array:23 [ "pii" => "S0210480607736719" "issn" => "02104806" "doi" => "10.1016/S0210-4806(07)73671-9" "estado" => "S300" "fechaPublicacion" => "2007-01-01" "aid" => "73671" "copyright" => "Asociación Española de Urología (AEU)" "copyrightAnyo" => "2007" "documento" => "article" "crossmark" => 0 "subdocumento" => "fla" "cita" => "Actas Urol Esp. 2007;31:482-7" "abierto" => array:3 [ "ES" => false "ES2" => false "LATM" => false ] "gratuito" => false "lecturas" => array:2 [ "total" => 1413 "formatos" => array:3 [ "EPUB" => 7 "HTML" => 898 "PDF" => 508 ] ] "itemSiguiente" => array:18 [ "pii" => "S0210480607736720" "issn" => "02104806" "doi" => "10.1016/S0210-4806(07)73672-0" "estado" => "S300" "fechaPublicacion" => "2007-01-01" "aid" => "73672" "copyright" => "Asociación Española de Urología (AEU)" "documento" => "article" "crossmark" => 0 "subdocumento" => "fla" "cita" => "Actas Urol Esp. 2007;31:488-92" "abierto" => array:3 [ "ES" => false "ES2" => false "LATM" => false ] "gratuito" => false "lecturas" => array:2 [ "total" => 1678 "formatos" => array:3 [ "EPUB" => 8 "HTML" => 1026 "PDF" => 644 ] ] "es" => array:10 [ "idiomaDefecto" => true "titulo" => "Evaluación de un protocolo para el control de la vasectomía y modificaciones a realizar" "tienePdf" => "es" "tieneTextoCompleto" => 0 "tieneResumen" => array:2 [ 0 => "es" 1 => "en" ] "paginas" => array:1 [ 0 => array:2 [ "paginaInicial" => "488" "paginaFinal" => "492" ] ] "titulosAlternativos" => array:1 [ "en" => array:1 [ "titulo" => "Evaluation of a guidelines for the assessment of success after vasectomy and needed improvements" ] ] "contieneResumen" => array:2 [ "es" => true "en" => true ] "contienePdf" => array:1 [ "es" => true ] "autores" => array:1 [ 0 => array:2 [ "autoresLista" => "M. Cháfer Rudilla, L. Navarro Casado, M.L. Quintanilla Mata, M. Belilty Araque, C. Andrés Fernández, J. Salinas Sánchez" "autores" => array:6 [ 0 => array:2 [ "nombre" => "M." "apellidos" => "Cháfer Rudilla" ] 1 => array:2 [ "nombre" => "L." "apellidos" => "Navarro Casado" ] 2 => array:2 [ "nombre" => "M.L." "apellidos" => "Quintanilla Mata" ] 3 => array:2 [ "nombre" => "M." "apellidos" => "Belilty Araque" ] 4 => array:2 [ "nombre" => "C." "apellidos" => "Andrés Fernández" ] 5 => array:2 [ "nombre" => "J." "apellidos" => "Salinas Sánchez" ] ] ] ] ] "idiomaDefecto" => "es" "EPUB" => "https://multimedia.elsevier.es/PublicationsMultimediaV1/item/epub/S0210480607736720?idApp=UINPBA00004N" "url" => "/02104806/0000003100000005/v1_201304251840/S0210480607736720/v1_201304251840/es/main.assets" ] "itemAnterior" => array:18 [ "pii" => "S0210480607736707" "issn" => "02104806" "doi" => "10.1016/S0210-4806(07)73670-7" "estado" => "S300" "fechaPublicacion" => "2007-01-01" "aid" => "73670" "copyright" => "Asociación Española de Urología (AEU)" "documento" => "article" "crossmark" => 0 "subdocumento" => "fla" "cita" => "Actas Urol Esp. 2007;31:477-81" "abierto" => array:3 [ "ES" => false "ES2" => false "LATM" => false ] "gratuito" => false "lecturas" => array:2 [ "total" => 1143 "formatos" => array:3 [ "EPUB" => 6 "HTML" => 703 "PDF" => 434 ] ] "es" => array:10 [ "idiomaDefecto" => true "titulo" => "Cirugía renal laparoscópica conservadora de parénquima. Experiencia inicial" "tienePdf" => "es" "tieneTextoCompleto" => 0 "tieneResumen" => array:2 [ 0 => "es" 1 => "en" ] "paginas" => array:1 [ 0 => array:2 [ "paginaInicial" => "477" "paginaFinal" => "481" ] ] "titulosAlternativos" => array:1 [ "en" => array:1 [ "titulo" => "Laparoscopic nephron sparing surgery. initial experience" ] ] "contieneResumen" => array:2 [ "es" => true "en" => true ] "contienePdf" => array:1 [ "es" => true ] "autores" => array:1 [ 0 => array:2 [ "autoresLista" => "A. Aguilera Bazán, S. Alonso y Gregorio, M. Pérez Utrilla, J.R. Cansino Alcalde, J. Cisneros Ledo, J. De la Peña Barthel" "autores" => array:6 [ 0 => array:2 [ "nombre" => "A." "apellidos" => "Aguilera Bazán" ] 1 => array:2 [ "nombre" => "S." "apellidos" => "Alonso y Gregorio" ] 2 => array:2 [ "nombre" => "M." "apellidos" => "Pérez Utrilla" ] 3 => array:2 [ "nombre" => "J.R." "apellidos" => "Cansino Alcalde" ] 4 => array:2 [ "nombre" => "J." "apellidos" => "Cisneros Ledo" ] 5 => array:2 [ "nombre" => "J." "apellidos" => "De la Peña Barthel" ] ] ] ] ] "idiomaDefecto" => "es" "EPUB" => "https://multimedia.elsevier.es/PublicationsMultimediaV1/item/epub/S0210480607736707?idApp=UINPBA00004N" "url" => "/02104806/0000003100000005/v1_201304251840/S0210480607736707/v1_201304251840/es/main.assets" ] "es" => array:14 [ "idiomaDefecto" => true "titulo" => "Importancia de la integridad de la mucosa y submucosa uretral en la continencia de los pacientes con esfínteres urinarios artificiales" "tieneTextoCompleto" => 0 "paginas" => array:1 [ 0 => array:2 [ "paginaInicial" => "482" "paginaFinal" => "487" ] ] "autores" => array:1 [ 0 => array:4 [ "autoresLista" => "F García Montes, A.R. Mundy, S.L. Knight, M.D. Craggs" "autores" => array:4 [ 0 => array:4 [ "nombre" => "F" "apellidos" => "García Montes" "email" => array:1 [ 0 => "fgmontes@wanadoo.es" ] "referencia" => array:3 [ 0 => array:2 [ "etiqueta" => "<span class="elsevierStyleSup">*</span>" "identificador" => "aff0005" ] 1 => array:2 [ "etiqueta" => "<span class="elsevierStyleSup">**</span>" "identificador" => "aff0010" ] 2 => array:2 [ "etiqueta" => "<span class="elsevierStyleSup">1</span>" "identificador" => "cor0005" ] ] ] 1 => array:3 [ "nombre" => "A.R." "apellidos" => "Mundy" "referencia" => array:1 [ 0 => array:2 [ "etiqueta" => "<span class="elsevierStyleSup">*</span>" "identificador" => "aff0005" ] ] ] 2 => array:3 [ "nombre" => "S.L." "apellidos" => "Knight" "referencia" => array:1 [ 0 => array:2 [ "etiqueta" => "<span class="elsevierStyleSup">*</span>" "identificador" => "aff0005" ] ] ] 3 => array:3 [ "nombre" => "M.D." "apellidos" => "Craggs" "referencia" => array:1 [ 0 => array:2 [ "etiqueta" => "<span class="elsevierStyleSup">*</span>" "identificador" => "aff0005" ] ] ] ] "afiliaciones" => array:2 [ 0 => array:3 [ "entidad" => "Institue of Urology and Nephrology. University College of London." "etiqueta" => "<span class="elsevierStyleSup">*</span>" "identificador" => "aff0005" ] 1 => array:3 [ "entidad" => "Hospital Universitario Son Dureta, Palma de Mallorca Islas Baleares." "etiqueta" => "<span class="elsevierStyleSup">**</span>" "identificador" => "aff0010" ] ] "correspondencia" => array:1 [ 0 => array:3 [ "identificador" => "cor0005" "etiqueta" => "1" "correspondencia" => "Correspondencia autor: Dr. F. García Montes Hospital Universitario Son Dureta Andrea Doria, 55 - 07014 Palma de Mallora (Islas Baleares) Tel.: 971 175 000" ] ] ] ] "titulosAlternativos" => array:1 [ "en" => array:1 [ "titulo" => "The role of low urethral mucosal and submucosal blood perfusion in patients with artificial urinary sphincters" ] ] "pdfFichero" => "main.pdf" "tienePdf" => true "fechaRecibido" => "2006-11-01" "fechaAceptado" => "2007-03-01" "PalabrasClave" => array:2 [ "es" => array:1 [ 0 => array:4 [ "clase" => "keyword" "titulo" => "Palabras clave" "identificador" => "xpalclavsec88265" "palabras" => array:3 [ 0 => "Atrofia uretral" 1 => "Esfínter urinario artificial" 2 => "Incontinencia de orina" ] ] ] "en" => array:1 [ 0 => array:4 [ "clase" => "keyword" "titulo" => "Key words" "identificador" => "xpalclavsec88266" "palabras" => array:3 [ 0 => "Urethral atrophy" 1 => "Artificial urinary sphincter" 2 => "Urinary incontinence" ] ] ] ] "tieneResumen" => true "resumen" => array:2 [ "es" => array:2 [ "titulo" => "Resumen" "resumen" => "<span class="elsevierStyleSectionTitle">Introducción</span><p id="spar0005" class="elsevierStyleSimplePara elsevierViewall">La reaparición de incontinencia por atrofia uretral en pacientes con esfínteres urinarios artificiales (EUA) tradicionalmente ha sido atribuida al déficit de transmisión de la presión oclusiva. Existe, sin embargo, una fuerza pasiva que reside en la mucosa y submucosa uretral y contribuye al sellado de la luz uretral. Nuestro objetivo fue determinar el papel de la mucosa y submucosa uretral en la continencia de los pacientes con EUA en la uretra bulbar.</p> <span class="elsevierStyleSectionTitle">Materiales y Métodos</span><p id="spar0010" class="elsevierStyleSimplePara elsevierViewall">Se estudiaron dos grupos de pacientes con un EUA in situ durante más de 1 año (n <span class="elsevierStyleInf">total</span> = 11). El grupo I estaba constituido por pacientes continentes (n<span class="elsevierStyleInf">I</span> = 6) y el grupo II por pacientes incontinentes debido a atrofia uretral (n<span class="elsevierStyleInf">II</span> = 5). Se valoró la presión intrauretral (PI) y la perfusión sanguínea (PS) de la mucosa y submucosa de forma simultánea con la técnica de microtransductor multicanal y láser-doppler respectivamente. El estudio se realizó comparando la PI y la PS de la uretra proximal y distal al manguito con la PI y la PS del segmento uretral por debajo del manguito en cada uno de los pacientes.</p> <span class="elsevierStyleSectionTitle">Resultados</span><p id="spar0015" class="elsevierStyleSimplePara elsevierViewall">La PS del grupo I (continente) no varió de forma significativa a lo largo de la uretra. La PS del grupo II (incontinente por atrofia uretral) fue significativamente menor por debajo del manguito que en la uretra proximal y distal. La IP del tramo uretral por debajo del manguito de ambos grupos no presentó diferencias significativas.</p> <span class="elsevierStyleSectionTitle">Discusión</span><p id="spar0020" class="elsevierStyleSimplePara elsevierViewall">La continencia de los pacientes con EUA depende de dos factores: 1) la presión que el manguito ejerce sobre la uretra bulbar y 2) la preservación de la perfusión sanguínea de la mucosa y submucosa uretral. Para un determinado rango de presiones en el manguito, el factor más importante es la perfusión sanguínea uretral. Los pacientes con buena perfusión permanecerán continentes y aquellos en los que la isquemia impide el efecto de sellado de la mucosa y submucosa desarrollarán incontinencia.</p>" ] "en" => array:2 [ "titulo" => "Abstract" "resumen" => "<span class="elsevierStyleSectionTitle">Introduction</span><p id="spar0025" class="elsevierStyleSimplePara elsevierViewall">A common complication following insertion of a bulbar AUS is recurrent incontinence, and once other causes have been ruled out, a diagnosis of urethral atrophy is then made. Urethral atrophy probably occurs to a certain degree in all patients with an AUS but the reappearance of incontinence is often attributed to inadequate pressure transfer from the cuff to the atrophic urethra. The normal urethral closure mechanism depends also on passive forces which rely on the integrity of the urethral mucosa and submucosa.