Atuação do enfermeiro estomaterapeuta no manejo da incontinência urinária de esforço / The role of the nurse stomatherapist in the management of stress urinary incontinence / El papel de las enfermeras de terapia estomal en el manejo de la incontinencia urinaria de esfuerzo

Objetivo: Relatar a atuação do enfermeiro estomaterapeuta no manejo da incontinência urinária de esforço. Métodos: Estudo observacional, do tipo relato de caso, seguindo duas fases, onde a primeira foi a coleta de dados e levantamento do histórico clínico do paciente, e segunda fase foi descrever a atuação do enfermeiro estomaterapeuta no manejo da incontinência urinária de esforço. Resultados: Na primeira etapa revelou-se o diagnóstico de incontinência urinária por esforço. Foram aplicados o diário miccional, a terapia comportamental, a cinesioterapia e a eletroestimulação. Conclusão: A atuação do enfermeiro estomaterapeuta no manejo da incontinência urinária de esforço compreende a implementação do tratamento conservador, perpassando pela prevenção, estimulação da mudança comportamental e manejo de tecnologias para fortalecimento da musculatura do assoalho pélvico. (AU)

Objective: To report the role of the nurse stomatherapist in the management of stress urinary incontinence. Methods: Observational study, of the case report type, following two phases, where the first was the collection of data and survey of the patients clinical history, and the second phase was to describe the role of the nurse stomatherapist in the management of stress urinary incontinence. Results: In the first stage the diagnosis of stress urinary incontinence was revealed. Were applied the mictional diary, behavioral therapy, kinesiotherapy and electrostimulation. Conclusion: The role of the nurse stomatherapist in the management of stress urinary incontinence includes the implementation of conservative treatment, through prevention, stimulation of behavioral change and management of technologies for strengthening the pelvic floor muscles. (AU)

Objetivo: Informar sobre el papel de la enfermera estomaterapeuta en el tratamiento de la incontinencia urinaria de esfuerzo. Métodos: Estudio observacional, del tipo case report, siguiendo dos fases, donde la primera fue la recolección de datos y relevamiento de la historia clínica de la paciente, y la segunda fase fue describir la actuación de la enfermera estomaterapeuta en el manejo de la incontinencia urinaria de esfuerzo. Resultados: En la primera etapa se reveló el diagnóstico de incontinencia urinaria de esfuerzo. Se aplicaron el diario miccional, la terapia comportamental, la cinesiterapia y la electroestimulación. Conclusión: La actuación del enfermero estomaterapeuta en el manejo de la incontinência urinaria de esfuerzo comprende la aplicación del tratamiento conservador, pasando por la prevención, la estimación del cambio de comportamiento y el manejo de tecnologías para el fortalecimiento de la musculatura del assoalado pelviano. (AU)

Prevalência de mulheres com incontinência urinária e seu impacto na qualidade de vida / Prevalence of women with urinary incontinence and its impact on quality of life / Prevalencia de mujeres con incontinencia urinaria y su impacto en la calidad de vida

A incontinência urinária é definida como qualquer tipo de perda involuntária de urina. Essa condição afeta muitas mulheres e pode apresentar impacto significativo na qualidade de vida dessa população. Nesse sentido, este estudo teve como objetivo descrever a proporção de mulheres com incontinência urinária e seu impacto na qualidade de vida. Trata-se de um estudo observacional transversal. A amostra da pesquisa foi composta por mulheres atendidas em uma clínica-escola de fisioterapia de uma universidade particular do interior do estado de São Paulo. A coleta de dados foi realizada presencialmente, com a aplicação de uma ficha geral para reunir informações sobre o perfil sociodemográfico e clínico, bem como do instrumento International Consultation on Incontinence Questionnaire ­ Short Form (ICIQ-SF), para avaliar a incontinência urinária e seu impacto na qualidade de vida das participantes. Os dados foram tabulados em planilha Excel e analisados estatisticamente com o programa JAMOVI. O nível de significância adotado para os testes estatísticos foi de p < 0,05. Participaram da pesquisa 35 mulheres, das quais 62,85% apresentaram ocorrência de perda involuntária de urina. Dentro desse grupo, 81,81% relataram perda de qualidade de vida devido à incontinência urinária. Infere-se que a incontinência urinária apresenta elevada prevalência e impacto na qualidade de vida das mulheres, sendo fundamental a adoção de medidas que visem prevenir e tratar essa condição.

Urinary incontinence is defined as the involuntary emission of urine. This condition affects many women and can significantly impact their quality of life. Thus, this cross-sectional observational study aimed to describe the proportion of women with urinary incontinence and its impact on quality of life. The research sample comprised women treated at a physical therapy school clinic at a private university in inner São Paulo State. Data were collected in person using a general form to gather information on participants' sociodemographic and clinical profile and the International Consultation on Incontinence Questionnaire ­ Short Form (ICIQ-SF) instrument to assess urinary incontinence and its impact on quality of life. Data were tabulated on an Excel spreadsheet and statistically analyzed on JAMOVI. The significance level adopted for statistical tests was p < 0.05. This research included 35 women, of which 62.85% involuntary emitted urine. Within this group, 81.81% reported a loss of quality of life due to urinary incontinence. Urinary incontinence has a high prevalence and impact on the quality of life of women, entailing the adoption of measures to prevent and treat this condition.

La incontinencia urinaria se define como la pérdida involuntaria de orina. Esta condición afecta a muchas mujeres y puede impactar significativamente la calidad de vida de esta población. En este sentido, este estudio tuvo como objetivo describir la proporción de mujeres con incontinencia urinaria y su impacto en la calidad de vida. Se trata de un estudio observacional transversal. La muestra de la investigación estuvo compuesta por mujeres atendidas en una clínica de fisioterapia de una universidad privada del interior del estado de São Paulo, Brasil. Se recolectaron los datos de manera presencial mediante un formulario general para recopilar información sobre el perfil sociodemográfico y clínico, y el instrumento International Consultation on Incontinence Questionnaire ­ Short Form (ICIQ-SF) para evaluar la incontinencia urinaria y su impacto en la calidad de vida de las participantes. Los datos fueron tabulados en una hoja de cálculo Excel y analizados estadísticamente mediante el programa JAMOVI. El nivel de significación adoptado para las pruebas estadísticas fue p < 0,05. En la investigación participaron 35 mujeres, de las cuales el 62,85% presentó pérdida involuntaria de orina. Dentro de este grupo, el 81,81% refirió pérdida de calidad de vida por incontinencia urinaria. Se infiere que la incontinencia urinaria tiene una alta prevalencia e impacto en la calidad de vida de las mujeres, por lo que es imprescindible adoptar medidas para prevenir y tratar esta condición.

