Urodynamic aspects of feminine urinary incontinence treated with slings | Actas Urológicas Españolas (English Edition)

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Singh, R.J. Sinha" "autores" => array:2 [ 0 => array:2 [ "nombre" => "V." "apellidos" => "Singh" ] 1 => array:2 [ "nombre" => "R.J." "apellidos" => "Sinha" ] ] ] ] ] "idiomaDefecto" => "en" "Traduccion" => array:1 [ "es" => array:9 [ "pii" => "S0210480611002889" "doi" => "10.1016/j.acuro.2011.06.022" "estado" => "S300" "subdocumento" => "" "abierto" => array:3 [ "ES" => false "ES2" => false "LATM" => false ] "gratuito" => false "lecturas" => array:1 [ "total" => 0 ] "idiomaDefecto" => "es" "EPUB" => "https://multimedia.elsevier.es/PublicationsMultimediaV1/item/epub/S0210480611002889?idApp=UINPBA00004N" ] ] "EPUB" => "https://multimedia.elsevier.es/PublicationsMultimediaV1/item/epub/S2173578612000571?idApp=UINPBA00004N" "url" => "/21735786/0000003600000002/v1_201304251738/S2173578612000571/v1_201304251738/en/main.assets" ] "en" => array:20 [ "idiomaDefecto" => true "cabecera" => "Original article" "titulo" => "Urodynamic aspects of feminine urinary incontinence treated with slings" "tieneTextoCompleto" => true "paginas" => array:1 [ 0 => array:2 [ "paginaInicial" => "79" "paginaFinal" => "85" ] ] "autores" => array:1 [ 0 => array:4 [ "autoresLista" => "J. Salinas, S. Méndez, M. Virseda, I. Arance, H. Pelaquim, J. Moreno Sierra, J.C. Ramírez, L. Resel-Folkersma, A. Silmi" "autores" => array:9 [ 0 => array:4 [ "nombre" => "J." "apellidos" => "Salinas" "email" => array:1 [ 0 => "jsalinascasado@yahoo.es" ] "referencia" => array:1 [ 0 => array:2 [ "etiqueta" => "¿" "identificador" => "cor0005" ] ] ] 1 => array:2 [ "nombre" => "S." "apellidos" => "Méndez" ] 2 => array:2 [ "nombre" => "M." "apellidos" => "Virseda" ] 3 => array:2 [ "nombre" => "I." "apellidos" => "Arance" ] 4 => array:2 [ "nombre" => "H." "apellidos" => "Pelaquim" ] 5 => array:2 [ "nombre" => "J." "apellidos" => "Moreno Sierra" ] 6 => array:2 [ "nombre" => "J.C." "apellidos" => "Ramírez" ] 7 => array:2 [ "nombre" => "L." "apellidos" => "Resel-Folkersma" ] 8 => array:2 [ "nombre" => "A." "apellidos" => "Silmi" ] ] "afiliaciones" => array:1 [ 0 => array:1 [ "entidad" => "Servicio de Urología, Hospital Clínico Universitario San Carlos, Universidad Complutense de Madrid, Madrid, Spain" ] ] "correspondencia" => array:1 [ 0 => array:3 [ "identificador" => "cor0005" "etiqueta" => "⁎" "correspondencia" => "Corresponding author." ] ] ] ] "titulosAlternativos" => array:1 [ "es" => array:1 [ "titulo" => "Aspectos urodinámicos de la incontinencia urinaria femenina tratada con cabestrillos" ] ] "resumenGrafico" => array:2 [ "original" => 0 "multimedia" => array:7 [ "identificador" => "fig0015" "etiqueta" => "Figure 3" "tipo" => "MULTIMEDIAFIGURA" "mostrarFloat" => true "mostrarDisplay" => false "figura" => array:1 [ 0 => array:4 [ "imagen" => "gr3.jpeg" "Alto" => 1587 "Ancho" => 1503 "Tamanyo" => 103838 ] ] "descripcion" => array:1 [ "en" => "Diagnostic yield curve of Qmax with regard to postoperative urodynamic stress incontinence." ] ] ] "textoCompleto" => "IntroductionSurgical treatment of stress urinary incontinence (SUI) aims the urethral pressure to be maintained above the bladder pressure, both at rest and during increases in pressure caused by increased abdominal pressure. With the objective of improving the results of the technique, and of minimizing the discomfort of the treatment, various models of tension-free sling which have appeared on the market have been used.In order to know the factors that influence the outcome of the surgical treatment of the SUI, we face the difficulty of performing rigorous experimental studies, with objective approach such as determining whether a variable is related to the outcome of the different types of treatment described.In this sense, the main objective of this work is to determine which preoperative variables can be used to predict the outcome of the surgical treatment of female SUI with the different suburethral sling techniques. The secondary objectives are to analyze: (a) if SUI surgery causes other changes in the filling phase of the lower urinary tract and, if so, whether there are predictive variables with respect to these changes; and (b) if SUI surgery leads to changes in the voiding phase of the lower urinary tract and, if so, whether there are predictive variables regarding these changes.Material and methodsWe performed a retrospective study on a cohort of 139 women of mean age 61.7 years (standard deviation: 10.88 years), undergoing incontinence because of presenting SUI. The patients were classified according to urethral hypermobility (52%) and cervical incompetence (4%).The choice of the surgical technique has not been a variable possible to control, because it is a retrospective analysis of patients assigned to different services. The surgical techniques used are shown in <a class="elsevierStyleCrossRef" href="#fig0005">Fig. 1</a>. In 118 cases (84.8%) slings, which are the main study population, of different types, were used: TVT (30.9%), T0T (29.5%), REEMEX (15.8%), and SAFYRE (TVT) (8.6%) and Infast (2.2%).<elsevierMultimedia ident="fig0005"></elsevierMultimedia>The patients underwent a clinical examination before surgery and three months thereafter (evaluating the presence of SUI, overactive bladder syndrome, and symptoms of the voiding phase), and a complete video urodynamic study (prior informed consent), both of the filling and the voiding stages. A urethral profile was also performed in the postoperative period.The data were recorded in an Excel® spreadsheet, and imported into the SPSS® software for statistical analysis. The statistical tests used were: Fisher's exact test for dichotomous variables, non-parametric Wilcoxon's test for two dependent categorical samples, non-parametric Friedman's test for more than two categorical dependent samples, Student's ‘t’ test for comparison of means for two dependent parametric samples, and Pearson's chi-square test for independent categorical variables, and Student's ‘t’ test for comparison of means for two independent parametric samples. The significance level was set at bilateral p<0.05. Bilateral p<0.1 was considered a trend toward significance.Finally, we performed a multivariate logistic regression analysis for predictive purposes, the dependent variable being persistent postoperative SUI, using the step elimination method in steps (step-way).ResultsThe variation of the most significant symptoms after surgery is shown in <a class="elsevierStyleCrossRef" href="#tbl0005">Table 1</a>. A significant decrease in the percentage of both clinical SUI and urodynamic SUI was observed, from 100% preoperatively to 25% postoperatively, this reduction being statistically significant (p=0.000). With regard to the success of the different surgical techniques, there were no statistically significant differences between them (p=0.443). The postoperative variation of the urodynamic variables is shown in <a class="elsevierStyleCrossRefs" href="#tbl0010">Tables 2–4</a>.<elsevierMultimedia ident="tbl0005"></elsevierMultimedia><elsevierMultimedia ident="tbl0010"></elsevierMultimedia><elsevierMultimedia ident="tbl0015"></elsevierMultimedia><elsevierMultimedia ident="tbl0020"></elsevierMultimedia>In the filling phase, 30% of the patients had symptoms of preoperative bladder overactivity. In the postoperative period, there was a statistically significant decrease in these symptoms (p=0.001). Although we found more cases of detrusor overactivity postoperatively (36%) than preoperatively (30%), no statistically significant differences were detected (p=0.493). In the postoperative period, there was diminished amplitude of the involuntary contraction (p=0.013) and of the bladder capacity at which the contraction occurred (p=0.000) in the patients with persistent overactivity after surgery. Ex novo overactivity appeared in 12% of the cases.As for the voiding phase, there was a slight increase in the symptoms of the voiding phase, but only with a tendency to statistical significance (p=0.072). We did find, however, a significant decrease in the peak flow in the postoperative period (p=0.017) and in the peak flow percentile postoperatively (p=0.001), as well as a significant increase in the UR increase (p=0.004). No differences in the contractile power (W80-20) between the pre- and postoperative periods (p=0.490).The preoperative variables (<a class="elsevierStyleCrossRefs" href="#tbl0025">Tables 5 and 6</a>) that might be predictive of the outcome of the intervention were studied. The only variables that had statistical significance were age and preoperative urinary flow and, with a trend to significance, cervical incompetence. There was a significant relation between the absence of postoperative urodynamic SUI and age (p=0.024). However, we observed that the patients with preoperative abnormal peak flow percentile (p<50) have a greater risk of not healing (p=0.045), and the same thing happens if the preoperative peak flow rate is decreased (p=0.026). The patients with cervical incompetence also had a greater risk of not healing (p=0.099), with a relative risk of 2.78. Neither the preoperative UR increase nor the power of the detrusor was predictive of the success or failure of the intervention.<elsevierMultimedia ident="tbl0025"></elsevierMultimedia><elsevierMultimedia ident="tbl0030"></elsevierMultimedia>The ROC curves were constructed for the variables with statistically significant predictive value for the cure of the SUI, age (<a class="elsevierStyleCrossRef" href="#fig0010">Fig. 2</a>) and preoperative peak flow (<a class="elsevierStyleCrossRef" href="#fig0015">Fig. 3</a>). For the peak flow, the ideal cut-off point was set at 16ml/s and at 61 years for age, i.e., the patients aged over 61 years or with flow under 16ml/s in the preoperative period were less likely to cure the incontinence after the intervention.<elsevierMultimedia ident="fig0010"></elsevierMultimedia><elsevierMultimedia ident="fig0015"></elsevierMultimedia>The only preoperative variable that was statistically significant for the disappearance of detrusor overactivity in the postoperative period was age, setting the ideal cut-off point by means of the ROC curve at 60 years (p=0.020) (<a class="elsevierStyleCrossRef" href="#fig0020">Fig. 4</a>) We did not obtain any statistically significant relation between the different preoperative variables and the occurrence of the de novo detrusor overactivity. No Statistical significance between the preoperative variables and the postoperative peak flow reduction was not observed either, although the previous decreased Qmax almost reached statistical significance differences (p=0.056).<elsevierMultimedia ident="fig0020"></elsevierMultimedia>The emergence of postvoid residue in the postoperative period was associated with the preoperative UR increase, those with higher UR increase having greater residue in the preoperative period (p=0.029). A tendency to the residue was also shown in the patients with preoperative symptoms of the voiding phase (p=0.063), in which TVT and REEMEX were placed (p=0.080) and which had decreased preoperative Qmax (p=0.065).Finally, we also studied the relations between the postoperative, both clinical and urodynamic, variables. We found a significant relation between persistent postoperative clinical and urodynamic SUI (p=0.001) and between postoperative urodynamic SUI and a lower closing pressure on the urethral profile (p=0.025). In contrast, none of the entities, such as detrusor overactivity, peak flow, the closing functional length (urethral profile), the UR increase, the transmission of pressures, were statistically significant among the patients with and without SUI postoperatively.Regarding the voiding phase in the postoperative period, the presence of symptoms of the voiding phase was associated with the existence in the postoperative period of decreased peak flow (p=0.001) and showed a trend toward significance in the patients with postvoid residue (p=0.058). The postoperative peak flow was greater when there was no overactivity (p=0.005) and there was a tendency to UR increase and W80-20 higher when there was detrusor overactivity. The postoperative peak flow is inversely related to the postoperative UR increase (p=0.007) and directly to the W80-20 (p=0.000). There was a trend to statistical significance between the UR increase and the emergence of postvoid residue.In the multivariate analysis, three variables associated to persistent postoperative SUI were found: age, peak flow, and presence of bladder neck incompetence. In the step-way analysis, only one independent predictor of postoperative SUI was found: preoperative peak flow (p=0.0001). Age was shown to be dependent on Qmax, decreased flow occurring at an older age.DiscussionThe cure rate of our incontinence series and the decreased urodynamic SUI are similar to those described by other authors.