</p> <span class="elsevierStyleSectionTitle">Material and Methods</span><p id="spar0030" class="elsevierStyleSimplePara elsevierViewall">Two groups of patients with a first AUS implant which had been in place for more than 1 year were studied (n=11). Group I consisted of continent patients (n<span class="elsevierStyleInf">I</span>=6) whereas Group II had significant incontinence due to urethral atrophy (n<span class="elsevierStyleInf">II</span>=5). Intraurethral pressures (IP) and blood flux (BF) were measured simultaneously with a micro-tip transducer and a laser Doppler flowmeter in each patient. Positional measurements were recorded proximal, within, and distal to the cuff first with the AUS deactivated and then activated.</p> <span class="elsevierStyleSectionTitle">Results</span><p id="spar0035" class="elsevierStyleSimplePara elsevierViewall">Group I patients exhibited similar IP and BF at all positions along the urethra. In Group II the IP was similar along the urethra but the BF within the cuff was qualitatively different (non pulsatile) and decreased significantly when compared to either side of the cuff during.</p> <span class="elsevierStyleSectionTitle">Discussion</span><p id="spar0040" class="elsevierStyleSimplePara elsevierViewall">Continence in patients with artificial urinary sphincters depends not only on the cuff occlusive force but is also dependent on the viability of the mucosal and submucosal tissues. For a given pressure range mucosal and submucosal blood perfusion is determinant: patients with normal blood perfusion would remain continent whereas patients with impaired perfusion would become incontinent.</p>" ] ] "bibliografia" => array:2 [ "titulo" => "Referencias" "seccion" => array:1 [ 0 => array:2 [ "identificador" => "bibs0005" "bibliografiaReferencia" => array:8 [ 0 => array:3 [ "identificador" => "bib0005" "etiqueta" => "1." "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Role of inner urethral softness in urinary continence" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:3 [ 0 => "N.R. Zinner" 1 => "A.M. Sterling" 2 => "R.C. Ritter" ] ] ] ] ] "host" => array:1 [ 0 => array:1 [ "Revista" => array:7 [ "tituloSerie" => "Urology" "fecha" => "1980" "volumen" => "16" "numero" => "1" "paginaInicial" => "115" "paginaFinal" => "117" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/7190337" "web" => "Medline" ] ] ] ] ] ] ] ] 1 => array:3 [ "identificador" => "bib0010" "etiqueta" => "2." "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "The mechanism of micturition." "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:1 [ 0 => "J.G. Blaivas" ] ] ] ] ] "host" => array:1 [ 0 => array:1 [ "LibroEditado" => array:4 [ "titulo" => "Scientific Foundations of Urology" "paginaInicial" => "273" "paginaFinal" => "285" "serieFecha" => "1990" ] ] ] ] ] ] 2 => array:3 [ "identificador" => "bib0015" "etiqueta" => "3." "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Artificial sphincter pressure versus detrusor leakage pressure" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:4 [ 0 => "C. Blok" 1 => "M.P. Van Riel" 2 => "G.E. Van Verooij" 3 => "B.L. Coolsaet" ] ] ] ] ] "host" => array:1 [ 0 => array:1 [ "Revista" => array:7 [ "tituloSerie" => "J Urol" "fecha" => "1985" "volumen" => "133" "numero" => "1" "paginaInicial" => "117" "paginaFinal" => "120" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/3964869" "web" => "Medline" ] ] ] ] ] ] ] ] 3 => array:3 [ "identificador" => "bib0020" "etiqueta" => "4." "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "The use of the AMS-AS 800 artificial sphincter for continent urinary diversion. Investigations including