Complications from the placement of a tension-free suburethral sling using the transobturator and retropubic methods for treatment of female urinary incontinence.

OBJECTIVE: The aim of our study was to retrospectively analyze surgical complications arising from the collocation of suburethral mesh in the lower urinary tract, using both the transobturator and retropubic methods. PATIENTS AND METHODS: During the period between November 2002 and June 2011, we retrospectively studied 190 patients that were treated for stress urinary incontinence using a tension-free suburethral sling. 50 patients were treated using the retropubic route (SPARC®), and 140 patients were treated using a transobturator (MONARC®). RESULTS: In total, 16.57% of the patients presented with intraoperative, immediate postoperative or later postoperative complications. We observed a higher rate of complications with patients who were operated on retropubically (26%) than with patients who were operated on using the transobturator method (12%). CONCLUSIONS: The rate of complications for our study was low, and was even lower in the case of transobturator tape. Thus, we usually used transobturator tape in the treatment of stress incontinence.

Mineral density and bone remodelling markers in patients with calcium lithiasis.

UNLABELLED: What's known on the subject? and What does the study add? Hypercalciuria is related with bone mineral density loss. This study demonstrates the relationship between recurrent calcium nephrolithiasis and bone mineral density loss and their correlation with bone markers. OBJECTIVES: • To show that a relationship exists between the loss of bone mineral density (BMD) and calcium renal lithiasis and that bone remodelling markers correlate with changes in BMD. • It is possible that many cases hypercalciuria are related to the increase of bone turnover and the predominance of bone resorption phenomena. PATIENTS AND METHODS: • The present study comprised a transversal investigation in three groups: group O, without lithiasis; group A, with a single episode of lithiasis; and group B, with relapsed calcium renal lithiasis. • An analysis was made of body mass index; abdominal X-ray and/or urography and renal ultrasonography; osteocalcin and ß-crosslaps bone markers; calcium and citrate concentrations in the urine; and femur and spinal column bone densitometry. • The results were analyzed by analysis of variance and Pearson's correlation coefficient. RESULTS: • Patients with relapsed calcium renal lithiasis present a greater BMD loss than those in the O or A groups. • Densitometry: T-score femur -0.2 group O, -0.5 group A, -1.2 group B (P= 0.001); T-score column -0.6 group O, -0.6 group A, -1.3 group B (P= 0.05). • A statistically significant negative correlation exists between values of ß-crosslaps and T-score femur (R=-0.251; P= 0.009) and T-score column (R=-0.324; P= 0.001); thus, a higher concentration of ß-crosslaps was accompanied by a lower value of the T-score and a greater loss of BMD. • A positive relationship is observed between ß-crosslaps and osteocalcin (R= 0.611; P < 0.001) and between calciuria and cocient ß-crosslaps/osteocalcin (R= 0.303; P= 0.001). CONCLUSIONS: • A statistically significant relationship is shown between the loss of BMD and relapsed calcium renal lithiasis. • Determination of bone remodelling markers (i.e. osteocalcin and ß-crosslaps) facilitates the diagnosis of osteopaenia/osteoporosis in these patients.