<a class="elsevierStyleCrossRef" href="#bib0005">1</a> Possibly, our series do not show better results when patients come from different teaching hospitals and it is an outcome of the learning curve, and when the indication has been established by clinical symptoms only. Although apparently TVT-Safyre and TOT showed better results, there was no difference of statistical significance. Other authors have shown no significant differences between different techniques.<a class="elsevierStyleCrossRef" href="#bib0010">2</a>Studying the clinical variables, both their relations to urodynamic parameters and their possible predictive value, in our study, we found a statistically significant relation between clinical and urodynamic SUI.<a class="elsevierStyleCrossRef" href="#bib0015">3</a>Age in our series appeared as a predictor of absence of SUI in the postoperative period of incontinence surgery. However, multivariate analysis determined that age is not an independent variable. Deutsch et al.<a class="elsevierStyleCrossRef" href="#bib0020">4</a> also observe that age is a poor prognostic factor. However, in a multivariate analysis, Daneshgari et al.<a class="elsevierStyleCrossRef" href="#bib0025">5</a> found that neither age nor body mass index, race, obstetric history, or hormonal status were risk factors for recurrence of incontinence after surgery.The presence of overactive bladder syndrome was not proved as a prognostic factor of the result of incontinence surgery. There was no relation between symptoms of the voidinging phase and the presence of postoperative urodynamic SUI either.<a class="elsevierStyleCrossRef" href="#bib0030">6</a>Regarding urodynamic findings, preoperative peak flow was the only urodynamic parameter with predictive value regarding the postoperative outcome.<a class="elsevierStyleCrossRefs" href="#bib0035">7,8</a> In addition, the multivariate analysis showed that it was the only independent predictor of the postoperative outcome. Although the peak flow rate depends on three factors (micturition volume, urethral resistance, and bladder contractility), in our series, we found no relation among these three variables alone and postoperative urinary continence.With regard to the video-urodynamic results, we found no differences in the outcome between cases with or without urethral hypermobility. In the literature, there are different opinions. To Fritel et al.,<a class="elsevierStyleCrossRef" href="#bib0045">9</a> the presence or absence of urethral hypermobility is a predictive factor for the outcome of surgery; the greater mobility, the better result. Similarly, Meschia et al.<a class="elsevierStyleCrossRef" href="#bib0050">10</a> report that the absence of hypermobility in the preoperative period is a poor prognostic sign. In contrast, other authors such as Minaglia et al.<a class="elsevierStyleCrossRef" href="#bib0055">11</a> find no relation between postoperative hypermobility and the cure of urinary incontinence. In our series, the presence of an open bladder neck was a risk factor for persistent postoperative SUI. However, this difference was not fully significant, possibly due to the small number of women with open neck who underwent surgery.<a class="elsevierStyleCrossRef" href="#bib0060">12</a>In our series, we observed a significant relation between postoperative maximum urethral closure pressure (MUCP) and urinary incontinence. The patients with incontinence had a significantly lower MUCP. However, the length of the functional urethra showed no relation. Dörflinger et al.<a class="elsevierStyleCrossRef" href="#bib0065">13</a> also found a relation between maximum urethral closure pressure and urinary incontinence.After surgery, 50% of the patients with overactive bladder syndrome disappeared, while in 26% of the patients without prior overactive bladder syndrome it appeared after surgery (12% if we look at urodynamic detrusor overactivity). Overall, the net result was that the percentage of patients with overactive bladder syndrome decreased from 61 to 42%. Kulseng-Hanssen et al.<a class="elsevierStyleCrossRef" href="#bib0070">14</a> observed the occurrence of de novo urge incontinence in 11% of patients operated on for TVT and found that women with mixed incontinence had worse postoperative outcome than those who only had SUI. Porena et al.<a class="elsevierStyleCrossRef" href="#bib0010">2</a> suggest that patients undergoing TVT experienced more symptoms of the filling phase compared with those who underwent TOT. Overall, we observed an increase in the percentage of postoperative detrusor overactivity (30–36%). However, this change was not statistically significant.Overall, the net result was that the percentage of patients with overactive bladder syndrome decreased from 61 to 42%. Kulseng-Hanssen et al.<a class="elsevierStyleCrossRef" href="#bib0070">14</a> observed the occurrence of de novo urge incontinence in 11% of the patients operated on for TVT, and they found that women with mixed incontinence had worse postoperative outcome than those who only had SUI. Porena et al.<a class="elsevierStyleCrossRef" href="#bib0010">2</a> suggest that the patients undergoing TVT experienced more symptoms of the filling phase compared to those who underwent TOT. Overall, we observed an increase in the percentage of postoperative detrusor overactivity (30–36%). However, this change was not statistically significant.Osman<a class="elsevierStyleCrossRef" href="#bib0075">15</a> compared anticholinergic treatment versus surgical treatment with pubovaginal sling or Burch in women with mixed incontinence, and they observed a higher percentage of disappearance of urge incontinence with surgery than with medical treatment, although urge incontinence appeared after the intervention in 20% of patients with prior isolated SUI. Duckett et al.<a class="elsevierStyleCrossRef" href="#bib0080">16</a> observed a higher percentage of post-TVT detrusor overactivity in cases with decreased preoperative urinary flow, attributing it to an obstructive effect of surgery.In our study, the only variable that significantly predicted postoperative disappearance of hyperactivity was the age of the patient. The patients younger than 60 years had a significantly better healing rate. With regard to the ex novo detrusor overactivity, we have not detected any predictive factor of its appearance. However, the literature has identified other factors such as detrusor pressure greater than 15cm H2O during the filling<a class="elsevierStyleCrossRef" href="#bib0085">17</a> or elevated preoperative flow acceleration<a class="elsevierStyleCrossRef" href="#bib0090">18</a> in addition to age, previous surgery, or radiological evidence of urethral compression.<a class="elsevierStyleCrossRef" href="#bib0095">19</a>Another interesting aspect is the impact of the intervention on the voiding phase. In our series we observed a significant decrease in peak urinary flow with surgery. This observation had already been identified by other authors.<a class="elsevierStyleCrossRef" href="#bib0100">20</a> Dolan et al.<a class="elsevierStyleCrossRef" href="#bib0105">21</a> point that the decrease in peak flow is only observed in the patients in whom incontinence disappears after surgery, and this decrease in the peak flow is accompanied by an increased opening voiding pressure.In our study, the postvoid residue did not increase after surgery, although a direct relation was found between the presence of postoperative postvoid residue with prior existence of symptoms of the filling phase and with preoperative peak flow. The strongest relation was established between the postoperative postvoid residue and the preoperative UR increase figure.<a class="elsevierStyleCrossRefs" href="#bib0110">22,23</a> The surgical technique used did show an influence on the appearance of the postvoid residue in our series, the residue being less with TOT and TVT-Safyre than with TVT and REEMEX.Contractile power measured by the parameter W80-20 did not experience any change either. Groen and Bosch<a class="elsevierStyleCrossRef" href="#bib0120">24</a> found that the patients with greater contractile power measured by the parameter WF tend not to require catheterization in postoperative incontinence surgery.We think that although the urodynamic study is subject to revisions with regard to its indications in female SUI, it remains a useful tool to decide the treatment of this pathology.<a class="elsevierStyleCrossRef" href="#bib0125">25</a> Furthermore, the introduction of new types of less invasive slings is necessary to consider the importance of a long-term urodynamic evaluation of this condition, allowing us to better understand the functional evolution of the patients and to better predict the risk of failure of the surgery.<a class="elsevierStyleCrossRefs" href="#bib0130">26,27</a>Conflict of interestThe authors declare that they have no conflict of interest." "textoCompletoSecciones" => array:1 [ "secciones" => array:10 [ 0 => array:2 [ "identificador" => "xres100107" "titulo" => array:5 [ 0 => "Abstract" 1 => "Objectives" 2 => "Material and methods" 3 => "Results" 4 => "Conclusions" ] ] 1 => array:2 [ "identificador" => "xpalclavsec87271" "titulo" => "Keywords" ] 2 => array:2 [ "identificador" => "xres100106" "titulo" => array:5 [ 0 => "Resumen" 1 => "Objetivos" 2 => "Material y métodos" 3 => "Resultados" 4 => "Conclusiones" ] ] 3 => array:2 [ "identificador" => "xpalclavsec87272" "titulo" => "Palabras clave" ] 4 => array:2 [ "identificador" => "sec0005" "titulo" => "Introduction" ] 5 => array:2 [ "identificador" => "sec0010" "titulo" => "Material and methods" ] 6 => array:2 [ "identificador" => "sec0015" "titulo" => "Results" ] 7 => array:2 [ "identificador" => "sec0020" "titulo" => "Discussion" ] 8 => array:2 [ "identificador" => "sec0025" "titulo" => "Conflict of interest" ] 9 => array:1 [ "titulo" => "References" ] ] ] "pdfFichero" => "main.pdf" "tienePdf" => true "fechaRecibido" => "2010-03-14" "fechaAceptado" => "2010-06-18" "PalabrasClave" => array:2 [ "en" => array:1 [ 0 => array:4 [ "clase" => "keyword" "titulo" => "Keywords" "identificador" => "xpalclavsec87271" "palabras" => array:3 [ 0 => "Stress urinary incontinence" 1 => "Slings" 2 => "Urodynamics" ] ] ] "es" => array:1 [ 0 => array:4 [ "clase" => "keyword" "titulo" => "Palabras clave" "identificador" => "xpalclavsec87272" "palabras" => array:3 [ 0 => "Incontinencia urinaria de esfuerzo" 1 => "Slings" 2 => "Urodinámica" ] ] ] ] "tieneResumen" => true "resumen" => array:2 [ "en" => array:2 [ "titulo" => "Abstract" "resumen" => "ObjectivesTreatment of feminine stress urinary incontinence (SUI) with slings aims to supplement the function of the damaged ligaments, favoring the correct transmission of the tensions. Our objective is to determine which preoperative variables could predict the outcome of surgical treatment of SUI and to study the urodynamic changes produced by the surgery. Material and methods139 women (age X¯=61.7; σ=10.88) operated on due to SUI were studied retrospectively. In 118 cases (84.8%), sling techniques (TVT, TOT, TVT-Safyre, and REEMEX) were used. Clinical evaluation and complete preoperative video-urodynamics were made pre-operatively and at 3 months of surgery. A statistical study (Fisher's test, Wilcoxon, Friedman, Student's t and Pearson's χ2) and analysis of multivariant logistic regression analysis by step elimination method were performed. ResultsPost-operatively, the SUI (p=0.000) and bladder hyperactivity syndrome decreased. The success percentages (urodynamic absence of SUI) for each technique were: TVT-Safyre (75%), TOT (73%), TVT (60%) and REEMEX (57%), without significant differences. Age (ROC cut-off: 61 years) was a prognostic factor of success (p=0.024). Preoperative maximum flow (Qmax) (16ml/s) constituted the only urodynamic parameter with a predictive value for success (p=0.026). An open bladder neck was a risk factor for persistence of postoperative SUI (RR=2.78). A significant decrease of the postsurgical Qmax (p=0.017) was verified, without increase of the post micturition residue or of the Wmax. An increase of the postsurgical urethral resistance (UR) was also observed (p=0.004). ConclusionsThe pre-operative Qmax is the most important urodynamic prognostic parameter in feminine SUI surgery, its normality being associated to a greater probability of cure of the incontinence. In the cases of decreased preoperative flow, use of slings that increase urethral resistance more (REEMEX) is not recommended. Hyperactivity of the preoperative detrusor does not significantly modify the results of surgery of the SUI." ] "es" => array:2 [ "titulo" => "Resumen" "resumen" => "ObjetivosEl tratamiento de la incontinencia urinaria de esfuerzo (IUE) femenina con cabestrillos, pretende suplir la función de los ligamentos dañados, favoreciendo la transmisión correcta de las tensiones. Nuestro objetivo es determinar qué variables preoperatorias pueden predecir el resultado del tratamiento quirúrgico de la IUE y estudiar los cambios urodinámicos que produce la cirugía. Material y métodos139 mujeres (edad X¯=61,7; σ=10,88) intervenidas por IUE fueron estudiadas retrospectivamente. En 118 casos (84,8%) se utilizaron técnicas de cabestrillo (TVT, TOT, TVT-Safyre, REEMEX). Se realizó evaluación clínica y video-urodinámica completa preoperatoria y a los tres meses de cirugía. Se realizó tratamiento estadístico (test de Fisher, Wilcoxon, Friedman, t Student y χ2 Pearson) y análisis de regresión logística multivariante mediante método de eliminación por pasos. ResultadosPostoperatoriamente disminuyó la IUE (p=0.000) y el síndrome de hiperactividad vesical (p=0,001). Los porcentajes de éxito (ausencia urodinámica de IUE) para cada técnica fueron: TVT-Safyre (75%), TOT (73%), TVT (60%) y REEMEX (57%), sin diferencias significativas. La edad (punto de corte ROC 61 años) fue factor pronóstico de éxito (p=0,024). El flujo máximo (Qmax) preoperatorio (16ml/s) constituyó el único parámetro urodinámico con valor predictivo (p=0,026) para éxito. Un cuello vesical abierto fue factor de riesgo para la persistencia de IUE postoperatoria (RR=2,78). Se comprobó disminución significativa de Qmax postquirúrgico (p=0,017), sin aumento del residuo postmiccional ni de Wmax. También se observó aumento de URA (resistencia uretral) post-cirugía (p=0,004). ConclusionesEl Qmax preoperatorio es el parámetro urodinámico pronóstico mas importante en la cirugía de la IUE femenina, asociándose su normalidad a una mayor posibilidad de cura de la incontinencia. En los casos de flujo preoperatorio disminuido se desaconseja los cabestrillos que más incrementan la resistencia uretral (REEMEX). La hiperactividad del detrusor preoperatoria no modifica significativamente los resultados de la cirugía de la IUE." ] ] "NotaPie" => array:1 [ 0 => array:2 [ "etiqueta" => "☆" "nota" => "Please cite this article as: Salinas J, Méndez S, Virseda M, Arance I, Pelaquim H, Moreno Sierra J, et al. Aspectos urodinámicos d ela incontinencia urinaria femenina tratada con cabestrillos. Actas Urol Esp. 2012;36:79–85." ] ] "multimedia" => array:10 [ 0 => array:7 [ "identificador" => "fig0005" "etiqueta" => "Figure 1" "tipo" => "MULTIMEDIAFIGURA" "mostrarFloat" => true "mostrarDisplay" => false "figura" => array:1 [ 0 => array:4 [ "imagen" => "gr1.jpeg" "Alto" => 1527 "Ancho" => 1629 "Tamanyo" => 146115 ] ] "descripcion" => array:1 [ "en" => "Type of female SUI interventions performed." ] ] 1 => array:7 [ "identificador" => "fig0010" "etiqueta" => "Figure 2" "tipo" => "MULTIMEDIAFIGURA" "mostrarFloat" => true "mostrarDisplay" => false "figura" => array:1 [ 0 => array:4 [ "imagen" => "gr2.jpeg" "Alto" => 1562 "Ancho" => 1487 "Tamanyo" => 105433 ] ] "descripcion" => array:1 [ "en" => "Diagnostic yield curve of age with regard to healing of postoperative urodynamic stress incontinence." ] ] 2 => array:7 [ "identificador" => "fig0015" "etiqueta" => "Figure 3" "tipo" => "MULTIMEDIAFIGURA" "mostrarFloat" => true "mostrarDisplay" => false "figura" => array:1 [ 0 => array:4 [ "imagen" => "gr3.jpeg" "Alto" => 1587 "Ancho" => 1503 "Tamanyo" => 103838 ] ] "descripcion" => array:1 [ "en" => "Diagnostic yield curve of Qmax with regard to postoperative urodynamic stress incontinence." ] ] 3 => array:7 [ "identificador" => "fig0020" "etiqueta" => "Figure 4" "tipo" => "MULTIMEDIAFIGURA" "mostrarFloat" => true "mostrarDisplay" => false "figura" => array:1 [ 0 => array:4 [ "imagen" => "gr4.jpeg" "Alto" => 1554 "Ancho" => 1501 "Tamanyo" => 98494 ] ] "descripcion" => array:1 [ "en" => "Diagnostic yield curve of age with regard to the healing of detrusor overactivity." ] ] 4 => array:7 [ "identificador" => "tbl0005" "etiqueta" => "Table 1" "tipo" => "MULTIMEDIATABLA" "mostrarFloat" => true "mostrarDisplay" => false "tabla" => array:2 [ "tablatextoimagen" => array:1 [ 0 => array:2 [ "tabla" => array:1 [ 0 => """ <table border="0" frame="\n \t\t\t\t\tvoid\n \t\t\t\t" class=""><thead title="thead"><tr title="table-row"><td class="td" title="\n \t\t\t\t\ttable-head\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t" style="border-bottom: 2px solid black">Symptoms \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-head\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t" style="border-bottom: 2px solid black">Statistical significance \t\t\t\t\t\t\n \t\t\t\t</td></tr></thead><tbody title="tbody"><tr title="table-row"><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">Decreased SUI \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="char" valign="\n \t\t\t\t\ttop\n \t\t\t\t">p=0.000<a class="elsevierStyleCrossRef" href="#tblfn0005">*</a> \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">Decreased overactive bladder syndrome \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="char" valign="\n \t\t\t\t\ttop\n \t\t\t\t">p=0.001<a class="elsevierStyleCrossRef" href="#tblfn0005">*</a> \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">Increased filling phase symptoms \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="char" valign="\n \t\t\t\t\ttop\n \t\t\t\t">p=0.072<a class="elsevierStyleCrossRef" href="#tblfn0010">**</a> \t\t\t\t\t\t\n \t\t\t\t</td></tr></tbody></table> """ ] "imagenFichero" => array:1 [ 0 => "xTab183940.png" ] ] ] "notaPie" => array:2 [ 0 => array:3 [ "identificador" => "tblfn0005" "etiqueta" => "*" "nota" => "Significant." ] 1 => array:3 [ "identificador" => "tblfn0010" "etiqueta" => "**" "nota" => "Trend to significance." ] ] ] "descripcion" => array:1 [ "en" => "Postsurgical variation of symptoms." ] ] 5 => array:7 [ "identificador" => "tbl0010" "etiqueta" => "Table 2" "tipo" => "MULTIMEDIATABLA" "mostrarFloat" => true "mostrarDisplay" => false "tabla" => array:2 [ "tablatextoimagen" => array:1 [ 0 => array:2 [ "tabla" => array:1 [ 0 => """ <table border="0" frame="\n \t\t\t\t\tvoid\n \t\t\t\t" class=""><thead title="thead"><tr title="table-row"><td class="td" title="\n \t\t\t\t\ttable-head\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t" style="border-bottom: 2px solid black"><a class="elsevierStyleCrossRef" href="#tblfn0015">a</a>Variable \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-head\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t" style="border-bottom: 2px solid black">Preoperative period \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-head\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t" style="border-bottom: 2px solid black">Postoperative period \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-head\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t" style="border-bottom: 2px solid black">Significance \t\t\t\t\t\t\n \t\t\t\t</td></tr></thead><tbody title="tbody"><tr title="table-row"><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">Qmax (ml/s) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="char" valign="\n \t\t\t\t\ttop\n \t\t\t\t">23.39 (22.70) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="char" valign="\n \t\t\t\t\ttop\n \t\t\t\t">19.02 (10.91) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="char" valign="\n \t\t\t\t\ttop\n \t\t\t\t">0.017<a class="elsevierStyleCrossRef" href="#tblfn0025">c</a> \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">Postvoid residue (ml) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="char" valign="\n \t\t\t\t\ttop\n \t\t\t\t">13.49 (42.82) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="char" valign="\n \t\t\t\t\ttop\n \t\t\t\t">10.56 (35.3) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="char" valign="\n \t\t\t\t\ttop\n \t\t\t\t">0.839 \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t"><a class="elsevierStyleCrossRef" href="#tblfn0020">b</a>Involuntary contraction amplitude (cm H2O) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="char" valign="\n \t\t\t\t\ttop\n \t\t\t\t">27.58 (16.50) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="char" valign="\n \t\t\t\t\ttop\n \t\t\t\t">16.12 (18.04) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="char" valign="\n \t\t\t\t\ttop\n \t\t\t\t">0.013<a class="elsevierStyleCrossRef" href="#tblfn0025">c</a> \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t"><a class="elsevierStyleCrossRef" href="#tblfn0020">b</a>Involuntary contraction capacity (ml) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="char" valign="\n \t\t\t\t\ttop\n \t\t\t\t">133.21 (81.54) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="char" valign="\n \t\t\t\t\ttop\n \t\t\t\t">55.33 (75.61) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="char" valign="\n \t\t\t\t\ttop\n \t\t\t\t">0.000<a class="elsevierStyleCrossRef" href="#tblfn0025">c</a> \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">UR increase (cmH2O) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="char" valign="\n \t\t\t\t\ttop\n \t\t\t\t">10.14 (5.79) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="char" valign="\n \t\t\t\t\ttop\n \t\t\t\t">12.30 (8.55) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="char" valign="\n \t\t\t\t\ttop\n \t\t\t\t">0.004<a class="elsevierStyleCrossRef" href="#tblfn0025">c</a> \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">W 80-20 (W/m2) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="char" valign="\n \t\t\t\t\ttop\n \t\t\t\t">1.40 (3.22) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="char" valign="\n \t\t\t\t\ttop\n \t\t\t\t">2.51 (10.31) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="char" valign="\n \t\t\t\t\ttop\n \t\t\t\t">0.490 \t\t\t\t\t\t\n \t\t\t\t</td></tr></tbody></table> """ ] "imagenFichero" => array:1 [ 0 => "xTab183938.png" ] ] ] "notaPie" => array:3 [ 0 => array:3 [ "identificador" => "tblfn0015" "etiqueta" => "a" "nota" => "Mean (standard deviation between brackets)." ] 1 => array:3 [ "identificador" => "tblfn0020" "etiqueta" => "b" "nota" => "Patients with pre- and postoperarive overactivity." ] 2 => array:3 [ "identificador" => "tblfn0025" "etiqueta" => "c" "nota" => "Significant." ] ] ] "descripcion" => array:1 [ "en" => "Postsurgical variation of urodynamic variables." ] ] 6 => array:7 [ "identificador" => "tbl0015" "etiqueta" => "Table 3" "tipo" => "MULTIMEDIATABLA" "mostrarFloat" => true "mostrarDisplay" => false "tabla" => array:2 [ "tablatextoimagen" => array:1 [ 0 => array:2 [ "tabla" => array:1 [ 0 => """ <table border="0" frame="\n \t\t\t\t\tvoid\n \t\t\t\t" class=""><thead title="thead"><tr title="table-row"><td class="td" title="\n \t\t\t\t\ttable-head\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t" style="border-bottom: 2px solid black">Variable<a class="elsevierStyleCrossRef" href="#tblfn0030">a</a> \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-head\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t" style="border-bottom: 2px solid black">Preoperative percentage (%) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-head\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t" style="border-bottom: 2px solid black">Postoperative percentage (%) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-head\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t" style="border-bottom: 2px solid black">Significance level \t\t\t\t\t\t\n \t\t\t\t</td></tr></thead><tbody title="tbody"><tr title="table-row"><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">SUI \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="char" valign="\n \t\t\t\t\ttop\n \t\t\t\t">100 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="char" valign="\n \t\t\t\t\ttop\n \t\t\t\t">25 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="char" valign="\n \t\t\t\t\ttop\n \t\t\t\t">0.000<a class="elsevierStyleCrossRef" href="#tblfn0040">c</a> \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">Detrusor overactivity \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="char" valign="\n \t\t\t\t\ttop\n \t\t\t\t">30 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="char" valign="\n \t\t\t\t\ttop\n \t\t\t\t">36 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="char" valign="\n \t\t\t\t\ttop\n \t\t\t\t">0.493 \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t"><a class="elsevierStyleCrossRef" href="#tblfn0035">b</a>Percentile Qmax \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="char" valign="\n \t\t\t\t\ttop\n \t\t\t\t">23 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="char" valign="\n \t\t\t\t\ttop\n \t\t\t\t">9 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="char" valign="\n \t\t\t\t\ttop\n \t\t\t\t">0.001<a class="elsevierStyleCrossRef" href="#tblfn0040">c</a> \t\t\t\t\t\t\n \t\t\t\t</td></tr></tbody></table> """ ] "imagenFichero" => array:1 [ 0 => "xTab183939.png" ] ] ] "notaPie" => array:3 [ 0 => array:3 [ "identificador" => "tblfn0030" "etiqueta" => "a" "nota" => "Presence of the symptom." ] 1 => array:3 [ "identificador" => "tblfn0035" "etiqueta" => "b" "nota" => "P50." ] 2 => array:3 [ "identificador" => "tblfn0040" "etiqueta" => "c" "nota" => "Significant." ] ] ] "descripcion" => array:1 [ "en" => "Postoperative variation of urodynamic variables." ] ] 7 => array:7 [ "identificador" => "tbl0020" "etiqueta" => "Table 4" "tipo" => "MULTIMEDIATABLA" "mostrarFloat" => true "mostrarDisplay" => false "tabla" => array:1 [ "tablatextoimagen" => array:1 [ 0 => array:2 [ "tabla" => array:1 [ 0 => """ <table border="0" frame="\n \t\t\t\t\tvoid\n \t\t\t\t" class=""><thead title="thead"><tr title="table-row"><td class="td" title="\n \t\t\t\t\ttable-head\n \t\t\t\t " align="" valign="\n \t\t\t\t\ttop\n \t\t\t\t"> \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-head\n \t\t\t\t " colspan="4" align="center" valign="\n \t\t\t\t\ttop\n \t\t\t\t" style="border-bottom: 2px solid black">Postoperative urodynamic results</td></tr><tr title="table-row"><td class="td" title="\n \t\t\t\t\ttable-head\n \t\t\t\t " align="" valign="\n \t\t\t\t\ttop\n \t\t\t\t" style="border-bottom: 2px solid black"> \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-head\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t" style="border-bottom: 2px solid black">Normal (%) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-head\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t" style="border-bottom: 2px solid black">SUI (%) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-head\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t" style="border-bottom: 2px solid black">SUI and overactivity (%) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-head\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t" style="border-bottom: 2px solid black">Overactivity (%) \t\t\t\t\t\t\n \t\t\t\t</td></tr></thead><tbody title="tbody"><tr title="table-row"><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">SUI (preoperative) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="char" valign="\n \t\t\t\t\ttop\n \t\t\t\t">51.32 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="char" valign="\n \t\t\t\t\ttop\n \t\t\t\t">23.68 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="char" valign="\n \t\t\t\t\ttop\n \t\t\t\t">11.84 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="char" valign="\n \t\t\t\t\ttop\n \t\t\t\t">13.16 \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">SUI and overactivity (preoperative) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="char" valign="\n \t\t\t\t\ttop\n \t\t\t\t">30.30 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="char" valign="\n \t\t\t\t\ttop\n \t\t\t\t">15.15 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="char" valign="\n \t\t\t\t\ttop\n \t\t\t\t">15.15 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="char" valign="\n \t\t\t\t\ttop\n \t\t\t\t">39.39 \t\t\t\t\t\t\n \t\t\t\t</td></tr></tbody></table> """ ] "imagenFichero" => array:1 [ 0 => "xTab183936.png" ] ] ] ] "descripcion" => array:1 [ "en" => "Postoperative variation of urodynamic variables." ] ] 8 => array:7 [ "identificador" => "tbl0025" "etiqueta" => "Table 5" "tipo" => "MULTIMEDIATABLA" "mostrarFloat" => true "mostrarDisplay" => false "tabla" => array:2 [ "tablatextoimagen" => array:1 [ 0 => array:2 [ "tabla" => array:1 [ 0 => """ <table border="0" frame="\n \t\t\t\t\tvoid\n \t\t\t\t" class=""><thead title="thead"><tr title="table-row"><td class="td" title="\n \t\t\t\t\ttable-head\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">Variable \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-head\n \t\t\t\t " colspan="2" align="center" valign="\n \t\t\t\t\ttop\n \t\t\t\t" style="border-bottom: 2px solid black">Healing percentage (%)</td><td class="td" title="\n \t\t\t\t\ttable-head\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">Relative risk (%) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-head\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">Significance level \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="\n \t\t\t\t\ttable-head\n \t\t\t\t " align="" valign="\n \t\t\t\t\ttop\n \t\t\t\t" style="border-bottom: 2px solid black"> \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-head\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t" style="border-bottom: 2px solid black">Yes \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-head\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t" style="border-bottom: 2px solid black">No \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-head\n \t\t\t\t " align="" valign="\n \t\t\t\t\ttop\n \t\t\t\t" style="border-bottom: 2px solid black"> \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-head\n \t\t\t\t " align="" valign="\n \t\t\t\t\ttop\n \t\t\t\t" style="border-bottom: 2px solid black"> \t\t\t\t\t\t\n \t\t\t\t</td></tr></thead><tbody title="tbody"><tr title="table-row"><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">Overactive bladder syndrome \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="char" valign="\n \t\t\t\t\ttop\n \t\t\t\t">68 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="char" valign="\n \t\t\t\t\ttop\n \t\t\t\t">67 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="char" valign="\n \t\t\t\t\ttop\n \t\t\t\t">0.99 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="char" valign="\n \t\t\t\t\ttop\n \t\t\t\t">1.00 \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">Voiding phase symptoms \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="char" valign="\n \t\t\t\t\ttop\n \t\t\t\t">63 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="char" valign="\n \t\t\t\t\ttop\n \t\t\t\t">68 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="char" valign="\n \t\t\t\t\ttop\n \t\t\t\t">1.07 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="char" valign="\n \t\t\t\t\ttop\n \t\t\t\t">0.788 \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">Detrusor overactivity \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="char" valign="\n \t\t\t\t\ttop\n \t\t\t\t">70 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="char" valign="\n \t\t\t\t\ttop\n \t\t\t\t">68 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="char" valign="\n \t\t\t\t\ttop\n \t\t\t\t">0.97 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="char" valign="\n \t\t\t\t\ttop\n \t\t\t\t">0.826 \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">p<50 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="char" valign="\n \t\t\t\t\ttop\n \t\t\t\t">56 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="char" valign="\n \t\t\t\t\ttop\n \t\t\t\t">75 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="char" valign="\n \t\t\t\t\ttop\n \t\t\t\t">1.10 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="char" valign="\n \t\t\t\t\ttop\n \t\t\t\t">0.045<a class="elsevierStyleCrossRef" href="#tblfn0045">a</a> \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">Urethral hypermobility \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="char" valign="\n \t\t\t\t\ttop\n \t\t\t\t">63 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="char" valign="\n \t\t\t\t\ttop\n \t\t\t\t">77 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="char" valign="\n \t\t\t\t\ttop\n \t\t\t\t">1.22 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="char" valign="\n \t\t\t\t\ttop\n \t\t\t\t">0.188 \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">Cervical incompetence \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="char" valign="\n \t\t\t\t\ttop\n \t\t\t\t">25 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="char" valign="\n \t\t\t\t\ttop\n \t\t\t\t">69 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="char" valign="\n \t\t\t\t\ttop\n \t\t\t\t">2.78 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="char" valign="\n \t\t\t\t\ttop\n \t\t\t\t">0.099<a class="elsevierStyleCrossRef" href="#tblfn0050">b</a> \t\t\t\t\t\t\n \t\t\t\t</td></tr></tbody></table> """ ] "imagenFichero" => array:1 [ 0 => "xTab183941.png" ] ] ] "notaPie" => array:2 [ 0 => array:3 [ "identificador" => "tblfn0045" "etiqueta" => "a" "nota" => "Significant." ] 1 => array:3 [ "identificador" => "tblfn0050" "etiqueta" => "b" "nota" => "Trend toward significance." ] ] ] "descripcion" => array:1 [ "en" => "Qualitative prognostic factors for healing of SUI." ] ] 9 => array:7 [ "identificador" => "tbl0030" "etiqueta" => "Table 6" "tipo" => "MULTIMEDIATABLA" "mostrarFloat" => true "mostrarDisplay" => false "tabla" => array:2 [ "tablatextoimagen" => array:1 [ 0 => array:2 [ "tabla" => array:1 [ 0 => """ <table border="0" frame="\n \t\t\t\t\tvoid\n \t\t\t\t" class=""><thead title="thead"><tr title="table-row"><td class="td" title="\n \t\t\t\t\ttable-head\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">Variable \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-head\n \t\t\t\t " colspan="2" align="center" valign="\n \t\t\t\t\ttop\n \t\t\t\t" style="border-bottom: 2px solid black">Mean (standard deviation)</td><td class="td" title="\n \t\t\t\t\ttable-head\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">Significance \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="\n \t\t\t\t\ttable-head\n \t\t\t\t " align="" valign="\n \t\t\t\t\ttop\n \t\t\t\t" style="border-bottom: 2px solid black"> \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-head\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t" style="border-bottom: 2px solid black">Healing \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-head\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t" style="border-bottom: 2px solid black">No healing \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-head\n \t\t\t\t " align="" valign="\n \t\t\t\t\ttop\n \t\t\t\t" style="border-bottom: 2px solid black"> \t\t\t\t\t\t\n \t\t\t\t</td></tr></thead><tbody title="tbody"><tr title="table-row"><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">Age \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="char" valign="\n \t\t\t\t\ttop\n \t\t\t\t">60.1 (11.09) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="char" valign="\n \t\t\t\t\ttop\n \t\t\t\t">64.5 (9.90) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="char" valign="\n \t\t\t\t\ttop\n \t\t\t\t">0.024<a class="elsevierStyleCrossRef" href="#tblfn0055">a</a> \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">Peak flow (ml/s) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="char" valign="\n \t\t\t\t\ttop\n \t\t\t\t">26.03 (26.24) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="char" valign="\n \t\t\t\t\ttop\n \t\t\t\t">18.26 (8.74) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="char" valign="\n \t\t\t\t\ttop\n \t\t\t\t">0.026<a class="elsevierStyleCrossRef" href="#tblfn0055">a</a> \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">Postvoid residue (ml) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="char" valign="\n \t\t\t\t\ttop\n \t\t\t\t">12.75 (39.17) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="char" valign="\n \t\t\t\t\ttop\n \t\t\t\t">15.23 (53.76) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="char" valign="\n \t\t\t\t\ttop\n \t\t\t\t">0.787 \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">Involuntary contraction amplitude (ml) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="char" valign="\n \t\t\t\t\ttop\n \t\t\t\t">26.83 (12.77) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="char" valign="\n \t\t\t\t\ttop\n \t\t\t\t">29.30 (23.76) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="char" valign="\n \t\t\t\t\ttop\n \t\t\t\t">0.699 \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">Capacity of involuntary contraction (ml) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="char" valign="\n \t\t\t\t\ttop\n \t\t\t\t">139.65 (80.39) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="char" valign="\n \t\t\t\t\ttop\n \t\t\t\t">118.40 (88.56) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="char" valign="\n \t\t\t\t\ttop\n \t\t\t\t">0.682 \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">UR increase (cm H2O) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="char" valign="\n \t\t\t\t\ttop\n \t\t\t\t">10.25 (6.17) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="char" valign="\n \t\t\t\t\ttop\n \t\t\t\t">9.88 (4.86) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="char" valign="\n \t\t\t\t\ttop\n \t\t\t\t">0.794 \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">W80-20 (W/m2) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="char" valign="\n \t\t\t\t\ttop\n \t\t\t\t">1.17 (3.07) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="char" valign="\n \t\t\t\t\ttop\n \t\t\t\t">1.93 (3.14) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="char" valign="\n \t\t\t\t\ttop\n \t\t\t\t">0.349 \t\t\t\t\t\t\n \t\t\t\t</td></tr></tbody></table> """ ] "imagenFichero" => array:1 [ 0 => "xTab183937.png" ] ] ] "notaPie" => array:1 [ 0 => array:3 [ "identificador" => "tblfn0055" "etiqueta" => "a" "nota" => "Significant." ] ] ] "descripcion" => array:1 [ "en" => "Quantitative prognostic factors for healing of SUI." ] ] ] "bibliografia" => array:2 [ "titulo" => "References" "seccion" => array:1 [ 0 => array:2 [ "identificador" => "bibs0005" "bibliografiaReferencia" => array:27 [ 0 => array:3 [ "identificador" => "bib0005" "etiqueta" => "1" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Tension free vaginal tape versus Burch colposuspension for treatment of female stress urinary incontinence" 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Urodynamic aspects of feminine urinary incontinence treated with slings

Aspectos urodinámicos de la incontinencia urinaria femenina tratada con cabestrillos

J. Salinas

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jsalinascasado@yahoo.es

Corresponding author.

