TOT Manejo de segunda línea Incontinencia urinaria recurrente o persistente Enfermedades Incontinencia Urinaria Incontinencia Urinaria de Esfuerzo Recurrent/persistent urinary incontinence Urinary incontinence Mid urethral tape TVT TOT Second line management Introducción: La incontinencia urinaria femenina es una entidad con una prevalencia hasta del 40%. El manejo quirúrgico de primera línea es con cintas de uretra media en el caso de la incontinencia tipo esfuerzo, sin embargo, cuando dicho manejo falla, no se tiene claridad sobre cuál debe ser el manejo. Metodología: Revisión sistemática de la literatura con meta-análisis de proporciones, incluyendo estudios observacionales y de intervención, en los cuales se evaluaron los manejos de la incontinencia urinaria recurrente o persistente en mujeres con una cinta de uretra media. Resultados: Se identificaron y tamizaron 161 estudios en la búsqueda sistemática, se incluyeron 29 estudios en la síntesis cualitativa y 27 en la síntesis cuantitativa. Dada la alta heterogeneidad clínica y metodológica entre los estudios, se obtuvo una medida de proporción de curación y/o curación/mejoría combinada para cada uno de los tipos de manejo y no se realizó comparación entre ellos. Se estimó una proporción de curación total combinada en cintas ajustables de 86% (IC95%: 76,4%-92,1%), en segunda cinta de uretra media de 75,1% (IC95%: 68%-81,1%), en acortamiento de la cinta de uretra media previa de 62,3% (IC95%: 49,1%-73,9%) y en la implantación de agentes abultantes de 55,4% (IC95%: 43,2%-67%). No se encontraron pudo realizar con respecto a: sling pubovaginal, colposuspensión y terapia de piso pélvico, al igual que para los desenlaces secundarios. Conclusión: La evidencia encontrada no permite generar un grado de recomendación. Es importante tener en cuenta que estos resultados deben ser corroborados con ensayos clínicos aleatorizados colaborativos multicéntricos. Introduction: Female urinary incontinence has a prevalence of up to 40%. First-line surgical management is with mid urethral tapes in the case of stress-type incontinence, however, when such management fails, it is unclear what should be the management . Methodology: Systematic review of the literature with meta-analysis of proportions, including observational and interventional studies, in which the management of recurrent or persistent urinary incontinence in women with a mid urethral tape was evaluated. Results: 161 studies were identified and screened in the systematic search, 29 studies were included in the qualitative synthesis and 27 in the quantitative synthesis. Given the high clinical and methodological heterogeneity between the studies, a measure of cure and / or combination / cure / improvement ratio was obtained for each type of management and no comparison was made between them. A combined total cure rate on adjustable tapes was estimated at 86% (95% CI: 76.4% -92.1%), the second mid urethral tape at 75.1% (95% CI: 68% -81.1 %), the shortenning of the previous tape at 62.3% (95% CI: 49.1% -73.9%) and in the implantation of bulking agents at 55.4% (95% CI: 43.2 % -67%). We were not able to perform such analysis with respect to: pubovaginal sling, colposuspension and pelvic floor therapy, as well as secondary outcomes. Conclusion: The evidence found does not allow us to generate a degree of recommendation. 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score 11,388624