Incontinencia urinaria en trabajadoras de la salud como factor predisponente de presentismo en Chile: estudio exploratorio de método mixto / Urinary incontinence in health workers as a predisposing factor for presenteeism in Chile: A mixed-methods exploratory study

Introducción La incontinencia urinaria impacta de forma negativa la calidad de vida de quienes la padecen y puede perjudicar las actividades laborales, siendo causante de presentismo en las profesionales de salud. Esto puede implicar la disminución en la calidad de la atención y seguridad de la/el paciente. El objetivo del presente estudio es explorar la autopercepción de las trabajadoras de salud que padecen incontinencia urinaria como factor predisponente de presentismo. Métodos Estudio mixto de carácter exploratorio-descriptivo. La muestra fue seleccionada de forma no probabilística e intencionada por criterio y conveniencia con un tamaño de 14 voluntarias, considerando la saturación de la información. Para el proceso y análisis de datos temáticos se consideraron los criterios de confiabilidad definidos por Guba. Resultados Muestra con edad media de 38,9 + 7,1 años y un puntaje de SPS-6 medio de 15,8 + 3,5 puntos, mostrando mayor alteración en la dimensión de evitar la desconcentración. Las narrativas presentes en el caso estudiado aportaron información relevante de cómo la incontinencia urinaria afecta el desempeño laboral de las trabajadoras de salud a través de la interrupción en su jornada, disminución en la calidad de la atención clínica, como también el aumento de su ansiedad respecto a su entorno. Conclusiones Dado que la incontinencia urinaria y el presentismo son experiencias subjetivas y multidimensionales, al igual que el efecto negativo en el desempeño laboral, se recomienda un estudio que permita identificar variables predictoras y las pérdidas económicas asociadas a esta condición. Con ello se buscaría establecer mejoras en el ambiente laboral, así como en el autocuidado de funcionarias, procurando mayores beneficios y mejores niveles de eficiencia en la organización.

Introduction Urinary incontinence negatively impacts the quality of life and can harm work activities, causing presenteeism in health professionals and decreasing the quality of care and patient safety. The objective of this study is to explore the self-perception of health workers who suffer from urinary incontinence as a predisposing factor for presenteeism. Methods Mixed study of an exploratory-descriptive nature. The sample was selected in a non-probabilistic and intentional way by criterion and convenience with a size of 14 volunteers, considering the saturation of the information. Reliability criteria defined by Guba for the process and analysis of thematic data were considered. Results The sample had a mean age of 38.9 + 7.1 years and a mean SPS-6 score of 15.8 + 3.5 points, showing alteration in the dimension of avoiding deconcentration. The narratives in the case study provide relevant information on how urinary incontinence affects the work performance of health workers through the interruption in their day, decreases the quality of clinical care, and increases their anxiety regarding their environment. Conclusions Urinary incontinence and presenteeism are subjective, and multidimensional experiences affect work performance. Therefore, further studies are recommended to identify predictor variables and the economic losses associated with this condition to establish improvements in the work environment and the self-care of female employees seeking greater benefits and better levels of efficiency in the organization

Impacto de la terapia de biorretroalimentación en pacientes con incontinencia fecal o constipación en una unidad de neurofisiología gastrointestinal en Bogotá, D.C / Impact of biofeedback therapy on patients with fecal incontinence or constipation in a gastrointestinal neurophysiology unit in Bogotá, D.C

RESUMEN Introducción: El tratamiento de los trastornos funcionales de la unidad anorrectal debe centrarse en la causa subyacente. La terapia de biorretroalimentación es un reentrenamiento funcional del suelo pélvico que ha demostrado su utilidad en el tratamiento del estreñimiento asociado a la disinergia y en el manejo de la incontinencia fecal. Este estudio describe las primeras experiencias con esta forma de terapia de biorretroalimentación en Colombia. Objetivo: Describir nuestra experiencia con la terapia de biorretroalimentación en la unidad de neurofisiología gastrointestinal. Materiales y métodos: Esta cohorte histórica incluyó pacientes con indicación de terapia de biorretroalimentación por estreñimiento o incontinenciafecalenlaunidaddeneurofisiologíagastrointestinalenelperiododerecolección de datos. Se describe la respuesta a la terapia comparando los hallazgos manométricos antes y después de 10 sesiones de biorretroalimentación. Resultados: Se incluyó a 21 pacientes (71,4% mujeres, el promedio de edad fue de 68, 9 con estreñimiento y 12 con incontinencia fecal. Entre los pacientes con estreñimiento hubo una mejoría significativa en el 71,4% de los que tenían hiposensibilidad rectal y en el 57,1% de los que tenían disinergia. La terapia de biorretroalimentación aumentó significativamente la tasa de expulsión del balón (11,1 frente a 66,7%, p=0,02). En pacientes con incontinencia fecal, hubo mejoría en el 50% de los que tenían hipotonía anal y en el 80% de los que tenían hiposensibilidad anal. Conclusiones: Este estudio demuestra que la terapia de biorretroalimentación tiene un impacto favorable en un alto número de pacientes con estreñimiento e incontinencia fecal, en nuestro centro, la respuesta es similar a la de la literatura mundial.

ABSTRACT Introduction: Treatment of functional disorders of the anorectal unit should focus on the underlying cause. Biofeedback therapy is a functional retraining of the pelvic floor that has proven useful in the treatment of constipation associated with dyssynergia and in the management of fecal incontinence. This study describes the first experiences with this form of biofeedback therapy in Colombia. Objective: Describe our experience with biofeedback therapy in the gastrointestinal neurophysiology unit. Materials and methods: This historical cohort included patients with an indication for biofeedback therapy for constipation or fecal incontinence in the gastrointestinal neurophysiology unit during the data collection period. The response to therapy is described by comparing manometric findings before and after 10 biofeedback sessions. Results: 21 patients were included (71.4% women, the average age was 68, 9 with constipation and 12 with fecal incontinence. Among the patients with constipation there was a significant improvement in 71.4% of those who had rectal hyposensitivity and in 57.1% of those with dyssynergia. Biofeedback therapy significantly increased the balloon expulsion rate (11.1 vs. 66.7%, p=0.02). In patients with fecal incontinence, there was improvement in 50% of those who had anal hypotonia and in 80% of those who had anal hyposensitivity. Conclusions: This study demonstrates that biofeedback therapy has a favorable impact on a high number of patients with constipation and fecal incontinence; in our center, the response is similar to that of the world literature.

