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dc.contributor.advisorPalacios, Arlex Urial 
dc.creatorVega-López, Johanna 
dc.creatorDurán-Torres, Felipe 
dc.creatorSánchez-Moreno, David 
dc.date.accessioned2017-10-27T15:04:07Z
dc.date.available2017-10-27T15:04:07Z
dc.date.created2017-09-20
dc.date.issued2017 
dc.identifier.urihttp://repository.urosario.edu.co/handle/10336/13874
dc.descriptionIntroducción: La incontinencia urinaria femenina es una entidad con una prevalencia hasta del 40%. El manejo quirúrgico de primera línea es con cintas de uretra media en el caso de la incontinencia tipo esfuerzo, sin embargo, cuando dicho manejo falla, no se tiene claridad sobre cuál debe ser el manejo. Metodología: Revisión sistemática de la literatura con meta-análisis de proporciones, incluyendo estudios observacionales y de intervención, en los cuales se evaluaron los manejos de la incontinencia urinaria recurrente o persistente en mujeres con una cinta de uretra media. Resultados: Se identificaron y tamizaron 161 estudios en la búsqueda sistemática, se incluyeron 29 estudios en la síntesis cualitativa y 27 en la síntesis cuantitativa. Dada la alta heterogeneidad clínica y metodológica entre los estudios, se obtuvo una medida de proporción de curación y/o curación/mejoría combinada para cada uno de los tipos de manejo y no se realizó comparación entre ellos. Se estimó una proporción de curación total combinada en cintas ajustables de 86% (IC95%: 76,4%-92,1%), en segunda cinta de uretra media de 75,1% (IC95%: 68%-81,1%), en acortamiento de la cinta de uretra media previa de 62,3% (IC95%: 49,1%-73,9%) y en la implantación de agentes abultantes de 55,4% (IC95%: 43,2%-67%). No se encontraron pudo realizar con respecto a: sling pubovaginal, colposuspensión y terapia de piso pélvico, al igual que para los desenlaces secundarios. Conclusión: La evidencia encontrada no permite generar un grado de recomendación. Es importante tener en cuenta que estos resultados deben ser corroborados con ensayos clínicos aleatorizados colaborativos multicéntricos.
dc.description.abstractIntroduction: Female urinary incontinence has a prevalence of up to 40%. First-line surgical management is with mid urethral tapes in the case of stress-type incontinence, however, when such management fails, it is unclear what should be the management . Methodology: Systematic review of the literature with meta-analysis of proportions, including observational and interventional studies, in which the management of recurrent or persistent urinary incontinence in women with a mid urethral tape was evaluated. Results: 161 studies were identified and screened in the systematic search, 29 studies were included in the qualitative synthesis and 27 in the quantitative synthesis. Given the high clinical and methodological heterogeneity between the studies, a measure of cure and / or combination / cure / improvement ratio was obtained for each type of management and no comparison was made between them. A combined total cure rate on adjustable tapes was estimated at 86% (95% CI: 76.4% -92.1%), the second mid urethral tape at 75.1% (95% CI: 68% -81.1 %), the shortenning of the previous tape at 62.3% (95% CI: 49.1% -73.9%) and in the implantation of bulking agents at 55.4% (95% CI: 43.2 % -67%). We were not able to perform such analysis with respect to: pubovaginal sling, colposuspension and pelvic floor therapy, as well as secondary outcomes. Conclusion: The evidence found does not allow us to generate a degree of recommendation. It is important to note that these results should be corroborated with multicenter, randomized, collaborative trials
dc.format.mimetypeapplication/pdf
dc.language.isospa
dc.rights.urihttp://creativecommons.org/licenses/by-nc-nd/2.5/co/
dc.sourceinstname:Universidad del Rosario
dc.sourcereponame:Repositorio Institucional EdocUR
dc.subjectIncontinencia urinaria
dc.subjectCintas de uretra media
dc.subjectTVT
dc.subjectTOT
dc.subjectManejo de segunda línea
dc.subjectIncontinencia urinaria recurrente o persistente
dc.subject.ddcEnfermedades 
dc.subject.lembIncontinencia Urinaria
dc.subject.lembIncontinencia Urinaria de Esfuerzo
dc.titleColocación de segunda cinta de uretra media en el manejo de incontinencia urinaria recurrente o persistente en contraste con otras opciones terapéuticas. Revisión sistemática de la literatura y meta-análisis
dc.typemasterThesis
dc.publisherUniversidad del Rosario
dc.creator.degreeMagíster en epidemiología
dc.publisher.programMaestría en Epidemiología
dc.publisher.departmentFacultad de medicina
dc.subject.keywordRecurrent/persistent urinary incontinence
dc.subject.keywordUrinary incontinence
dc.subject.keywordMid urethral tape
dc.subject.keywordTVT
dc.subject.keywordTOT
dc.subject.keywordSecond line management
dc.rights.accesRightsinfo:eu-repo/semantics/openAccess
dc.type.spaTesis de maestría
dc.rights.accesoAbierto (Texto completo)
dc.type.hasVersioninfo:eu-repo/semantics/acceptedVersion
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