, S. Méndez, M. Virseda, I. Arance, H. Pelaquim, J. Moreno Sierra, J.C. Ramírez, L. Resel-Folkersma, A. Silmi

Servicio de Urología, Hospital Clínico Universitario San Carlos, Universidad Complutense de Madrid, Madrid, Spain

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    "cabecera" => "<span class="elsevierStyleTextfn">Original article</span>"
    "titulo" => "Urodynamic aspects of feminine urinary incontinence treated with slings"
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        "titulo" => "Aspectos urodin&#225;micos de la incontinencia urinaria femenina tratada con cabestrillos"
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          "en" => "<p id="spar0055" class="elsevierStyleSimplePara elsevierViewall">Diagnostic yield curve of <span class="elsevierStyleItalic">Q</span><span class="elsevierStyleInf">max</span> with regard to postoperative urodynamic stress incontinence&#46;</p>"
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    "textoCompleto" => "<span class="elsevierStyleSections"><span id="sec0005" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle">Introduction</span><p id="par0005" class="elsevierStylePara elsevierViewall">Surgical treatment of stress urinary incontinence &#40;SUI&#41; aims the urethral pressure to be maintained above the bladder pressure&#44; both at rest and during increases in pressure caused by increased abdominal pressure&#46; With the objective of improving the results of the technique&#44; and of minimizing the discomfort of the treatment&#44; various models of tension-free sling which have appeared on the market have been used&#46;</p><p id="par0010" class="elsevierStylePara elsevierViewall">In order to know the factors that influence the outcome of the surgical treatment of the SUI&#44; we face the difficulty of performing rigorous experimental studies&#44; with objective approach such as determining whether a variable is related to the outcome of the different types of treatment described&#46;</p><p id="par0015" class="elsevierStylePara elsevierViewall">In this sense&#44; the main objective of this work is to determine which preoperative variables can be used to predict the outcome of the surgical treatment of female SUI with the different suburethral sling techniques&#46; The secondary objectives are to analyze&#58; &#40;a&#41; if SUI surgery causes other changes in the filling phase of the lower urinary tract and&#44; if so&#44; whether there are predictive variables with respect to these changes&#59; and &#40;b&#41; if SUI surgery leads to changes in the voiding phase of the lower urinary tract and&#44; if so&#44; whether there are predictive variables regarding these changes&#46;</p></span><span id="sec0010" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle">Material and methods</span><p id="par0020" class="elsevierStylePara elsevierViewall">We performed a retrospective study on a cohort of 139 women of mean age 61&#46;7 years &#40;standard deviation&#58; 10&#46;88 years&#41;&#44; undergoing incontinence because of presenting SUI&#46; The patients were classified according to urethral hypermobility &#40;52&#37;&#41; and cervical incompetence &#40;4&#37;&#41;&#46;</p><p id="par0025" class="elsevierStylePara elsevierViewall">The choice of the surgical technique has not been a variable possible to control&#44; because it is a retrospective analysis of patients assigned to different services&#46; The surgical techniques used are shown in <a class="elsevierStyleCrossRef" href="#fig0005">Fig&#46; 1</a>&#46; In 118 cases &#40;84&#46;8&#37;&#41; slings&#44; which are the main study population&#44; of different types&#44; were used&#58; TVT &#40;30&#46;9&#37;&#41;&#44; T0T &#40;29&#46;5&#37;&#41;&#44; REEMEX &#40;15&#46;8&#37;&#41;&#44; and SAFYRE &#40;TVT&#41; &#40;8&#46;6&#37;&#41; and Infast &#40;2&#46;2&#37;&#41;&#46;</p><elsevierMultimedia ident="fig0005"></elsevierMultimedia><p id="par0030" class="elsevierStylePara elsevierViewall">The patients underwent a clinical examination before surgery and three months thereafter &#40;evaluating the presence of SUI&#44; overactive bladder syndrome&#44; and symptoms of the voiding phase&#41;&#44; and a complete video urodynamic study &#40;prior informed consent&#41;&#44; both of the filling and the voiding stages&#46; A urethral profile was also performed in the postoperative period&#46;</p><p id="par0035" class="elsevierStylePara elsevierViewall">The data were recorded in an Excel<span class="elsevierStyleSup">&#174;</span> spreadsheet&#44; and imported into the SPSS<span class="elsevierStyleSup">&#174;</span> software for statistical analysis&#46; The statistical tests used were&#58; Fisher&#39;s exact test for dichotomous variables&#44; non-parametric Wilcoxon&#39;s test for two dependent categorical samples&#44; non-parametric Friedman&#39;s test for more than two categorical dependent samples&#44; Student&#39;s &#8216;<span class="elsevierStyleItalic">t</span>&#8217; test for comparison of means for two dependent parametric samples&#44; and Pearson&#39;s chi-square test for independent categorical variables&#44; and Student&#39;s &#8216;<span class="elsevierStyleItalic">t</span>&#8217; test for comparison of means for two independent parametric samples&#46; The significance level was set at bilateral <span class="elsevierStyleItalic">p</span><span class="elsevierStyleHsp" style=""></span>&#60;<span class="elsevierStyleHsp" style=""></span>0&#46;05&#46; Bilateral <span class="elsevierStyleItalic">p</span><span class="elsevierStyleHsp" style=""></span>&#60;<span class="elsevierStyleHsp" style=""></span>0&#46;1 was considered a trend toward significance&#46;</p><p id="par0040" class="elsevierStylePara elsevierViewall">Finally&#44; we performed a multivariate logistic regression analysis for predictive purposes&#44; the dependent variable being persistent postoperative SUI&#44; using the step elimination method in steps &#40;step-way&#41;&#46;</p></span><span id="sec0015" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle">Results</span><p id="par0045" class="elsevierStylePara elsevierViewall">The variation of the most significant symptoms after surgery is shown in <a class="elsevierStyleCrossRef" href="#tbl0005">Table 1</a>&#46; A significant decrease in the percentage of both clinical SUI and urodynamic SUI was observed&#44; from 100&#37; preoperatively to 25&#37; postoperatively&#44; this reduction being statistically significant &#40;<span class="elsevierStyleItalic">p</span><span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>0&#46;000&#41;&#46; With regard to the success of the different surgical techniques&#44; there were no statistically significant differences between them &#40;<span class="elsevierStyleItalic">p</span><span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>0&#46;443&#41;&#46; The postoperative variation of the urodynamic variables is shown in <a class="elsevierStyleCrossRefs" href="#tbl0010">Tables 2&#8211;4</a>&#46;</p><elsevierMultimedia ident="tbl0005"></elsevierMultimedia><elsevierMultimedia ident="tbl0010"></elsevierMultimedia><elsevierMultimedia ident="tbl0015"></elsevierMultimedia><elsevierMultimedia ident="tbl0020"></elsevierMultimedia><p id="par0050" class="elsevierStylePara elsevierViewall">In the filling phase&#44; 30&#37; of the patients had symptoms of preoperative bladder overactivity&#46; In the postoperative period&#44; there was a statistically significant decrease in these symptoms &#40;<span class="elsevierStyleItalic">p</span><span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>0&#46;001&#41;&#46; Although we found more cases of detrusor overactivity postoperatively &#40;36&#37;&#41; than preoperatively &#40;30&#37;&#41;&#44; no statistically significant differences were detected &#40;<span class="elsevierStyleItalic">p</span><span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>0&#46;493&#41;&#46; In the postoperative period&#44; there was diminished amplitude of the involuntary contraction &#40;<span class="elsevierStyleItalic">p</span><span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>0&#46;013&#41; and of the bladder capacity at which the contraction occurred &#40;<span class="elsevierStyleItalic">p</span><span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>0&#46;000&#41; in the patients with persistent overactivity after surgery&#46; <span class="elsevierStyleItalic">Ex novo</span> overactivity appeared in 12&#37; of the cases&#46;</p><p id="par0055" class="elsevierStylePara elsevierViewall">As for the voiding phase&#44; there was a slight increase in the symptoms of the voiding phase&#44; but only with a tendency to statistical significance &#40;<span class="elsevierStyleItalic">p</span><span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>0&#46;072&#41;&#46; We did find&#44; however&#44; a significant decrease in the peak flow in the postoperative period &#40;<span class="elsevierStyleItalic">p</span><span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>0&#46;017&#41; and in the peak flow percentile postoperatively &#40;<span class="elsevierStyleItalic">p</span><span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>0&#46;001&#41;&#44; as well as a significant increase in the UR increase &#40;<span class="elsevierStyleItalic">p</span><span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>0&#46;004&#41;&#46; No differences in the contractile power &#40;W80-20&#41; between the pre- and postoperative periods &#40;<span class="elsevierStyleItalic">p</span><span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>0&#46;490&#41;&#46;</p><p id="par0060" class="elsevierStylePara elsevierViewall">The preoperative variables &#40;<a class="elsevierStyleCrossRefs" href="#tbl0025">Tables 5 and 6</a>&#41; that might be predictive of the outcome of the intervention were studied&#46; The only variables that had statistical significance were age and preoperative urinary flow and&#44; with a trend to significance&#44; cervical incompetence&#46; There was a significant relation between the absence of postoperative urodynamic SUI and age &#40;<span class="elsevierStyleItalic">p</span><span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>0&#46;024&#41;&#46; However&#44; we observed that the patients with preoperative abnormal peak flow percentile &#40;<span class="elsevierStyleItalic">p</span><span class="elsevierStyleHsp" style=""></span>&#60;<span class="elsevierStyleHsp" style=""></span>50&#41; have a greater risk of not healing &#40;<span class="elsevierStyleItalic">p</span><span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>0&#46;045&#41;&#44; and the same thing happens if the preoperative peak flow rate is decreased &#40;<span class="elsevierStyleItalic">p</span><span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>0&#46;026&#41;&#46; The patients with cervical incompetence also had a greater risk of not healing &#40;<span class="elsevierStyleItalic">p</span><span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>0&#46;099&#41;&#44; with a relative risk of 2&#46;78&#46; Neither the preoperative UR increase nor the power of the detrusor was predictive of the success or failure of the intervention&#46;</p><elsevierMultimedia ident="tbl0025"></elsevierMultimedia><elsevierMultimedia ident="tbl0030"></elsevierMultimedia><p id="par0065" class="elsevierStylePara elsevierViewall">The ROC curves were constructed for the variables with statistically significant predictive value for the cure of the SUI&#44; age &#40;<a class="elsevierStyleCrossRef" href="#fig0010">Fig&#46; 2</a>&#41; and preoperative peak flow &#40;<a class="elsevierStyleCrossRef" href="#fig0015">Fig&#46; 3</a>&#41;&#46; For the peak flow&#44; the ideal cut-off point was set at 16<span class="elsevierStyleHsp" style=""></span>ml&#47;s and at 61 years for age&#44; i&#46;e&#46;&#44; the patients aged over 61 years or with flow under 16<span class="elsevierStyleHsp" style=""></span>ml&#47;s in the preoperative period were less likely to cure the incontinence after the intervention&#46;</p><elsevierMultimedia ident="fig0010"></elsevierMultimedia><elsevierMultimedia ident="fig0015"></elsevierMultimedia><p id="par0070" class="elsevierStylePara elsevierViewall">The only preoperative variable that was statistically significant for the disappearance of detrusor overactivity in the postoperative period was age&#44; setting the ideal cut-off point by means of the ROC curve at 60 years &#40;<span class="elsevierStyleItalic">p</span><span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>0&#46;020&#41; &#40;<a class="elsevierStyleCrossRef" href="#fig0020">Fig&#46; 4</a>&#41; We did not obtain any statistically significant relation between the different preoperative variables and the occurrence of the de novo detrusor overactivity&#46; No Statistical significance between the preoperative variables and the postoperative peak flow reduction was not observed either&#44; although the previous decreased <span class="elsevierStyleItalic">Q</span><span class="elsevierStyleInf">max</span> almost reached statistical significance differences &#40;<span class="elsevierStyleItalic">p</span><span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>0&#46;056&#41;&#46;</p><elsevierMultimedia ident="fig0020"></elsevierMultimedia><p id="par0075" class="elsevierStylePara elsevierViewall">The emergence of postvoid residue in the postoperative period was associated with the preoperative UR increase&#44; those with higher UR increase having greater residue in the preoperative period &#40;<span class="elsevierStyleItalic">p</span><span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>0&#46;029&#41;&#46; A tendency to the residue was also shown in the patients with preoperative symptoms of the voiding phase &#40;<span class="elsevierStyleItalic">p</span><span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>0&#46;063&#41;&#44; in which TVT and REEMEX were placed &#40;<span class="elsevierStyleItalic">p</span><span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>0&#46;080&#41; and which had decreased preoperative <span class="elsevierStyleItalic">Q</span><span class="elsevierStyleInf">max</span> &#40;<span class="elsevierStyleItalic">p</span><span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>0&#46;065&#41;&#46;</p><p id="par0080" class="elsevierStylePara elsevierViewall">Finally&#44; we also studied the relations between the postoperative&#44; both clinical and urodynamic&#44; variables&#46; We found a significant relation between persistent postoperative clinical and urodynamic SUI &#40;<span class="elsevierStyleItalic">p</span><span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>0&#46;001&#41; and between postoperative urodynamic SUI and a lower closing pressure on the urethral profile &#40;<span class="elsevierStyleItalic">p</span><span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>0&#46;025&#41;&#46; In contrast&#44; none of the entities&#44; such as detrusor overactivity&#44; peak flow&#44; the closing functional length &#40;urethral profile&#41;&#44; the UR increase&#44; the transmission of pressures&#44; were statistically significant among the patients with and without SUI postoperatively&#46;</p><p id="par0085" class="elsevierStylePara elsevierViewall">Regarding the voiding phase in the postoperative period&#44; the presence of symptoms of the voiding phase was associated with the existence in the postoperative period of decreased peak flow &#40;<span class="elsevierStyleItalic">p</span><span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>0&#46;001&#41; and showed a trend toward significance in the patients with postvoid residue &#40;<span class="elsevierStyleItalic">p</span><span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>0&#46;058&#41;&#46; The postoperative peak flow was greater when there was no overactivity &#40;<span