Validação de instrumento brasileiro para mapeamento dos fatores de risco e diagnóstico precoce de incontinência urinária feminina

Objetivo: Validar o conteúdo do Instrumento de Mapeamento dos Fatores de Risco para Incontinência Urinária Feminina (IMFRIU-Fem) considerando o contexto das mulheres adultas jovens. Método: Trata-se de uma pesquisa metodológica quantitativa, desenvolvida no período de abril 2020 a dezembro de 2021, em três etapas: revisão integrativa da literatura, construção do instrumento e validação do conteúdo. Resultados: Através da revisão integrativa, 55 fatores de risco foram identificados e agrupados em dimensões na estrutura do instrumento, considerando desde os aspectos sociodemográficos até os sistemas corporais. O instrumento foi validado pelo índice de validade de conteúdo (IVC) e contou com a avaliação de 7 juízes. Para a maioria das dimensões do instrumento os juízes apresentaram uma resposta unanime, expressando uma porcentagem de 91 % quanto a clareza e compreensão, o que significa dizer que tais dimensões apresentam funcionalidade diante do objetivo de mapear os fatores de risco para a incontinência urinária feminina. O IVC global das dimensões, mostrou-se extremamente significativos, com IVC = 0,91. Conclusão: Espera-se que o IMFRIU-Fem possa auxiliar os enfermeiros a identificar precocemente os fatores de risco para a incontinência urinária, fornecendo dados longitudinais que permitam elaborar um plano assistencial que considere a integralidade da saúde da mulher.

Objetivo: Validar el contenido del Instrumento de Mapeo de Factores de Riesgo para la Incontinencia Urinaria Femenina (IMFRIU-Fem) considerando el contexto de las mujeres adultas jóvenes. Método: Se trata de una investigación metodológica cuantitativa, desarrollada entre abril de 2020 y diciembre de 2021, en tres etapas: revisión bibliográfica integradora, construcción del instrumento y validación de contenido. Resultados: A través de la revisión integradora, se identificaron 55 factores de riesgo y se agruparon en dimensiones en la estructura del instrumento, considerando desde aspectos sociodemográficos hasta sistemas corporales. El instrumento fue validado por el índice de validez de contenido (IVC) y fue evaluado por 7 jueces. Para la mayoría de las dimensiones del instrumento los jueces presentaron una respuesta unánime, expresando un porcentaje del 91 % en cuanto a claridad y comprensión, lo que significa que dichas dimensiones presentan funcionalidad frente al objetivo de mapear los factores de riesgo de la incontinencia urinaria femenina. El IVC global de las dimensiones resultó ser extremadamente significativo, con un valor de 0.91. Conclusión: Se espera que el IMFRIU-Fem pueda ayudar al personal de enfermería a identificar de forma precoz los factores de riesgo para la incontinencia urinaria, proporcionando datos longitudinales que permitan elaborar un plan de asistencia que considere la integralidad de la salud de la mujer.

Objective: To validate the content of the Risk Factors Mapping Instrument for Female Urinary Incontinence (IMFRIU-Fem) considering the context of young adult women. Method: This is quantitative methodological research, developed from April 2020 to December 2021, in three stages: integrative literature review, instrument construction and content validation. Results: Through the integrative review, 55 risk factors were identified and grouped into dimensions in the structure of the instrument, considering from sociodemographic aspects to body systems. The instrument was validated by the content validity index (CVI) and was assessed by 7 judges. For most of the dimensions of the instrument the judges presented a unanimous answer, expressing a percentage of 91 % as to clarity and understanding, which means that such dimensions present functionality in the face of the objective of mapping the risk factors for female urinary incontinence. The global CVI of the dimensions showed to be extremely significant, with CVI = 0.91. Conclusion: It is expected that the IMFRIU-Fem may help nurses to identify early risk factors for urinary incontinence, providing longitudinal data that allow the elaboration of a care plan that considers the integrality of women's health.

Urinary symptoms, falls and fear of falling in older people with cognitive impairment / Sintomas urinários, quedas e medo de cair em idosos com comprometimento cognitivo

Abstract Introduction: Among geriatric syndromes, cognitive impairment, urinary incontinence, nocturia, and falls stand out. Older adults with urinary incontinence are more prone to falls and exhibit fear of falling. Objective: To investigate the frequency of urinary incontinence and nocturia and evaluate the association of these variables with falls and fear of falling in older individuals with cognitive impairment. Methods: Cross-sectional study with older adults referred from Basic Health Units with cognitive impairment evaluated between 2019 and 2021. Information on urinary incontinence, nocturia, history of falls, and fear of falling provided by the participants and their caregivers was collected. Data were analyzed using Chi-square tests and univariate logistic regressions. Results: Data from 89 older adults were analyzed, of whom 58.4% had urinary incontinence, 28.1% had nocturia, 67.4% reported fear of falling, and 41.6% reported falls in the last six months. The group with urinary incontinence [χ2(1) = 5.147; p = 0.023] and the group with nocturia [χ2(1) = 4.353; p = 0.037] had significantly higher frequencies of fear of falling. No differences in the frequencies of history of falls were observed between individuals with and without urinary incontinence or nocturia (p > 0.05). Fear of falling was associated with urinary incontinence (OR = 2.833; 95% CI 1.137 - 7.062) and nocturia (OR = 3.365; 95% CI 1.033 - 10.966). Conclusion: Older adults with cognitive impairment have a high frequency of urinary incontinence, nocturia, falls, and fear of falling. Furthermore, there is an association between urinary incontinence, nocturia and fear of falling in this population.