pressure-flow studies, using rabbit intestinal loops" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:3 [ 0 => "U.H. Engelmann" 1 => "T.P. Felderman" 2 => "F.B. Scott" ] ] ] ] ] "host" => array:1 [ 0 => array:1 [ "Revista" => array:7 [ "tituloSerie" => "J Urol" "fecha" => "1985" "volumen" => "134" "numero" => "1" "paginaInicial" => "183" "paginaFinal" => "185" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/4009820" "web" => "Medline" ] ] ] ] ] ] ] ] 4 => array:3 [ "identificador" => "bib0025" "etiqueta" => "5." "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Evaluation of the AMS-AS 800 artificial sphincter for continent urinary diversion using intestinal loops" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:3 [ 0 => "U.H. Englemann" 1 => "T.P. Felderman" 2 => "F.B. Scott" ] ] ] ] ] "host" => array:1 [ 0 => array:1 [ "Revista" => array:6 [ "tituloSerie" => "Urology" "fecha" => "1985" "volumen" => "5" "numero" => "6" "paginaInicial" => "620" "paginaFinal" => "621" ] ] ] ] ] ] 5 => array:3 [ "identificador" => "bib0030" "etiqueta" => "6." "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "The relationship between mucosal blood flow measured using laser Doppler flowmetry and pressure in the human penile urethra" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:4 [ 0 => "S. Knight" 1 => "I. Hussein" 2 => "A.R. Mundy" 3 => "M.D. Craggs" ] ] ] ] ] "host" => array:1 [ 0 => array:1 [ "Revista" => array:5 [ "tituloSerie" => "Eur Urol" "fecha" => "1998" "volumen" => "Vol 33" "numero" => "suppl 1" "paginaInicial" => "97" ] ] ] ] ] ] 6 => array:3 [ "identificador" => "bib0035" "etiqueta" => "7." "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "The significance of low urethral blood flow in recurrent incontinence in patients with a long standing artificial urinary sphincter" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:4 [ 0 => "F. Garcia Montes" 1 => "S. Knight" 2 => "A.R. Mundy" 3 => "M.D. Craggs" ] ] ] ] ] "host" => array:1 [ 0 => array:1 [ "Revista" => array:6 [ "tituloSerie" => "Neurourol and Urodyn" "fecha" => "1999" "volumen" => "18" "numero" => "4" "paginaInicial" => "394" "paginaFinal" => "396" ] ] ] ] ] ] 7 => array:3 [ "identificador" => "bib0040" "etiqueta" => "8." "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Effects of artificial urinary sphincters on urethral blood perfusion measured with laser Doppler" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:4 [ 0 => "F. Garcia Montes" 1 => "S. Knight" 2 => "A.R. Mundy" 3 => "M.D. Craggs" ] ] ] ] ] "host" => array:1 [ 0 => array:1 [ "Revista" => array:6 [ "tituloSerie" => "Br J Urol Int" "fecha" => "1999" "volumen" => "8" "numero" => "1" "paginaInicial" => "154" "paginaFinal" => "155" ] ] ] ] ] ] ] ] ] ] ] "idiomaDefecto" => "es" "url" => "/02104806/0000003100000005/v1_201304251840/S0210480607736719/v1_201304251840/es/main.assets" "Apartado" => array:4 [ "identificador" => "6429" "tipo" => "SECCION" "es" => array:2 [ "titulo" => "Original" "idiomaDefecto" => true ] "idiomaDefecto" => "es" ] "PDF" => "https://static.elsevier.es/multimedia/02104806/0000003100000005/v1_201304251840/S0210480607736719/v1_201304251840/es/main.pdf?idApp=UINPBA00004N&text.app=https://www.elsevier.es/" "EPUB" => "https://multimedia.elsevier.es/PublicationsMultimediaV1/item/epub/S0210480607736719?idApp=UINPBA00004N" ]
Journal Information
Importancia de la integridad de la mucosa y submucosa uretral en la continencia de los pacientes con esfínteres urinarios artificiales
The role of low urethral mucosal and submucosal blood perfusion in patients with artificial urinary sphincters