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Factores pronósticos para la incontinencia urinaria persistente después de la cirugía de honda en pacientes con
Enrique González-Díaz1, Leticia Padilla Mozo1, Ester Fraile López1
1Pelvic Floor Unit, Department of Obstetrics and Gynecology, Complejo Asistencial Universitario de León (CAULE), León, Spain.
European journal of obstetrics, gynecology, and reproductive biology
|February 11, 2026
Resumen
Una mayor severidad de los síntomas y el enfoque transobturador (TOT) están relacionados con la incontinencia urinaria persistente (UI) después de la cirugía de cabestrillo urétrico medio (MUS). El enfoque retropúbico (TVT) puede ofrecer mejores resultados para las mujeres con embudo uretral.
Área de la Ciencia:
- Uroginecología y Uroginecología.
- La medicina pélvica femenina es la medicina pélvica femenina.
- Innovación quirúrgica en cirugía.
Sus antecedentes:
- La incontinencia urinaria (IU) afecta a un número significativo de mujeres.
- La cirugía de cabestrillo uretral medio (MUS) es un tratamiento común para el estrés UI.
- El embudo uretral, identificado a través de ultrasonido del suelo pélvico (PFUS), es un factor de riesgo potencial para la recurrencia de UI después de MUS.
Objetivo del estudio:
- Para identificar factores pronósticos preoperatorios para la UI persistente después de MUS en mujeres con embudo uretral confirmado por ecografía.
- Para evaluar la asociación entre la gravedad de los síntomas, la longitud de la uretra, el enfoque quirúrgico y los resultados de la IU.
- Para informar la planificación quirúrgica y el asesoramiento al paciente para este grupo específico de pacientes.
Principales métodos:
- Estudio de cohorte retrospectivo que involucró a 47 mujeres con estrés o UI mixta y embudo uretral sometidas a MUS.
- La evaluación preoperatoria incluyó evaluación clínica, diarios de vaciado, cuestionarios ICIQ-UI-SF y PFUS.
- Los enfoques quirúrgicos incluyeron eslingas retropúbicas (TVT) y transobturadoras (TOT). La UI persistente se evaluó a los 24 meses después de la cirugía.
Principales resultados:
- La UI persistente se observó en el 27,7% de los pacientes.
- Las puntuaciones más altas de ICIQ-UI-SF (≥18) y la longitud uretral más larga (≥35 mm) se asociaron con UI persistente en el análisis univariado.
- El análisis multivariado identificó puntuaciones ICIQ-UI-SF más altas (OR = 6.2) y el enfoque TOT (OR = 6.8) como predictores independientes de la UI persistente.
Conclusiones:
- La gravedad de los síntomas preoperatorios (ICIQ-UI-SF ≥18) y el uso de un cabestrillo TOT se asocian de forma independiente con UI persistente después de MUS en mujeres con embudo uretral.
- El enfoque retropúbico (TVT) puede estar asociado con mejores resultados en esta población de alto riesgo.
- Estos hallazgos pueden ayudar en la toma de decisiones preoperatorias, la planificación quirúrgica y el asesoramiento al paciente.
Palabras clave:
El cabestrillo uretral medio.Ultrasonido del suelo pélvico.Incontinencia persistente y persistenteEl resultado quirúrgico.El embudo uretral es el embudo uretral.Más Videos Relacionados
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