Resumo Introdução: Entre as síndromes geriátricas, destacam-se o comprometimento cognitivo, a incontinência urinária, a noctúria e as quedas. Idosos com incontinência urinária são mais propensos a cair e apresentar medo de cair. Objetivo: Investigar a frequência de incontinência urinária e noctúria e avaliar a associação dessas variáveis com a ocorrência de quedas e com o medo de cair em idosos com comprometimento cognitivo. Métodos: Estudo transversal com idosos encaminhados das Unidades Básicas de Saúde com comprometimento cognitivo avaliados entre os anos de 2019 e 2021. Foram coletadas informações sobre incontinência urinária, noctúria, histórico de quedas e medo de cair, fornecidas pelos idosos e seus acompanhantes. Os dados foram analisados por meio dos testes quiquadrado e regressões logísticas univariadas. Resultados: Foram analisados dados de 89 idosos, dos quais 58,4% apresentavam incontinência urinária, 28,1% apresentavam noctúria, 67,4% tinham medo de cair e 41,6% relataram quedas nos últimos seis meses. O grupo com incontinência urinária [2(1) = 5,147; p = 0,023] e o grupo com noctúria [χ2(1) = 4,353; p = 0,037] apresentaram frequências significativamente maiores de medo de cair. Não foram observadas diferenças das frequências de histórico de quedas entre os indivíduos com e sem incontinência ou noctúria (p > 0,05). O medo de cair mostrouse associado à incontinência (OR = 2,833; IC95% 1,137 - 7,062) e à noctúria (OR = 3,365; IC 95% 1,033 - 10,966). Conclusão: Idosos com comprometimento cognitivo apresentam alta frequência de incontinência urinária, noctúria, quedas e medo de cair. Ademais, há associação da incontinência urinária e da noctúria com o medo de cair nessa população.

Effects of pelvic floor muscle training versus hypopressive abdominal gymnastics (HAG) on stress urinary incontinence in climacteric women: randomized clinical trial / Efectos del entrenamiento muscular del suelo pélvico versus la gimnasia abdominal hipopresiva (GAH) sobre la incontinencia urinaria de esfuerzo en mujeres climatéricas: ensayo clínico aleatorizado / Efeitos do treinamento muscular do assoalho pélvico versus Ginástica Abdominal Hipopressiva (GAH) na incontinência urinária de esforço de mulheres climatéricas: ensaio clínico randomizado

ABSTRACT Pelvic floor muscle training (PFMT) is recommended as first-line treatment for stress urinary incontinence (SUI) in women (scientific evidence level 1). Currently, hypopressive abdominal gymnastics (HAG) has been used in clinical practice without evidence for this purpose. To verify the superiority of an experimental treatment in relation to a positive control (gold standard) for the treatment of SUI and PFM function in climacteric women. A non-inferiority clinical trial was conducted with 31 climacteric women with SUI who were sexually active. They were allocated into two groups: 16 in the PFMT group and 15 in the HAG group. Both groups received 26 sessions twice per week and individual care. All participants were assessed twice, at the beginning and at the end of interventions. The primary outcome was assessed using the International Consultation on Incontinence Questionnaire - Short Form (ICIQ-SF) and the secondary were given by PFM function assessed via bidigital palpation. The methods used to analyze the results were the two-way repeated measures analysis of variance (ANOVA), followed by the Tukey post-hoc test, when necessary. PFMT was better in improving SUI in the primary outcome (p=0.01). The groups showed no significant difference in force of contraction, time of sustained PFM, and fast and slow repetitions at the time of analysis. Regarding the symptoms of SUI, PFMT performed better than HAG.

RESUMEN El entrenamiento muscular del suelo pélvico (EMSP) se recomienda como tratamiento de primera línea para las pruebas de nivel 1 de incontinencia urinaria de esfuerzo (IUE). Actualmente, se utiliza la gimnasia abdominal hipopresiva (GAH) en la práctica clínica con este fin. Este estudio tuvo por objetivo comprobar la superioridad de un tratamiento experimental en comparación con el tratamiento de referencia para la IUE y la función del suelo pélvico en mujeres menopáusicas. Se realizó un ensayo clínico aleatorizado de no inferioridad con 31 mujeres climatéricas sexualmente activas y con IUE. Las participantes se distribuyeron en dos grupos: 16 se sometieron a EMSP y 15 a GAH. Ambos recibieron 26 sesiones, dos veces por semana, en sesiones individuales. Todas las voluntarias fueron evaluadas en dos momentos, al principio y al final de las intervenciones. El resultado primario se evaluó mediante el cuestionario ICIQ-SF, y el resultado secundario mediante la evaluación bidigital del suelo pélvico. Para el análisis estadístico se utilizó la prueba ANOVA de dos vías, seguida de la prueba posterior de Tukey cuando necesario. El EMSP tuvo un mejor resultado en la mejora de la IUE (p=0,01). No hubo diferencias entre los grupos en cuanto a la fuerza de contracción, el tiempo de mantenimiento y las repeticiones rápidas y lentas. En cuanto a la mejora de los síntomas de IUE, se concluyó que el EMSP es superior a la GAH.

RESUMO O treinamento dos músculos do assoalho pélvico (TMAP) é recomendado como primeira linha no tratamento do nível 1 de evidência da incontinência urinária de esforço (IUE). Atualmente, a Ginástica Abdominal Hipopressiva (GAH) tem sido utilizada na prática clínica com este propósito. Este estudo tem como objetivo verificar a superioridade de um tratamento experimental em relação ao tratamento padrão-ouro para IUE e função do assoalho pélvico em mulheres na menopausa. Foi conduzido um ensaio clínico randomizado de não inferioridade com 31 mulheres climatéricas, sexualmente ativas e com IUE. Elas foram alocadas em dois grupos, em que: 16 foram submetidas ao TMAP e 15 à GAH. Ambos receberam 26 sessões, duas vezes por semana, em atendimentos individuais. Todas as voluntárias foram avaliadas em dois momentos, no início e ao término das intervenções. O desfecho primário foi avaliado pelo Questionário (ICIQ-SF) e o secundário pela avaliação bidigital do assoalho pélvico. Para a análise estatística, foram utilizados o teste ANOVA de duas vias, seguido do pós-teste de Tukey, quando necessário. O TMAP foi superior na melhora da IUE (p=0.01). Não houve diferença entre os grupos em relação a força de contração, tempo de sustentação, repetições rápidas e lentas. Em relação à melhora dos sintomas de IUE, concluiu-se que o TMAP é superior a GAH.

Mobile app for pelvic floor muscle training for urinary incontinence during the coronavirus disease 2019 pandemic: clinical trial

SUMMARY OBJECTIVE: The objective of this study was to evaluate the effects of home-based pelvic floor muscle training in women with urinary incontinence, addressing the difficulties arising from social isolation due to the coronavirus disease 2019 pandemic by utilizing a specialized mobile app. METHODS: This randomized, single-group clinical trial aimed to assess the efficacy of pelvic floor muscle training guided by a mobile app (Diario Saúde) in women with stress urinary incontinence. Participants were instructed via telephone to engage in pelvic floor muscle training exercises twice a day for 30 days. Pre- and post-treatment, participants completed validated questionnaires regarding urinary symptoms and quality of life through telephone interviews. Additionally, treatment adherence was evaluated. RESULTS: A total of 156 women were enrolled in the study, with a mean age of 49.3±14.2 years. Significant improvements in urinary incontinence symptoms and quality of life were observed following pelvic floor muscle training guided by the mobile app (p<0.001). Notably, 74.3% of the participants reported performing the exercises with appropriate frequency. Of the participants, 62% reported either complete or substantial improvement in urinary symptoms post-treatment. CONCLUSION: This study revealed notable enhancements in stress urinary incontinence, urinary storage, and overall quality of life subsequent to pelvic floor muscle training guided by a mobile app, particularly during the coronavirus disease 2019 pandemic. The mobile app demonstrated robust acceptance and adherence among women experiencing urinary incontinence.