class="elsevierStyleItalic">p</span><span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>0&#46;005&#41; and there was a tendency to UR increase and W80-20 higher when there was detrusor overactivity&#46; The postoperative peak flow is inversely related to the postoperative UR increase &#40;<span class="elsevierStyleItalic">p</span><span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>0&#46;007&#41; and directly to the W80-20 &#40;<span class="elsevierStyleItalic">p</span><span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>0&#46;000&#41;&#46; There was a trend to statistical significance between the UR increase and the emergence of postvoid residue&#46;</p><p id="par0090" class="elsevierStylePara elsevierViewall">In the multivariate analysis&#44; three variables associated to persistent postoperative SUI were found&#58; age&#44; peak flow&#44; and presence of bladder neck incompetence&#46; In the <span class="elsevierStyleItalic">step-way</span> analysis&#44; only one independent predictor of postoperative SUI was found&#58; preoperative peak flow &#40;<span class="elsevierStyleItalic">p</span><span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>0&#46;0001&#41;&#46; Age was shown to be dependent on <span class="elsevierStyleItalic">Q</span><span class="elsevierStyleInf">max</span>&#44; decreased flow occurring at an older age&#46;</p></span><span id="sec0020" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle">Discussion</span><p id="par0095" class="elsevierStylePara elsevierViewall">The cure rate of our incontinence series and the decreased urodynamic SUI are similar to those described by other authors&#46;<a class="elsevierStyleCrossRef" href="#bib0005"><span class="elsevierStyleSup">1</span></a> Possibly&#44; our series do not show better results when patients come from different teaching hospitals and it is an outcome of the learning curve&#44; and when the indication has been established by clinical symptoms only&#46; Although apparently TVT-Safyre and TOT showed better results&#44; there was no difference of statistical significance&#46; Other authors have shown no significant differences between different techniques&#46;<a class="elsevierStyleCrossRef" href="#bib0010"><span class="elsevierStyleSup">2</span></a></p><p id="par0100" class="elsevierStylePara elsevierViewall">Studying the clinical variables&#44; both their relations to urodynamic parameters and their possible predictive value&#44; in our study&#44; we found a statistically significant relation between clinical and urodynamic SUI&#46;<a class="elsevierStyleCrossRef" href="#bib0015"><span class="elsevierStyleSup">3</span></a></p><p id="par0105" class="elsevierStylePara elsevierViewall">Age in our series appeared as a predictor of absence of SUI in the postoperative period of incontinence surgery&#46; However&#44; multivariate analysis determined that age is not an independent variable&#46; Deutsch et al&#46;<a class="elsevierStyleCrossRef" href="#bib0020"><span class="elsevierStyleSup">4</span></a> also observe that age is a poor prognostic factor&#46; However&#44; in a multivariate analysis&#44; Daneshgari et al&#46;<a class="elsevierStyleCrossRef" href="#bib0025"><span class="elsevierStyleSup">5</span></a> found that neither age nor body mass index&#44; race&#44; obstetric history&#44; or hormonal status were risk factors for recurrence of incontinence after surgery&#46;</p><p id="par0115" class="elsevierStylePara elsevierViewall">The presence of overactive bladder syndrome was not proved as a prognostic factor of the result of incontinence surgery&#46; There was no relation between symptoms of the voidinging phase and the presence of postoperative urodynamic SUI either&#46;<a class="elsevierStyleCrossRef" href="#bib0030"><span class="elsevierStyleSup">6</span></a></p><p id="par0120" class="elsevierStylePara elsevierViewall">Regarding urodynamic findings&#44; preoperative peak flow was the only urodynamic parameter with predictive value regarding the postoperative outcome&#46;<a class="elsevierStyleCrossRefs" href="#bib0035"><span class="elsevierStyleSup">7&#44;8</span></a> In addition&#44; the multivariate analysis showed that it was the only independent predictor of the postoperative outcome&#46; Although the peak flow rate depends on three factors &#40;micturition volume&#44; urethral resistance&#44; and bladder contractility&#41;&#44; in our series&#44; we found no relation among these three variables alone and postoperative urinary continence&#46;</p><p id="par0125" class="elsevierStylePara elsevierViewall">With regard to the video-urodynamic results&#44; we found no differences in the outcome between cases with or without urethral hypermobility&#46; In the literature&#44; there are different opinions&#46; To Fritel et al&#46;&#44;<a class="elsevierStyleCrossRef" href="#bib0045"><span class="elsevierStyleSup">9</span></a> the presence or absence of urethral hypermobility is a predictive factor for the outcome of surgery&#59; the greater mobility&#44; the better result&#46; Similarly&#44; Meschia et al&#46;<a class="elsevierStyleCrossRef" href="#bib0050"><span class="elsevierStyleSup">10</span></a> report that the absence of hypermobility in the preoperative period is a poor prognostic sign&#46; In contrast&#44; other authors such as Minaglia et al&#46;<a class="elsevierStyleCrossRef" href="#bib0055"><span class="elsevierStyleSup">11</span></a> find no relation between postoperative hypermobility and the cure of urinary incontinence&#46; In our series&#44; the presence of an open bladder neck was a risk factor for persistent postoperative SUI&#46; However&#44; this difference was not fully significant&#44; possibly due to the small number of women with open neck who underwent surgery&#46;<a class="elsevierStyleCrossRef" href="#bib0060"><span class="elsevierStyleSup">12</span></a></p><p id="par0130" class="elsevierStylePara elsevierViewall">In our series&#44; we observed a significant relation between postoperative maximum urethral closure pressure &#40;MUCP&#41; and urinary incontinence&#46; The patients with incontinence had a significantly lower MUCP&#46; However&#44; the length of the functional urethra showed no relation&#46; D&#246;rflinger et al&#46;<a class="elsevierStyleCrossRef" href="#bib0065"><span class="elsevierStyleSup">13</span></a> also found a relation between maximum urethral closure pressure and urinary incontinence&#46;</p><p id="par0135" class="elsevierStylePara elsevierViewall">After surgery&#44; 50&#37; of the patients with overactive bladder syndrome disappeared&#44; while in 26&#37; of the patients without prior overactive bladder syndrome it appeared after surgery &#40;12&#37; if we look at urodynamic detrusor overactivity&#41;&#46; Overall&#44; the net result was that the percentage of patients with overactive bladder syndrome decreased from 61 to 42&#37;&#46; Kulseng-Hanssen et al&#46;<a class="elsevierStyleCrossRef" href="#bib0070"><span class="elsevierStyleSup">14</span></a> observed the occurrence of de novo urge incontinence in 11&#37; of patients operated on for TVT and found that women with mixed incontinence had worse postoperative outcome than those who only had SUI&#46; Porena et al&#46;<a class="elsevierStyleCrossRef" href="#bib0010"><span class="elsevierStyleSup">2</span></a> suggest that patients undergoing TVT experienced more symptoms of the filling phase compared with those who underwent TOT&#46; Overall&#44; we observed an increase in the percentage of postoperative detrusor overactivity &#40;30&#8211;36&#37;&#41;&#46; However&#44; this change was not statistically significant&#46;</p><p id="par0140" class="elsevierStylePara elsevierViewall">Overall&#44; the net result was that the percentage of patients with overactive bladder syndrome decreased from 61 to 42&#37;&#46; Kulseng-Hanssen et al&#46;<a class="elsevierStyleCrossRef" href="#bib0070"><span class="elsevierStyleSup">14</span></a> observed the occurrence of de novo urge incontinence in 11&#37; of the patients operated on for TVT&#44; and they found that women with mixed incontinence had worse postoperative outcome than those who only had SUI&#46; Porena et al&#46;<a class="elsevierStyleCrossRef" href="#bib0010"><span class="elsevierStyleSup">2</span></a> suggest that the patients undergoing TVT experienced more symptoms of the filling phase compared to those who underwent TOT&#46; Overall&#44; we observed an increase in the percentage of postoperative detrusor overactivity &#40;30&#8211;36&#37;&#41;&#46; However&#44; this change was not statistically significant&#46;</p><p id="par0145" class="elsevierStylePara elsevierViewall">Osman<a class="elsevierStyleCrossRef" href="#bib0075"><span class="elsevierStyleSup">15</span></a> compared anticholinergic treatment versus surgical treatment with pubovaginal sling or Burch in women with mixed incontinence&#44; and they observed a higher percentage of disappearance of urge incontinence with surgery than with medical treatment&#44; although urge incontinence appeared after the intervention in 20&#37; of patients with prior isolated SUI&#46; Duckett et al&#46;<a class="elsevierStyleCrossRef" href="#bib0080"><span class="elsevierStyleSup">16</span></a> observed a higher percentage of post-TVT detrusor overactivity in cases with decreased preoperative urinary flow&#44; attributing it to an obstructive effect of surgery&#46;</p><p id="par0150" class="elsevierStylePara elsevierViewall">In our study&#44; the only variable that significantly predicted postoperative disappearance of hyperactivity was the age of the patient&#46; The patients younger than 60 years had a significantly better healing rate&#46; With regard to the <span class="elsevierStyleItalic">ex novo</span> detrusor overactivity&#44; we have not detected any predictive factor of its appearance&#46; However&#44; the literature has identified other factors such as detrusor pressure greater than 15<span class="elsevierStyleHsp" style=""></span>cm H<span class="elsevierStyleInf">2</span>O during the filling<a class="elsevierStyleCrossRef" href="#bib0085"><span class="elsevierStyleSup">17</span></a> or elevated preoperative flow acceleration<a class="elsevierStyleCrossRef" href="#bib0090"><span class="elsevierStyleSup">18</span></a> in addition to age&#44; previous surgery&#44; or radiological evidence of urethral compression&#46;<a class="elsevierStyleCrossRef" href="#bib0095"><span class="elsevierStyleSup">19</span></a></p><p id="par0155" class="elsevierStylePara elsevierViewall">Another interesting aspect is the impact of the intervention on the voiding phase&#46; In our series we observed a significant decrease in peak urinary flow with surgery&#46; This observation had already been identified by other authors&#46;<a class="elsevierStyleCrossRef" href="#bib0100"><span class="elsevierStyleSup">20</span></a> Dolan et al&#46;<a class="elsevierStyleCrossRef" href="#bib0105"><span class="elsevierStyleSup">21</span></a> point that the decrease in peak flow is only observed in the patients in whom incontinence disappears after surgery&#44; and this decrease in the peak flow is accompanied by an increased opening voiding pressure&#46;</p><p id="par0160" class="elsevierStylePara elsevierViewall">In our study&#44; the postvoid residue did not increase after surgery&#44; although a direct relation was found between the presence of postoperative postvoid residue with prior existence of symptoms of the filling phase and with preoperative peak flow&#46; The strongest relation was established between the postoperative postvoid residue and the preoperative UR increase figure&#46;<a class="elsevierStyleCrossRefs" href="#bib0110"><span class="elsevierStyleSup">22&#44;23</span></a> The surgical technique used did show an influence on the appearance of the postvoid residue in our series&#44; the residue being less with TOT and TVT-Safyre than with TVT and REEMEX&#46;</p><p id="par0165" class="elsevierStylePara elsevierViewall">Contractile power measured by the parameter W80-20 did not experience any change either&#46; Groen and Bosch<a class="elsevierStyleCrossRef" href="#bib0120"><span class="elsevierStyleSup">24</span></a> found that the patients with greater contractile power measured by the parameter WF tend not to require catheterization in postoperative incontinence surgery&#46;</p><p id="par0170" class="elsevierStylePara elsevierViewall">We think that although the urodynamic study is subject to revisions with regard to its indications in female SUI&#44; it remains a useful tool to decide the treatment of this pathology&#46;<a class="elsevierStyleCrossRef" href="#bib0125"><span class="elsevierStyleSup">25</span></a> Furthermore&#44; the introduction of new types of less invasive slings is necessary to consider the importance of a long-term urodynamic evaluation of this condition&#44; allowing us to better understand the functional evolution of the patients and to better predict the risk of failure of the surgery&#46;<a class="elsevierStyleCrossRefs" href="#bib0130"><span class="elsevierStyleSup">26&#44;27</span></a></p></span><span id="sec0025" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle">Conflict of interest</span><p id="par0175" class="elsevierStylePara elsevierViewall">The authors declare that they have no conflict of interest&#46;</p></span></span>"
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            1 => "Slings"
            2 => "Urodynamics"
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        "titulo" => "Abstract"
        "resumen" => "<span class="elsevierStyleSectionTitle">Objectives</span><p id="spar0005" class="elsevierStyleSimplePara elsevierViewall">Treatment of feminine stress urinary incontinence &#40;SUI&#41; with slings aims to supplement the function of the damaged ligaments&#44; favoring the correct transmission of the tensions&#46; Our objective is to determine which preoperative variables could predict the outcome of surgical treatment of SUI and to study the urodynamic changes produced by the surgery&#46;</p> <span class="elsevierStyleSectionTitle">Material and methods</span><p id="spar0010" class="elsevierStyleSimplePara elsevierViewall">139 women &#40;age X&#175;&#61;61&#46;7&#59; <span class="elsevierStyleItalic"><span class="elsevierStyleBold">&#963;</span></span><span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>10&#46;88&#41; operated on due to SUI were studied retrospectively&#46; In 118 cases &#40;84&#46;8&#37;&#41;&#44; sling techniques &#40;TVT&#44; TOT&#44; TVT-Safyre&#44; and REEMEX&#41; were used&#46; Clinical evaluation and complete preoperative video-urodynamics were made pre-operatively and at 3 months of surgery&#46; A statistical study &#40;Fisher&#39;s test&#44; Wilcoxon&#44; Friedman&#44; Student&#39;s <span class="elsevierStyleItalic">t</span> and Pearson&#39;s <span class="elsevierStyleItalic">&#967;</span><span class="elsevierStyleSup">2</span>&#41; and analysis of multivariant logistic regression analysis by step elimination method were performed&#46;</p> <span class="elsevierStyleSectionTitle">Results</span><p id="spar0015" class="elsevierStyleSimplePara elsevierViewall">Post-operatively&#44; the SUI &#40;<span class="elsevierStyleItalic">p</span><span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>0&#46;000&#41; and bladder hyperactivity syndrome decreased&#46; The success percentages &#40;urodynamic absence of SUI&#41; for each technique were&#58; TVT-Safyre &#40;75&#37;&#41;&#44; TOT &#40;73&#37;&#41;&#44; TVT &#40;60&#37;&#41; and REEMEX &#40;57&#37;&#41;&#44; without significant differences&#46; Age &#40;ROC cut-off&#58; 61 years&#41; was a prognostic factor of success &#40;<span class="elsevierStyleItalic">p</span><span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>0&#46;024&#41;&#46; Preoperative maximum flow &#40;<span class="elsevierStyleItalic">Q</span><span class="elsevierStyleInf">max</span>&#41; &#40;16<span class="elsevierStyleHsp" style=""></span>ml&#47;s&#41; constituted the only urodynamic parameter with a predictive value for success &#40;<span class="elsevierStyleItalic">p</span><span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>0&#46;026&#41;&#46; An open bladder neck was a risk factor for persistence of postoperative SUI &#40;RR<span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>2&#46;78&#41;&#46; A significant decrease of the postsurgical <span class="elsevierStyleItalic">Q</span><span class="elsevierStyleInf">max</span> &#40;<span class="elsevierStyleItalic">p</span><span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>0&#46;017&#41; was verified&#44; without increase of the post micturition residue or of the <span class="elsevierStyleItalic">W</span><span class="elsevierStyleInf">max</span>&#46; An increase of the postsurgical urethral resistance &#40;UR&#41; was also observed &#40;<span class="elsevierStyleItalic">p</span><span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>0&#46;004&#41;&#46;</p> <span class="elsevierStyleSectionTitle">Conclusions</span><p id="spar0020" class="elsevierStyleSimplePara elsevierViewall">The pre-operative <span class="elsevierStyleItalic">Q</span><span class="elsevierStyleInf">max</span> is the most important urodynamic prognostic parameter in feminine SUI surgery&#44; its normality being associated to a greater probability of cure of the incontinence&#46; In the cases of decreased preoperative flow&#44; use of slings that increase urethral resistance more &#40;REEMEX&#41; is not recommended&#46; Hyperactivity of the preoperative detrusor does not significantly modify the results of surgery of the SUI&#46;</p>"
