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Santiago. Chile.</span>" ] ] "correspondencia" => array:1 [ 0 => array:3 [ "identificador" => "cor0005" "etiqueta" => "1" "correspondencia" => "Correspondencia autor: Dr. Paolo Ricci Arriola Unidad de Uroginecología y Cirugía Vaginal Clínica Las Condes. Lo Fontecilla 441, Las Condes, Santiago, Chile. Tel.: (56) 2 2104610" ] ] ] ] "titulosAlternativos" => array:1 [ "en" => array:1 [ "titulo" => "Proximal urethra portion perforation during TVT-O in a patient with urethral deviation secondary to previous failed Burch surgery" ] ] "pdfFichero" => "main.pdf" "tienePdf" => true "fechaRecibido" => "2007-07-01" "fechaAceptado" => "2009-01-01" "PalabrasClave" => array:2 [ "es" => array:1 [ 0 => array:4 [ "clase" => "keyword" "titulo" => "Palabras clave" "identificador" => "xpalclavsec88909" "palabras" => array:3 [ 0 => "TVT-O" 1 => "Complicación de TVT-O" 2 => "Perforación de uretra" ] ] ] "en" => array:1 [ 0 => array:4 [ "clase" => "keyword" "titulo" => "Keywords" "identificador" => "xpalclavsec88910" "palabras" => array:2 [ 0 => "TVT-O" 1 => "Complication of TVT-O Urethra perforation" ] ] ] ] "tieneResumen" => true "resumen" => array:2 [ "es" => array:2 [ "titulo" => "Resumen" "resumen" => "<p id="spar0005" class="elsevierStyleSimplePara elsevierViewall">Mujer de 59 años con antecedentes de Burch laparoscópico realizado durante el 2003 en otro recinto hospitalario. La paciente acude a nuestro centro el año 2006 por persistencia de una incontinencia urinaria, que en el estudio urodinámico mostró una incontinencia de esfuerzo tipo II y una vejiga inestable motora sin evidencia de obstrucción. Durante la realización de un TVT-O (Tensión-free Vaginal Tape Obturador in-out route: cinta libre de tensión vía obturador desde adentro hacia afuera), se evidenció salida de sangre por la sonda Foley después del paso de la aguja por el agujero obturador derecho. La cistoscopia demostró una desviación significativa de la uretra hacia la derecha y el paso de la cinta a través de la uretra proximal. La cinta se pasó nuevamente tomando las precauciones necesarias. Dos días después de la operación se retiró la sonda y se comprobó la ausencia de incontinencia de esfuerzo. Los síntomas de urgencia miccional remitieron con tratamiento médico (Tolteridina 2 mg/día). Creemos que la desviación uretral causada por un Burch laparoscópico técnicamente deficiente fue la causa de la perforación uretral ocurrida durante el TVT-O.</p>" ] "en" => array:1 [ "resumen" => "<span class="elsevierStyleSectionTitle">Abstract</span><p id="spar0010" class="elsevierStyleSimplePara elsevierViewall">A 59 years old woman with laparoscopic Burch made during 2003 in another hospital. During 2006, the patient is evaluating in our center for a persistent urinary incontinence, the urodynamic study demonstrated stress urinary incontinence type II and overactive bladder without obstruction evidences. A TVT-O (tension-free vaginal tape obturador in-out route) was made, nevertheless when the right branch was passed blood was observed in the Foley catheter. A cystoscopy showed an important deviation of urethra and the tape through urethra in the proximal portion. The right branch went again inserted taking the necessary precautions. Two days after surgery the Foley catheter was removed and the stress urinary incontinence symptoms disappeared. The urge incontinence symptoms disappeared with the pharmacalogical treatment (Tolterodine 2 mg/day). We believe that the urethral deviation caused by a technically deficient laparoscopic Burch was the reason for the urethral perforation during the TVT-O.</p>" ] ] "bibliografia" => array:2 [ "titulo" => "Referencias" "seccion" => array:1 [ 0 => array:2 [ "identificador" => "bibs0005" "bibliografiaReferencia" => array:10 [ 0 => array:3 [ "identificador" => "bib0005" "etiqueta" => "1." "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Transobturator and retropubic tape procedures in stress urinary incontinence: a systematic review and meta-analysis of effectiveness and complications" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:3 [ 0 => "P.M. Latthe" 1 => "R. Foon" 2 => "P. 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Perforación de la uretra proximal durante TVT-O, en paciente con desviación uretral secundaria a cirugía de Burch fallida
Proximal urethra portion perforation during TVT-O in a patient with urethral deviation secondary to previous failed Burch surgery
Paolo Ricci Arriola1
, Vicente Solà Dalenz, Jack Pardo Schanz
Autor para correspondencia
pricci@clinicalascondes.cl
pricci@vtr.net
Correspondencia autor: Dr. Paolo Ricci Arriola Unidad de Uroginecología y Cirugía Vaginal Clínica Las Condes. Lo Fontecilla 441, Las Condes, Santiago, Chile. Tel.: (56) 2 2104610
pricci@vtr.net
Correspondencia autor: Dr. Paolo Ricci Arriola Unidad de Uroginecología y Cirugía Vaginal Clínica Las Condes. Lo Fontecilla 441, Las Condes, Santiago, Chile. Tel.: (56) 2 2104610
Unidad de Uroginecología y Cirugía Vaginal de Clínica Las Condes. Santiago. Chile.