Prevalence of colorectal symptoms and anal incontinence in patients with pelvic organ prolapse attended at an outpatient urogynecology service

Abstract Objective: To analyze data of patients with symptomatic pelvic organ prolapse evaluated with PFDI20 and its subscales to report the prevalence of lower gastrointestinal symptoms and anal incontinence in the population of a public hospital and analyze its impact on quality of life. Methods: Cross-sectional study of patients with symptomatic POP. Patients were evaluated with demographic data, POP-Q, pelvic floor ultrasonography, urological parameters, and pelvic floor symptoms (PFDI-20), and quality of life (P-QoL) surveys. Patients were classified as CRADI-8 "positive" for colorectal symptoms, with responses "moderate" in at least 3 and/or "severe" in at least 2 of the items in the CRADI-8 questionnaires. Results: One hundred thirteen patients were included. 42.5% (48) were considered positive for colorectal symptoms on CRADI-8. 53.4% presented anal incontinence. No significant differences were found in sociodemographic variables, POP-Q stage, ultrasound parameters, or urological parameters. Positive patients had a significantly worse result in PFDI-20, POPDI (48 vs 28; p<0.001), UDI6 (51 vs 24; p<0.001), and in the areas of social limitation (44.4 vs 22.2; p = 0.045), sleep- energy (61.5 vs 44.4; p = 0.08), and severity (56.8 vs 43.7, p=0.015) according to P-QoL. Conclusion: Moderate or severe colorectal symptoms are seen in 40% of patients with symptomatic POP in our unit. Full evaluation of pelvic floor dysfunction symptoms should be performed routinely in urogynecology units. (FONIS SA12I2I53 - NCT02113969).

Sacral neuromodulation therapy for urinary and defecatory disorders: experience in a Latin American public hospital

Abstract 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.

Knowledge of nursing staff before and after training on incontinence-associated dermatitis / Conocimientos del personal de enfermería antes y después de la formación sobre la dermatitis asociada a la incontinencia / Conhecimento da equipe de enfermagem antes e após capacitação sobre dermatite associada à incontinência

ABSTRACT Objective: To verify the knowledge of nursing staff before and after training on incontinence-associated dermatitis. Method: A study before and after an educational intervention carried out with nursing staff from the medical and surgical clinics and intensive care unit of the university hospital in June 2023. The training took place over three meetings. Data was collected using a questionnaire administered immediately before and after the training. McNemar's test for dependent samples was used to compare before and after training. Results: 25 nurses and 14 nursing technicians took part. The items that showed statistical significance were related to the identification and correct differentiation of dermatitis associated with incontinence and pressure injury; and the correct way to sanitize the skin. Conclusion: The training of the nursing team made it possible to assess their knowledge of how to identify, prevent and treat incontinence-associated dermatitis.

RESUMEN Objetivo: Verificar los conocimientos del personal de enfermería antes y después de la formación sobre la dermatitis asociada a la incontinencia. Método: Estudio antes y después de una intervención formativa realizada con personal de enfermería de las clínicas médicas y quirúrgicas y de la unidad de cuidados intensivos de un hospital universitario en junio de 2023. La formación se impartió en tres sesiones. Los datos se recogieron mediante un cuestionario aplicado inmediatamente antes y después de la formación. Se utilizó la prueba de McNemar para muestras dependientes para comparar antes y después de la formación. Resultados: Participaron 25 enfermeras y 14 técnicos de enfermería. Los ítems que mostraron significación estadística estaban relacionados con la identificación y correcta diferenciación de la dermatitis asociada a la incontinencia y al daño por presión; y la forma correcta de higienizar la piel. Conclusión: La formación del equipo de enfermería permitió evaluar los conocimientos del equipo de enfermería sobre cómo identificar, prevenir y tratar la dermatitis asociada a la incontinencia.

RESUMO Objetivo: Verificar o conhecimento da equipe de enfermagem antes e após capacitação sobre dermatite associada à incontinência. Método: Estudo antes e depois de uma intervenção educativa realizado com profissionais da equipe de enfermagem das clínicas médicas, cirúrgicas e unidade de terapia intensiva do hospital universitário, no mês de junho de 2023. A capacitação ocorreu durante três encontros. Os dados foram coletados por meio de questionário, aplicado imediatamente antes e após a capacitação. Para a comparação do antes e após capacitação, foi realizado o teste de McNemar para amostras dependentes. Resultados: Participaram 25 enfermeiros e 14 técnicos de enfermagem. Os itens que apresentaram significância estatística foram relacionados à identificação e à diferenciação correta da dermatite associada à incontinência e lesão por pressão; e a forma correta para higienização da pele. Conclusão: A capacitação da equipe de enfermagem permitiu avaliar o conhecimento da equipe de enfermagem para identificar, prevenir e tratar a dermatite associada à incontinência.

Using an anatomic model to teach female stress incontinence to gynecologic residents‑in‑training: A prospective cohort study / Philippine Journal of Obstetrics and Gynecology