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        "titulo" => "Resumen"
        "resumen" => "<span class="elsevierStyleSectionTitle">Objetivos</span><p id="spar0025" class="elsevierStyleSimplePara elsevierViewall">El tratamiento de la incontinencia urinaria de esfuerzo &#40;IUE&#41; femenina con cabestrillos&#44; pretende suplir la funci&#243;n de los ligamentos da&#241;ados&#44; favoreciendo la transmisi&#243;n correcta de las tensiones&#46; Nuestro objetivo es determinar qu&#233; variables preoperatorias pueden predecir el resultado del tratamiento quir&#250;rgico de la IUE y estudiar los cambios urodin&#225;micos que produce la cirug&#237;a&#46;</p> <span class="elsevierStyleSectionTitle">Material y m&#233;todos</span><p id="spar0030" class="elsevierStyleSimplePara elsevierViewall">139 mujeres &#40;edad X&#175;&#61;61&#44;7&#59; <span class="elsevierStyleBold">&#963;</span><span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>10&#44;88&#41; intervenidas por IUE fueron estudiadas retrospectivamente&#46; En 118 casos &#40;84&#44;8&#37;&#41; se utilizaron t&#233;cnicas de cabestrillo &#40;TVT&#44; TOT&#44; TVT-Safyre&#44; REEMEX&#41;&#46; Se realiz&#243; evaluaci&#243;n cl&#237;nica y video-urodin&#225;mica completa preoperatoria y a los tres meses de cirug&#237;a&#46; Se realiz&#243; tratamiento estad&#237;stico &#40;test de Fisher&#44; Wilcoxon&#44; Friedman&#44; t Student y &#967;<span class="elsevierStyleSup">2</span> Pearson&#41; y an&#225;lisis de regresi&#243;n log&#237;stica multivariante mediante m&#233;todo de eliminaci&#243;n por pasos&#46;</p> <span class="elsevierStyleSectionTitle">Resultados</span><p id="spar0035" class="elsevierStyleSimplePara elsevierViewall">Postoperatoriamente disminuy&#243; la IUE &#40;p<span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>0&#46;000&#41; y el s&#237;ndrome de hiperactividad vesical &#40;p<span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>0&#44;001&#41;&#46; Los porcentajes de &#233;xito &#40;ausencia urodin&#225;mica de IUE&#41; para cada t&#233;cnica fueron&#58; TVT-Safyre &#40;75&#37;&#41;&#44; TOT &#40;73&#37;&#41;&#44; TVT &#40;60&#37;&#41; y REEMEX &#40;57&#37;&#41;&#44; sin diferencias significativas&#46; La edad &#40;punto de corte ROC 61 a&#241;os&#41; fue factor pron&#243;stico de &#233;xito &#40;p<span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>0&#44;024&#41;&#46; El flujo m&#225;ximo &#40;Qmax&#41; preoperatorio &#40;16<span class="elsevierStyleHsp" style=""></span>ml&#47;s&#41; constituy&#243; el &#250;nico par&#225;metro urodin&#225;mico con valor predictivo &#40;p<span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>0&#44;026&#41; para &#233;xito&#46; Un cuello vesical abierto fue factor de riesgo para la persistencia de IUE postoperatoria &#40;RR<span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>2&#44;78&#41;&#46; Se comprob&#243; disminuci&#243;n significativa de Qmax postquir&#250;rgico &#40;p<span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>0&#44;017&#41;&#44; sin aumento del residuo postmiccional ni de Wmax&#46; Tambi&#233;n se observ&#243; aumento de URA &#40;resistencia uretral&#41; post-cirug&#237;a &#40;p<span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>0&#44;004&#41;&#46;</p> <span class="elsevierStyleSectionTitle">Conclusiones</span><p id="spar0040" class="elsevierStyleSimplePara elsevierViewall">El Qmax preoperatorio es el par&#225;metro urodin&#225;mico pron&#243;stico mas importante en la cirug&#237;a de la IUE femenina&#44; asoci&#225;ndose su normalidad a una mayor posibilidad de cura de la incontinencia&#46; En los casos de flujo preoperatorio disminuido se desaconseja los cabestrillos que m&#225;s incrementan la resistencia uretral &#40;REEMEX&#41;&#46; La hiperactividad del detrusor preoperatoria no modifica significativamente los resultados de la cirug&#237;a de la IUE&#46;</p>"
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        "nota" => "<p class="elsevierStyleNotepara">Please cite this article as&#58; Salinas J&#44; M&#233;ndez S&#44; Virseda M&#44; Arance I&#44; Pelaquim H&#44; Moreno Sierra J&#44; et al&#46; Aspectos urodin&#225;micos d ela incontinencia urinaria femenina tratada con cabestrillos&#46; Actas Urol Esp&#46; 2012&#59;36&#58;79&#8211;85&#46;</p>"
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                  \t\t\t\t" style="border-bottom: 2px solid black">Symptoms&nbsp;\t\t\t\t\t\t\n
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                  <table border="0" frame="\n
                  \t\t\t\t\tvoid\n
                  \t\t\t\t" class=""><thead title="thead"><tr title="table-row"><td class="td" title="\n
                  \t\t\t\t\ttable-head\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t" style="border-bottom: 2px solid black"><a class="elsevierStyleCrossRef" href="#tblfn0015"><span class="elsevierStyleSup">a</span></a>Variable&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-head\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t" style="border-bottom: 2px solid black">Preoperative period&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-head\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t" style="border-bottom: 2px solid black">Postoperative period&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-head\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t" style="border-bottom: 2px solid black">Significance&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr></thead><tbody title="tbody"><tr title="table-row"><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t"><span class="elsevierStyleItalic">Q</span><span class="elsevierStyleInf">max</span> &#40;ml&#47;s&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="char" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">23&#46;39 &#40;22&#46;70&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="char" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">19&#46;02 &#40;10&#46;91&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="char" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">0&#46;017<a class="elsevierStyleCrossRef" href="#tblfn0025"><span class="elsevierStyleSup">c</span></a>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Postvoid residue &#40;ml&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="char" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">13&#46;49 &#40;42&#46;82&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="char" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">10&#46;56 &#40;35&#46;3&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="char" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">0&#46;839&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t"><a class="elsevierStyleCrossRef" href="#tblfn0020"><span class="elsevierStyleSup">b</span></a>Involuntary contraction amplitude &#40;cm H<span class="elsevierStyleInf">2</span>O&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="char" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">27&#46;58 &#40;16&#46;50&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="char" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">16&#46;12 &#40;18&#46;04&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="char" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">0&#46;013<a class="elsevierStyleCrossRef" href="#tblfn0025"><span class="elsevierStyleSup">c</span></a>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t"><a class="elsevierStyleCrossRef" href="#tblfn0020"><span class="elsevierStyleSup">b</span></a>Involuntary contraction capacity &#40;ml&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="char" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">133&#46;21 &#40;81&#46;54&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="char" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">55&#46;33 &#40;75&#46;61&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="char" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">0&#46;000<a class="elsevierStyleCrossRef" href="#tblfn0025"><span class="elsevierStyleSup">c</span></a>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">UR increase &#40;cm<span class="elsevierStyleHsp" style=""></span>H<span class="elsevierStyleInf">2</span>O&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="char" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">10&#46;14 &#40;5&#46;79&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="char" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">12&#46;30 &#40;8&#46;55&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="char" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">0&#46;004<a class="elsevierStyleCrossRef" href="#tblfn0025"><span class="elsevierStyleSup">c</span></a>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">W 80-20 &#40;W&#47;m<span class="elsevierStyleSup">2</span>&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="char" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">1&#46;40 &#40;3&#46;22&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="char" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">2&#46;51 &#40;10&#46;31&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="char" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">0&#46;490&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr></tbody></table>
                  """
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                0 => "xTab183938.png"
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            0 => array:3 [
              "identificador" => "tblfn0015"
              "etiqueta" => "a"
              "nota" => "<p class="elsevierStyleNotepara">Mean &#40;standard deviation between brackets&#41;&#46;</p>"
            ]
            1 => array:3 [
              "identificador" => "tblfn0020"
              "etiqueta" => "b"
              "nota" => "<p class="elsevierStyleNotepara">Patients with pre- and postoperarive overactivity&#46;</p>"
            ]
            2 => array:3 [
              "identificador" => "tblfn0025"
              "etiqueta" => "c"
              "nota" => "<p class="elsevierStyleNotepara">Significant&#46;</p>"
            ]
          ]
        ]
        "descripcion" => array:1 [
          "en" => "<p id="spar0070" class="elsevierStyleSimplePara elsevierViewall">Postsurgical variation of urodynamic variables&#46;</p>"
        ]
      ]
      6 => array:7 [
        "identificador" => "tbl0015"
        "etiqueta" => "Table 3"
        "tipo" => "MULTIMEDIATABLA"
        "mostrarFloat" => true
        "mostrarDisplay" => false
        "tabla" => array:2 [
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            0 => array:2 [
              "tabla" => array:1 [
                0 => """
                  <table border="0" frame="\n
                  \t\t\t\t\tvoid\n
                  \t\t\t\t" class=""><thead title="thead"><tr title="table-row"><td class="td" title="\n
                  \t\t\t\t\ttable-head\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t" style="border-bottom: 2px solid black">Variable<a class="elsevierStyleCrossRef" href="#tblfn0030"><span class="elsevierStyleSup">a</span></a>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-head\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t" style="border-bottom: 2px solid black">Preoperative percentage &#40;&#37;&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-head\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t" style="border-bottom: 2px solid black">Postoperative percentage &#40;&#37;&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-head\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t" style="border-bottom: 2px solid black">Significance level&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr></thead><tbody title="tbody"><tr title="table-row"><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">SUI&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="char" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">100&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="char" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">25&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="char" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">0&#46;000<a class="elsevierStyleCrossRef" href="#tblfn0040"><span class="elsevierStyleSup">c</span></a>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Detrusor overactivity&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="char" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">30&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="char" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">36&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="char" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">0&#46;493&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t"><a class="elsevierStyleCrossRef" href="#tblfn0035"><span class="elsevierStyleSup">b</span></a>Percentile <span class="elsevierStyleItalic">Q</span><span class="elsevierStyleInf">max</span>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="char" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">23&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="char" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">9&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="char" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">0&#46;001<a class="elsevierStyleCrossRef" href="#tblfn0040"><span class="elsevierStyleSup">c</span></a>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr></tbody></table>
                  """
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                0 => "xTab183939.png"
              ]
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            0 => array:3 [
              "identificador" => "tblfn0030"
              "etiqueta" => "a"
              "nota" => "<p class="elsevierStyleNotepara">Presence of the symptom&#46;</p>"
            ]
            1 => array:3 [
              "identificador" => "tblfn0035"
              "etiqueta" => "b"
              "nota" => "<p class="elsevierStyleNotepara">P50&#46;</p>"
            ]
            2 => array:3 [
              "identificador" => "tblfn0040"
