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Antecedentes: En las últimas décadas, el manejo postquimioterapia de seminoma ha evolucionado debido al uso creciente de tomografía por emisión de positrones con 18 fluoro-desoxi-D-glucosa (18-FDG-PET) este método solo o combinado con la tomografía computarizada (CT) se ha propuesto como herramienta no invasiva para evaluar la extensión de la enfermedad. El objetivo fue conocer su utilidad para determinar viabilidad tumoral en el manejo de masas residuales retroperitoneales de seminoma postquimioterapia. Material y Métodos: Estudio retrospectivo monocéntrico, se revisaron expedientes clínicos de 53 pacientes durante 2013-2018. Se definió respuesta a tratamiento mediante criterios de Recist 1.1 por CT y viabilidad tumoral mediante Suv Max por 18-FDG-PET/CT. Según resultado se dividió en grupos: vigilancia (grupo 1), cirugía de rescate (grupo 2), radioterapia (grupo 3) y quimioterapia (grupo 4). Se realizo estadística descriptiva con programa SPSS v24. Se uso curva ROC para definir punto de corte, sensibilidad (S) y especificidad (E). Resultados: Al analizar, sin discriminar por grupos, se encontró una curva ROC con punto de corte de 3.150, S 50% y E 60%, valores que no son discriminativos ni útiles para definir viabilidad tumoral. Al analizar el grupo de vigilancia y cirugía de rescate se obtuvieron S 80% y E 82%. Al comparar con los grupos 3 y 4 tuvieron un punto de corte de 3.150 y 2.350 respectivamente. Conclusiones: Primer estudio realizado en el país, el 18 FDG-PET/CT demostró una utilidad muy pobre para discriminar viabilidad tumoral en masas residuales seminomatosas postquimioterapia, mejorando discretamente los resultados para los grupos de vigilancia y cirugía de rescate.

Background: Overactive bladder treatment includes lifestyle changes, physical therapy, anticholinergics, neuromodulation, and botulinum toxin. Due to treatment refractoriness, there has been increasing interest in peripheral neuromodulation. Our aim was to evaluate the efficacy of transcutaneous vs percutaneous tibial nerve stimulation in non-neurogenic overactive bladder. Material and Methods: A randomized clinical trial was conducted on 61 patients, within the time frame of January-October 2019. The patients were divided into two groups: transcutaneous (n=33) and percutaneous (n=28). The stimulator (BioTENS) was utilized at 10 Hz/200 us to apply 12 20-minute sessions. Efficacy was evaluated through a 3-day bladder diary, symptom and quality of life questionnaire, and treatment benefit scale in sessions 1, 6, and 12. Descriptive statistics and correlation of variables were performed using the SPSS v22.0 program, and statistical significance was set at a p ≤ 0.05. Results: Mean patient age was 66 years. Diurnal and nocturnal urinary frequency decreased, mean urinary volume increased, and the number of urgency and urge incontinence episodes decreased, with no statistically significant differences between the two treatments. The perception of quality of life and improvement related to treatment increased positively with both techniques (p≥0.05). There were no side effects and treatment adherence was 83.6 % (n=51). A lower intensity level was employed in the percutaneous treatment (4 mA vs 7 mA; p=0.0001). Conclusions: Non-inferiority was demonstrated in this first randomized clinical trial conducted in Mexico that evaluated the efficacy of the two techniques. Keywords: Idiopathic overactive bladder, Neuromodulation, Transcutaneous, Percutaneous.

Background: Midurethral slings are one of the first-line surgical treatments for stress urinary incontinence. The aim of the present study was to evaluate the intraoperative and postoperative complications of retropubic and transobturator midurethral slings and the associated risk factors. Material and methods: A retrospective case series was conducted on 105 women within the time frame of 2016 to 2018. The women were divided into 2 groups: those that underwent retropubic sling placement (n=28) and those that underwent transobturator sling placement (n=77). Demographic variables, risk factors, intraoperative complications, and postoperative complications were analyzed. Descriptive statistics and correlations between variables were performed utilizing the SPSS version 17.0 program and statistical significance was set at a p ≤ 0.05. Results: Mean patient age was 56.7 ± 8.8 years. A total of 31.4% (n=33) of the patients presented with stress incontinence, 65.7% (n=69) with mixed incontinence, and 2.9% (n=3) with occult stress incontinence. The overall complication rate was 29.5% (n=31). The most common intraoperative complication was bladder perforation in 3.8% of the retropubic group patients and was associated with obesity (odds ratio:12.9). The postoperative complications were related to the transobturator sling (p=0.049) and included urinary tract infection (11.4%), inguinal pain (7.6%), and others (6.9%). The risk for postoperative urinary infection was associated with stress incontinence (p=0.03) and the absence of treatment for mixed urinary incontinence (p=0.04), increasing the postoperative urge urinary incontinence rate. Conclusions: The intraoperative complication rates with the transobturator approach were low, compared with the retropubic approach. The most common complication in our case series was urinary tract infection, showing the need for randomized prospective studies to be conducted.