Background@#Stress urinary incontinence (SUI) is a complex condition with a multifactorial etiology that makes its concepts challenging to teach. This study aimed to assess the efficacy of simulation-based training (SBT) with an anatomic teaching model in improving the understanding of SUI among gynecologic residents-in-training. @*Objective@#The primary objective of this study was to evaluate the efficacy of SUI simulation-based teaching in enhancing the learning experience for gynecologic residents-in-training. The secondary objective was to gather feedback from participants with the intent to further enhance existing teaching methodologies.@*Materials and Methods@#This was a descriptive prospective study within a single institution, involving gynecologic residents-in-training. Participants were given an anatomic teaching tool to construct, followed by an SUI lecture. Pre- and posttest Multiple Choice Questions were administered to assess the efficacy of the teaching tool in improving the participants’ understanding of SUI. Frequency and percentages were used to describe the categorical variables, whereas continuous variables were described using mean and standard deviation. Paired t-test was used to compare the pre- and posttest scores. ANOVA was used to compare the pre- and posttest scores of participants by year level. A P < 0.05 is statistically significant. A separate Likert-scale questionnaire, to evaluate changes in participant’s self-assessment on learning, response to teaching content and resources, and overall feedback of the SBT was used.@*Results@#There were 50 gynecologic residents-in-training that were included in the study. The mean posttest score is significantly higher (6.4 vs. 3.48) than the pretest score, with a mean difference of 3.48. The mean posttest score is significantly different between the year levels with a P < 0.05, with senior residents-in-training performing best. Although participants with only gynecologic conferences as SUI reference performed best, the mean pre- and posttest scores were not statistically different with respect to SUI education exposure. With the use of an anatomic SUI model, the number of correct answers for questions pertaining to anatomy, physiology, and pathophysiology was consistently higher in the posttest scores as compared to the pretest scores but did not reach statistical significance. The majority of participants strongly agree to recommend the course to a colleague.@*Conclusion@#This study supports the use of simple, low-fidelity physical teaching tools in improving the understanding of SUI in gynecologic residents-in-training. Considering the ease of production, improved test scores, and participants’ enthusiasm, the incorporation of the anatomic teaching tool for its use in SUI education should be encouraged.

Síndromes geriátricos y abandono

Fundamento: el abandono en la vejez es un condicionante de muchos trastornos de salud y constituye en mayor medida una condición de gran incidencia a nivel mundial. Objetivo: comparar los síndromes geriátricos y el abandono en pacientes adultos mayores. Métodos: se realizó un estudio transversal, descriptivo, analítico y correlacional, en la Unidad de Medicina Familiar No. 33 del Instituto Mexicano del Seguro Social de Tabasco. La muestra se conformó con 203 pacientes de 60 años y más, que acudieron a consulta de Medicina Familiar y Atención Médica Continua. Se aplicaron 3 instrumentos: la escala de Pfeiffer, el International Consultation on Incontinence Questionnaire Short-Form, la Escala de Percepción de Abandono del Adulto Mayor y se interrogó sobre el consumo de medicamentos prescritos y automedicados. Resultados: existió relación entre los síndromes geriátricos y el abandono, como se comprobó en la correlación entre las variables analizadas. El deterioro cognitivo leve, moderado y severo, se encontró en bajas proporciones. El 40,7 % de los pacientes aceptó tener incontinencia urinaria. La presencia de polifarmacia se encontró en altas proporciones. Conclusiones: los síndromes geriátricos presentes en el estudio fueron: deterioro cognitivo, polifarmacia e incontinencia urinaria, más la presencia de ser soltero, viudo o divorciado muestran una relación significativa para sufrir abandono.

Foundation: abandonment in old age is a condition of many health disorders and is, to a greater extent, a condition of high incidence worldwide. Objective: to compare geriatric syndromes and abandonment in older adult patients. Methods: a cross-sectional, descriptive, analytical and correlational study was carried out in the Family Medicine Unit No. 33 of the Mexican Social Security Institute of Tabasco. The sample was made up of 203 patients aged 60 and over, who attended Family Medicine and Continuing Medical Care consultations. Three instruments were applied: the Pfeiffer scale, the International Consultation on Incontinence Questionnaire Short-Form, the Perception of Abandonment Scale for the Elderly, and questions were asked about the consumption of prescribed and self-medicated medications. Results: there is a relationship between geriatric syndromes and abandonment, as verified in the correlation between the variables analyzed. Mild, moderate and severe cognitive impairment was found in low proportions. 40.7 % of the patients accepted having urinary incontinence. The presence of polypharmacy was found in high proportions. Conclusions: the geriatric syndromes present in the study such as: cognitive impairment, polypharmacy and urinary incontinence, plus the presence of being single, widowed or divorced show a significant relationship to suffering abandonment.

Assessment of functional outcome following Duhamel retro-rectal pull-through surgery for Hirschsprung's disease: a follow-up study

Context: Hirschsprung's disease (HD) is one of the commonest problems requiring surgery in children. More than 95% of children present during new-born period, when they are treated with leveling colostomy and are followed with pull-through surgery a few months later, once the child has gained adequate weight to withstand a major surgery. The commonest pull through surgery done is the Duhamel retro-rectal pull-through (DRPT) repair. Settings and Design: This is a retrospective study of children who presented to one unit in our institute, a tertiary care referral hospital for children less than 12 years, with HD and underwent DRPT procedure during the period between July 2017 to June 2020. The children were evaluated after three years of follow-up for fecal incontinence and constipation. The study was conducted in children diagnosed with classical segment recto-sigmoid HD who underwent surgery. The children who were diagnosed with HD other than classical segment, who underwent primary pull through surgery and who underwent other repairs for HD were excluded from the study. Results: Thirty-two children underwent DRPT procedure during the study period. Of them, five (15.6%) children were lost on follow-up and one (3.1%) child had expired in the immediate post-operative period. Twenty-six children were included in the study. The bowel function score was calculated. The mean age of definitive surgery was 4.2 years. The follow-up period was a minimum of three years. Only two children had a "good" score of eighteen and above. Nineteen children had a "fair" score of 13-17. Five children had a "poor" score of less than thirteen, and among them, two had a "very poor" score of less than nine. The mean BFS was 13.72. Conclusions: Functional outcomes following Duhamel procedure are satisfactory, with 7.7% of children are in the fringe of requiring another surgery for constipation and pseudo-incontinence. (AU)

Manejo Clínico da Incontinência Urinária em Mulheres Por Enfermeiros da Estratégia de Saúde da Família / Clinical Management of Urinary Incontinence in Women by Family Health Strategy Nurses / Manejo Clínico de la Incontinencia Urinaria en la Mujer Por Enfermeras de la Estrategia de Salud de la Familia

Objetivo:Analisar a atuação dos enfermeiros da Estratégia de Saúde da Família (ESF) no manejo clínico da incontinência urinária em mulheres numa área de planejamento do município do Rio de Janeiro (RJ). Método:Pesquisa descritiva, com abordagem quantitativa, realizada em sete Unidades Básicas de Saúde, no município do Rio de Janeiro. A amostra foi composta de 27 enfermeiros que atuavam na ESF. A análise dos dados deu-se por meio de estatística descritiva simples, com descrição de frequência relativa e absoluta. Resultados: Evidenciaram-se fragilidades na identificação dos aspectos que envolvem a abordagem precoce, os fatores de risco para o seu desenvolvimento, o tratamento e as atividades educativas. Conclusão: Apesar de se reconhecer que a ESF possui os recursos para o tratamento da incontinência urinária não complicada, algumas ações não são realizadas pelo enfermeiro, como envolver a equipe no cuidado das mulheres com esse acometimento, prescrever exercícios de fortalecimento do assoalho pélvico e avaliar e realizar o tratamento não farmacológico, bem como a investigação das mulheres sem queixa de perda urinária. Portanto, os resultados indicam a necessidade premente de capacitação dos enfermeiros que atuam na ESF.

