Browsing by Author "Santis, Fernanda"

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    Sacral neuromodulation therapy for urinary and defecatory disorders: experience in a Latin American public hospital
    (2024) Mass, Marcelo; Arévalo, Diego; Aleuanlli, Isidora; Santis, Fernanda; Maluenda, Andrea; Dines, Eitan; Cohen, Miriam; Saavedra, Álvaro; Raby, Trinidad; Blumel, Bernardita; Cuevas, Rodrigo; Pohlhammer, Simone; Alarcon, Gabriela; Arellano, Marco; Pizarro, Javier
    Objective: To show the experience of a Latin American public hospital, with SNM in the management of either OAB, NOUR or FI, reporting feasibility, short to medium-term success rates, and complications. Methods: A retrospective cohort was conducted using data collected prospectively from patients with urogynecological conditions and referred from colorectal surgery and urology services between 2015 and 2022. Results: Advanced or basic trial phases were performed on 35 patients, 33 (94%) of which were successful and opted to move on Implantable Pulse Generator (GG) implantation. The average follow-up time after definitive implantation was 82 months (SD 59). Of the 33 patients undergoing, 27 (81%)reported an improvement of 50% or more in their symptoms at last follow-up. Moreover, 30 patients (90%) with a definitive implant reported subjective improvement, with an average PGI-I "much better" and 9 of them reporting to be "excellent" on PGI-I. Conclusion: SNM is a feasible and effective treatment for pelvic floor dysfunction. Its implementation requires highly trained groups and innovative leadership. At a nation-wide level, greater diffusion of this therapy among professionals is needed to achieve timely referral of patients who require it.
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    Vaginal surgical repair of vesico-vaginal fistulas: a successful experience [Reparación quirúrgica por vía vaginal de fístulas vesicovaginales: una experiencia exitosa]
    (2023) Santis, Fernanda; Mergudich, Tania; Santis, Fernanda; Bonavia, Nicolás; Maluenda, Andrea; Arévalo, Diego
    Objetivo: Se presenta una serie de casos de reparación por vía vaginal de fístula vesicovaginal (FVV) de nuestro centro. Material y métodos: Estudio observacional descriptivo. Se evaluaron todas las pacientes con reparación quirúrgica de FVV en el Centro de Innovación de Piso Pélvico del Hospital Sótero del Río entre 2016 y 2022. Resultados: Se reportaron 16 casos, de los cuales el 81,3% fueron secundarios a cirugía ginecológica. En todos se realizó la reparación por vía vaginal, con cierre por planos. En el 94% (15/16) se logró una reparación exitosa en un primer intento. El tiempo de seguimiento poscirugía fue de 10 meses (rango: 3-29). No hubo casos de recidiva en el seguimiento. Una paciente presentó fístula de novo, la cual se reparó de manera exitosa en un segundo intento por vía vaginal. Se reportaron satisfechas con la cirugía 15 pacientes, con mejoría significativa de su calidad de vida. Una paciente reportó sentirse igual (6,3%), pero sus síntomas se debían a síndrome de vejiga hiperactiva que la paciente no lograba diferenciar de los síntomas previos a la cirugía. Conclusión: Las FVV en los países desarrollados son secundarias a cirugía ginecológica benigna. La cirugía por vía vagi-nal en nuestra serie demostró una alta tasa de éxito, con mejora significativa en la calidad de vida de las pacientes Objetive: We present a case series of vesico-vaginal fistulas (VVF) vaginal repair in our center. Material and methods: Des-criptive observational study. All patients with surgical repair of VVF at the Centro de Innovación en Piso Pélvico of Hospital Sótero del Río were evaluated between September 2016 and September 2022. Results: 16 cases were reported. 81.3% were secondary to gynecological surgery. In all cases, a vaginal repair was performed, with a layered closure. 94% (15/16) had no contrast extravasation at the time of examination, confirming fistula closure. The follow-up time was 10 months (range: 3-29). There were no cases of recurrence during follow-up. 1 patient presented de novo fistula which was successfully repaired in a second attempt vaginally. 15/16 patients reported being satisfied with the surgery, with significant improvement in quality of life. 1 patient reported feeling the same (6.3%), but her symptoms were due to overactive bladder syndrome that the patient could not differentiate from the symptoms prior to surgery. Conlusion: VFV in developed countries are mainly secondary to benign gynecological surgery. Vaginal surgery in our series achieved a significant improvement in the quality of life of patients.

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