Tratamiento quirúrgico ambulatorio de la incontinencia urinaria de esfuerzo femenina bajo anestesia local-sedación con cabestrillo transobturatriz de incisión única (Contasure-Needleless) / Outpatient Surgical Treatment of Female Stress Urinary Incontinence Under Local Anesthesia-sedation With Contrasure Needleless Incision

Objetivo: Evaluar los resultados obtenidos en el tratamiento quirúrgico ambulatorio de la incontinencia urinaria de esfuerzo femenina (IUE) con el empleo de un TOT de una sola incisión Contasure-Needleless (Neomedic-Internacional). Pacientes y método: Entre enero de 2007 y diciembre de 2011 hemos intervenido con anestesia local-sedación y en régimen estrictamente ambulatorio a 96 pacientes afectas de IUE mediante la colocación de cabestrillo suburetral sin tensión Needlelees. Se evalúan los criterios de inclusión y alta, así como los resultados obtenidos y el grado de satisfacción mediante la elaboración de un cuestionario. En todas las pacientes se realizó test de esfuerzo, estudio urodinámico y cuestionario de calidad de vida (ICIQ-SF) antes del procedimiento y al menos 3 meses después de la intervención. Resultados: La tolerancia al procedimiento fue buena. El tiempo quirúrgico fue inferior a 10 min y el de permanencia en el hospital hasta el alta menor de 2 h. Los resultados obtenidos son superponibles a los alcanzados con anestesia epidural e ingreso, siendo el grado de satisfacción con el tratamiento recibido superior al 90%. Conclusiones: La práctica totalidad de pacientes afectas son candidatas a incluirse en un programa de cirugía ambulatoria, mejorando ostensiblemente la relación coste-eficacia, no disminuyendo por ello la calidad asistencial ni el grado de satisfacción. Asimismo, el sistema Contasure-Needleless cumple los criterios de cirugía de mínima invasión, proporcionando una mayor estabilidad del cabestrillo que las «minibandas» de tercera generación, en virtud de una mayor longitud de la malla así como un menor dolor postoperatorio respecto al TOT convencional, por no precisar incisiones cutáneas

Objective: To evaluate the results obtained from out-patient surgical treatment of female stress urinary incontinence (SUI) with the use of trans-obturator tape (TOT) of a single Contrasure-Needleless incision (Neomedic-International). Patients and method: We performed an intervention with local anesthesia-sedation in outpatient regime between January 2007 and December 2011 on 96 patients affected by SUI using the placement of Needleless tension-free suburethral sling. Inclusion and discharge criteria and the results obtained as well as satisfaction grade were evaluated by a questionnaire. All the patients underwent a stress test, urodynamic study and quality of life questionnaire (ICIQ-SF) prior to and at least 3 months after the intervention. Results: Tolerance to the procedure was good. Surgical time was less than 10 min and stay in the hospital up to discharge less than 2 h. The results obtained are superimposable to those reached with epidural anesthesia and hospitalization, the grade of satisfactions with the treatment received being superior to 90%. Conclusions: Almost all of the patients affected are candidates for inclusion in an outpatient surgery program. This noticeably improves the cost-efficacy ratio, without decreasing the health care or grade of satisfaction. Furthermore, the Contasure-Needleless system fulfills the criteria for minimally invasive surgery, providing better stability of the sling than the third generation ‘minibands’ due to the greater length of the mesh and less post-operative pain regarding the conventional TOT as no cutaneous incisions are required

Outpatient surgical treatment of female stress urinary incontinence under local anesthesia-sedation with contrasure needleless incision.

OBJECTIVE: To evaluate the results obtained from out-patient surgical treatment of female stress urinary incontinence (SUI) with the use of trans-obturator tape (TOT) of a single Contrasure-Needleless incision (Neomedic-International). PATIENTS AND METHOD: We performed an intervention with local anesthesia-sedation in outpatient regime between January 2007 to December 2011 on 96 patients affected by SUI using the placement of Needleless tension-free suburethral sling. Inclusion and discharge criteria and the results obtained as well as satisfaction grade were evaluated by a questionnaire. All the patients underwent a stress test, urodynamic study and quality of life questionnaire (ICIQ-SF) prior to and at least 3 months after the intervention. RESULTS: Tolerance to the procedure was good. Surgical time was less than 10 minutes and stay in the hospital up to discharge less than 2hours. The results obtained are superimposable to those reached with epidural anesthesia and hospitalization, the grade of satisfactions with the treatment received being superior to 90%. CONCLUSIONS: Almost all of the patients affected are candidates for inclusion in an outpatient surgery program. This noticeably improves the cost-efficacy ratio, without decreasing the health care or grade of satisfaction. Furthermore, the Contasure-Needleless system fulfills the criteria for minimally invasive surgery, providing better stability of the sling than the third generation "minibands" due to the greater length of the mesh and less post-operative pain regarding the conventional TOT as no cutaneous incisions are required.