Objective:To analyze the performance of nurses from the Family Health Strategy (ESF) in the clinical management of urinary incontinence in women in a planning area in the city of Rio de Janeiro (RJ), Brazil. Method:Descriptive research, with a quantitative approach, was carried out in seven Basic Health Units, in the city of Rio de Janeiro. The sample consisted of 27 nurses who worked in the ESF. Data analysis was performed using simple descriptive statistics, with a description of relative and absolute frequency. Results: Weaknesses were shown in the identification of aspects involving an early approach, risk factors for its development, treatment, and educational activities. Conclusion: Despite recognizing that the ESF has the resources for the treatment of uncomplicated urinary incontinence, some actions are not carried out by the nurses, such as involving the team in the care of women with this condition, prescribing exercises to strengthen the pelvic floor and evaluating and carry out non-pharmacological treatment, as well as the investigation of women without complaints of urinary loss. Therefore, the results indicate the urgent need for training of nurses who work in the ESF

Conhecimento, Atitude e Prática de Gestantes Sobre Incontinência Urinária: Estudo Observacional / Knowledge, Attitude, and Practice of Pregnant Women About Urinary Incontinence: Observational Study / Conocimiento, Actitud y Práctica De Gestantes Sobre la Incontinencia Urinaria: Estudio Observacional

Objetivo:avaliar o conhecimento, a atitude e a prática (CAP) de gestantes sobre incontinência urinária (IU), identificar a prevalência de IU durante a gestação, avaliar seu impacto na qualidade de vida (QV) e identificar os fatores associados ao CAP inadequados em relação à IU. Metodologia: Estudo observacional realizado de maio a novembro de 2019 na cidade de Fortaleza, Ceará. Utilizaram-se dois instrumentos para coleta de dados: um para avaliação sociodemográfica, obstétrica e de perdas urinárias e outro para avaliação do CAP sobre IU. Resultados: Participaram 237 gestantes. A prevalência de IU foi de 49,3% e observou-se baixo impacto na QV. A maioria apresentou conhecimento (89,6%) e prática inadequados tanto para prevenir (89,2%) quanto para tratar (78,8%) a IU. Identificaram-se baixos percentuais de acerto relacionados ao conhecimento sobre fatores de risco (46,8%), prevenção (43,8%) e tratamento da IU (42,8%). Apesar disso, a atitude foi considerada adequada para a maioria das mulheres (98,5%). Ausência de orientação sobre o preparo do períneo para o parto durante o pré-natal (p = 0,019), baixa escolaridade (p < 0,001), casos mais leves de IU (p = 0,027) e gestação de alto risco (p = 0,004) associaram-se a prática inadequada. Conclusão: o conhecimento sobre causas, prevenção e tratamento da IU é insuficiente e interfere no manejo dessa condição.perineum for childbirth during prenatal care (p = 0.019), low education (p < 0.001), milder cases of UI (p = 0.027) and high-risk pregnancy (p = 0.004) were associated with inappropriate practice. Conclusions: knowledge about the causes, prevention and treatment of UI is insufficient and interferes with the management of this condition.

Objectives:To assess the knowledge, attitude and practice (KAP) of pregnant women about urinary incontinence (UI), identify the prevalence of UI, assess its impact on quality of life (QoL) and identify factors associated with inadequate KAP in relation to UI. Methodology: Observational study carried out from May to November 2019 in the city of Fortaleza, Ceará, Brazil. Two instruments were used for data collection: one for sociodemographic, obstetric and urinary loss assessment and another for KAP assessment on UI. Results: 237 pregnant women participated. The prevalence of UI was 49.3% and a low impact on QoL was observed. Most had knowledge (89.6%) and inadequate practice both to prevent (89.2%) and to treat (78.8%). Low percentages of correct answers were identified related to knowledge about risk factors (46.8%), prevention (43.8%) and treatment of UI (42.8%). Despite this, the attitude was considered adequate for most women (98.5%). Absence of guidance on preparation of the perineum for childbirth during prenatal care (p = 0.019), low education (p < 0.001), milder cases of UI (p = 0.027) and high-risk pregnancy (p = 0.004) were associated with inappropriate practice. Conclusions: knowledge about the causes, prevention and treatment of UI is insufficient and interferes with the management of this condition.

Objetivos:evaluar el conocimiento, la actitud y la práctica (CAP) de las gestantes sobre la incontinencia urinaria (IU), identificar la prevalencia de la IU, evaluar su impacto en la calidad de vida (CV) e identificar los factores asociados a una PAC inadecuada en relación con la IU. Metodología: estudio observacional realizado de mayo a noviembre de 2019 en la ciudad de Fortaleza/CE. Se utilizaron dos instrumentos para la recolección de datos: uno para la evaluación sociodemográfica, obstétrica y de pérdidas urinarias y otro para la evaluación del CAP en la IU. Resultados: Participaron 237 gestantes. La prevalencia de IU fue del 49,3% y se observó un bajo impacto en la CV. La mayoría tenía conocimiento (89,6%) y práctica inadecuada tanto para prevenir (89,2%) como para tratar (78,8%). Se identificaron bajos porcentajes de aciertos relacionados con el conocimiento sobre factores de riesgo (46,8%), prevención (43,8%) y tratamiento de la IU (42,8%). A pesar de ello, la actitud fue considerada adecuada por la mayoría de las mujeres (98,5%). La ausencia de orientación sobre la preparación del perineo para el parto durante el control prenatal (p = 0,019), la baja escolaridad (p < 0,001), los casos más leves de IU (p = 0,027) y el embarazo de alto riesgo (p = 0,004) se asociaron con una atención inadecuada. práctica. Conclusión: el conocimiento sobre las causas, la prevención y el tratamiento de la IU es insuficiente e interfiere con el manejo de esta condición.