              "etiqueta" => "c"
              "nota" => "<p class="elsevierStyleNotepara">Significant&#46;</p>"
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        "descripcion" => array:1 [
          "en" => "<p id="spar0075" class="elsevierStyleSimplePara elsevierViewall">Postoperative variation of urodynamic variables&#46;</p>"
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      7 => array:7 [
        "identificador" => "tbl0020"
        "etiqueta" => "Table 4"
        "tipo" => "MULTIMEDIATABLA"
        "mostrarFloat" => true
        "mostrarDisplay" => false
        "tabla" => array:1 [
          "tablatextoimagen" => array:1 [
            0 => array:2 [
              "tabla" => array:1 [
                0 => """
                  <table border="0" frame="\n
                  \t\t\t\t\tvoid\n
                  \t\t\t\t" class=""><thead title="thead"><tr title="table-row"><td class="td" title="\n
                  \t\t\t\t\ttable-head\n
                  \t\t\t\t  " align="" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-head\n
                  \t\t\t\t  " colspan="4" align="center" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t" style="border-bottom: 2px solid black">Postoperative urodynamic results</td></tr><tr title="table-row"><td class="td" title="\n
                  \t\t\t\t\ttable-head\n
                  \t\t\t\t  " align="" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t" style="border-bottom: 2px solid black">&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-head\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t" style="border-bottom: 2px solid black">Normal &#40;&#37;&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-head\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t" style="border-bottom: 2px solid black">SUI &#40;&#37;&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-head\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t" style="border-bottom: 2px solid black">SUI and overactivity &#40;&#37;&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-head\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t" style="border-bottom: 2px solid black">Overactivity &#40;&#37;&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr></thead><tbody title="tbody"><tr title="table-row"><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">SUI &#40;preoperative&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="char" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">51&#46;32&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="char" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">23&#46;68&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="char" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">11&#46;84&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="char" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">13&#46;16&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">SUI and overactivity &#40;preoperative&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="char" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">30&#46;30&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="char" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">15&#46;15&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="char" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">15&#46;15&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="char" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">39&#46;39&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr></tbody></table>
                  """
              ]
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                0 => "xTab183936.png"
              ]
            ]
          ]
        ]
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          "en" => "<p id="spar0080" class="elsevierStyleSimplePara elsevierViewall">Postoperative variation of urodynamic variables&#46;</p>"
        ]
      ]
      8 => array:7 [
        "identificador" => "tbl0025"
        "etiqueta" => "Table 5"
        "tipo" => "MULTIMEDIATABLA"
        "mostrarFloat" => true
        "mostrarDisplay" => false
        "tabla" => array:2 [
          "tablatextoimagen" => array:1 [
            0 => array:2 [
              "tabla" => array:1 [
                0 => """
                  <table border="0" frame="\n
                  \t\t\t\t\tvoid\n
                  \t\t\t\t" class=""><thead title="thead"><tr title="table-row"><td class="td" title="\n
                  \t\t\t\t\ttable-head\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Variable&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-head\n
                  \t\t\t\t  " colspan="2" align="center" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t" style="border-bottom: 2px solid black">Healing percentage &#40;&#37;&#41;</td><td class="td" title="\n
                  \t\t\t\t\ttable-head\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Relative risk &#40;&#37;&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-head\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Significance level&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="\n
                  \t\t\t\t\ttable-head\n
                  \t\t\t\t  " align="" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t" style="border-bottom: 2px solid black">&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-head\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t" style="border-bottom: 2px solid black">Yes&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-head\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t" style="border-bottom: 2px solid black">No&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-head\n
                  \t\t\t\t  " align="" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t" style="border-bottom: 2px solid black">&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-head\n
                  \t\t\t\t  " align="" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t" style="border-bottom: 2px solid black">&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr></thead><tbody title="tbody"><tr title="table-row"><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Overactive bladder syndrome&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="char" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">68&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="char" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">67&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="char" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">0&#46;99&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="char" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">1&#46;00&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Voiding phase symptoms&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="char" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">63&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="char" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">68&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="char" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">1&#46;07&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="char" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">0&#46;788&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Detrusor overactivity&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="char" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">70&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="char" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">68&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="char" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">0&#46;97&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="char" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">0&#46;826&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t"><span class="elsevierStyleItalic">p</span><span class="elsevierStyleHsp" style=""></span>&#60;<span class="elsevierStyleHsp" style=""></span>50&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="char" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">56&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="char" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">75&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="char" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">1&#46;10&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="char" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">0&#46;045<a class="elsevierStyleCrossRef" href="#tblfn0045"><span class="elsevierStyleSup">a</span></a>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Urethral hypermobility&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="char" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">63&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="char" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">77&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="char" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">1&#46;22&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="char" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">0&#46;188&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Cervical incompetence&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="char" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">25&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="char" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">69&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="char" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">2&#46;78&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="char" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">0&#46;099<a class="elsevierStyleCrossRef" href="#tblfn0050"><span class="elsevierStyleSup">b</span></a>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr></tbody></table>
                  """
              ]
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                0 => "xTab183941.png"
              ]
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            0 => array:3 [
              "identificador" => "tblfn0045"
              "etiqueta" => "a"
              "nota" => "<p class="elsevierStyleNotepara">Significant&#46;</p>"
            ]
            1 => array:3 [
              "identificador" => "tblfn0050"
              "etiqueta" => "b"
              "nota" => "<p class="elsevierStyleNotepara">Trend toward significance&#46;</p>"
            ]
          ]
        ]
        "descripcion" => array:1 [
          "en" => "<p id="spar0085" class="elsevierStyleSimplePara elsevierViewall">Qualitative prognostic factors for healing of SUI&#46;</p>"
        ]
      ]
      9 => array:7 [
        "identificador" => "tbl0030"
        "etiqueta" => "Table 6"
        "tipo" => "MULTIMEDIATABLA"
        "mostrarFloat" => true
        "mostrarDisplay" => false
        "tabla" => array:2 [
          "tablatextoimagen" => array:1 [
            0 => array:2 [
              "tabla" => array:1 [
                0 => """
                  <table border="0" frame="\n
                  \t\t\t\t\tvoid\n
                  \t\t\t\t" class=""><thead title="thead"><tr title="table-row"><td class="td" title="\n
                  \t\t\t\t\ttable-head\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Variable&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-head\n
                  \t\t\t\t  " colspan="2" align="center" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t" style="border-bottom: 2px solid black">Mean &#40;standard deviation&#41;</td><td class="td" title="\n
                  \t\t\t\t\ttable-head\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Significance&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="\n
                  \t\t\t\t\ttable-head\n
                  \t\t\t\t  " align="" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t" style="border-bottom: 2px solid black">&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-head\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t" style="border-bottom: 2px solid black">Healing&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-head\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t" style="border-bottom: 2px solid black">No healing&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-head\n
                  \t\t\t\t  " align="" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t" style="border-bottom: 2px solid black">&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr></thead><tbody title="tbody"><tr title="table-row"><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Age&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="char" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">60&#46;1 &#40;11&#46;09&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="char" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">64&#46;5 &#40;9&#46;90&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="char" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">0&#46;024<a class="elsevierStyleCrossRef" href="#tblfn0055"><span class="elsevierStyleSup">a</span></a>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Peak flow &#40;ml&#47;s&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="char" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">26&#46;03 &#40;26&#46;24&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="char" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">18&#46;26 &#40;8&#46;74&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="char" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">0&#46;026<a class="elsevierStyleCrossRef" href="#tblfn0055"><span class="elsevierStyleSup">a</span></a>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Postvoid residue &#40;ml&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="char" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">12&#46;75 &#40;39&#46;17&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="char" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">15&#46;23 &#40;53&#46;76&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="char" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">0&#46;787&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Involuntary contraction amplitude &#40;ml&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="char" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">26&#46;83 &#40;12&#46;77&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="char" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">29&#46;30 &#40;23&#46;76&#41;&nbsp;\t\t\t\t\t\t\n
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Article information

ISSN: 21735786
Original language: English

DOI:10.1016/j.acuroe.2012.04.006

The statistics are updated each day

Year/Month	Html	Pdf	Total

2018 March	28	0	28
2018 February	60	1	61
2018 January	3	1	4
2017 December	20	1	21
2017 November	3	1	4
2017 October	23	2	25
2017 September	7	1	8
2017 August	12	2	14
2017 July	9	3	12
2017 June	24	4	28
2017 May	13	1	14
2017 April	12	3	15
2017 March	5	11	16
2017 February	7	1	8
2017 January	15	0	15
2016 December	24	5	29
2016 November	14	2	16
2016 October	21	3	24
2016 September	10	6	16
2016 August	16	4	20
2016 July	8	1	9
2016 June	8	3	11
2016 May	12	11	23
2016 April	14	9	23
2016 March	16	12	28
2016 February	14	16	30
2016 January	18	17	35
2015 December	16	13	29
2015 November	8	14	22
2015 October	18	13	31
2015 September	17	6	23
2015 August	12	5	17
2015 July	4	3	7
2015 June	4	0	4
2015 May	11	7	18
2015 April	17	9	26
2015 March	17	9	26
2015 February	10	4	14
2015 January	24	1	25
2014 December	37	8	45
2014 November	18	3	21
2014 October	33	10	43
2014 September	40	4	44
2014 August	32	2	34
2014 July	26	4	30
2014 June	16	8	24
2014 May	20	1	21
2014 April	10	1	11
2014 March	24	1	25
2014 February	11	4	15
2014 January	4	2	6
2013 December	3	1	4
2013 November	13	4	17
2013 October	11	5	16
2013 September	3	4	7

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