Proposta de protocolo clínico para tratamento conservador da incontinência urinária de urgência / Proposal for a clinical protocol for the conservative treatment of urge urinary incontinence / Propuesta de protocolo clínico para el tratamiento conservador de la incontinencia urinaria de urgencia

Objetivo:Apresentar proposta de protocolo clínico para tratamento conservador da incontinência urinária de urgência (IUU). Método: Relato de experiência fundamentado nas evidências científicas existentes e na experiência clínica dos autores que realizam consultas de enfermagem a pessoas com IUU, delineada conforme proposição do Ministério da Saúde para elaboração de protocolos clínicos. Resultados: Foi proposto um protocolo clínico com diagnóstico e intervenções de enfermagem baseados na North American Nursing Diagnosis Association (NANDA) e na Nursing Interventions Classifications, com etapas sistematizadas em verificar presença de fatores relacionados ou condições associadas ao diagnóstico, sendo eles: assoalho pélvico hiperativo, ansiedade, constipação, infecção urinária, baixa ingestão hídrica, comportamento sanitário inadequado, diabetes mellitus, prolapso de órgão pélvico, alto consumo de potenciais irritantes vesicais e persistência de sintomas. Logo após, as ações que devem ser implementadas pelo enfermeiro são descritas de forma detalhada. Conclusão: Considera-se que o fluxo e o detalhamento das ações apresentadas possam ser adotados pelos enfermeiros de forma a identificarem e tratarem pessoas com IUU, minimizando assim a prevalência do problema e fomentando a qualidade de vida dessas pessoas.

Objective: To present a proposal for a clinical protocol for the conservative treatment of urge urinary incontinence. Method: Experience report based on existing scientific evidence and clinical experience of authors who perform nursing consultations for people with urge urinary incontinence, outlined in accordance with the Brazilian Ministry of Health's proposal for the elaboration of clinical protocols. Results: A clinical protocol was proposed with nursing diagnosis and interventions based on the North American Nursing Diagnosis Association (NANDA) and Nursing Interventions Classifications (NIC), with systematized steps to verify the presence of related factors or conditions associated with the diagnosis, namely: hyperactive pelvic floor, anxiety, constipation, urinary tract infection, low fluid intake, inadequate sanitary behavior, diabetes mellitus, pelvic organ prolapse, high consumption of potential bladder irritants and persistence of symptoms. Soon after, the actions that should be implemented by the nurse were described in detail. Conclusion: It is considered that the flow and detailing of the actions presented can be adopted by nurses in order to identify and treat people with urge urinary incontinence, thus minimizing the prevalence of the problem and promoting the quality of life of these people.

Objetivo:Presentar una propuesta de protocolo clínico para el tratamiento conservador de la incontinencia urinaria de urgencia. Método: Relato de experiencia basado en evidencia científica existente y experiencia clínica de autores que realizan consultas de enfermería a personas con incontinencia urinaria de urgencia, perfilado de acuerdo con la propuesta del Ministerio de Salud para la elaboración de protocolos clínicos. Resultados: Se propuso un protocolo clínico con Diagnósticos e Intervenciones de Enfermería basado en las Clasificaciones de Intervenciones de Enfermería y Diagnósticos de Enfermería de América del Norte, con pasos sistematizados para verificar la presencia de factores relacionados o condiciones asociadas al diagnóstico, a saber: piso pélvico hiperactivo , ansiedad, estreñimiento, infección del tracto urinario, baja ingesta de líquidos, conducta sanitaria inadecuada, diabetes mellitus, prolapso de órganos pélvicos, alto consumo de potenciales irritantes vesicales y persistencia de los síntomas. Posteriormente, se describieron en detalle las acciones que debe implementar la enfermera. Conclusión: Se considera que la fluidez y el detalle de las acciones presentadas pueden ser adoptadas por los enfermeros para identificar y tratar a las personas con incontinencia urinaria de urgencia, minimizando así la prevalencia del problema y promoviendo la calidad de vida de esas personas.DESCRIPTORES:Estomaterapia. Incontinencia urinaria. Enfermería.

Dando voz aos homens: repercussões do viver com incontinência urinária e a prática sexual / Giving men a voice: repercussions of living with urinary incontinence and sexual practice / Dando voz a los hombres: repercusiones de vivir con incontinencia urinaria y la práctica sexual

Objetivo: compreender as repercussões da incontinência urinária na prática sexual de homens. Método: estudo descritivo, qualitativo, apoiado na teoria de Dorothea Orem, realizado em uma clínica de atenção especializada à população com incontinência urinária do Rio de Janeiro, em 2020, com 18 homens maiores de 18 anos, com esse diagnóstico médico, após aprovação pelo Comitê de Ética em Pesquisa. Para coleta dos dados, aplicou-se a entrevista semiestruturada, transcrita e submetida à análise de conteúdo. Resultados: a incontinência urinária acarreta, aos indivíduos, medo da rejeição e sentimentos de baixa autoeficácia, pois acreditam que não satisfazem seus parceiros sexuais, o que compromete os relacionamentos afetivosexuais. Bem como, interfere no desenvolvimento das atividades cotidianas ocasionando o afastamento das redes de apoio, além do sentimento de frustração e impotência, que comprometem a qualidade de vida dos homens. Conclusão: a incontinência urinária acarreta isolamento social, constrangimento, vergonha, baixa autoestima e insatisfação sexual dos homens acometidos(AU)

Objective: to understand the repercussions of urinary incontinence in the sexual practice of men. Method: descriptive, qualitative study, supported by Dorothea Orem's theory, carried out in a polyclinic in Rio de Janeiro, in 2020, with 18 men over 18 years old, with urinary incontinence, after approval by the Research Ethics Committee. For data collection, a semi-structured interview was applied, transcribed and submitted to content analysis. Results: urinary incontinence causes in individuals fear of rejection and feelings of low self-efficacy, as they believe that they do not satisfy their sexual partners, which compromises affective-sexual relationships. As well as it interferes in the development of daily activities, causing the removal of support networks, in addition to the feeling of frustration and impotence, which compromise the quality of life of men. Conclusion: urinary incontinence causes social isolation, embarrassment, shame, low self-esteem and sexual dissatisfaction in affected men(AU)

Objetivo: comprender las repercusiones de la incontinencia urinaria en la práctica sexual de los hombres. Método: estudio descriptivo, cualitativo, basado en la teoría de Dorothea Orem, realizado en una clínica de atención especializada a la población con incontinencia urinaria de Río de Janeiro, en 2020, con 18 hombres mayores de 18 años, con ese diagnóstico, después de la aprobación por el Comité de Ética en Investigación. La recolección de datos se hizo por medio de una entrevista semiestructurada, transcrita y sometida al análisis de contenido. Resultados: la incontinencia urinaria provoca miedo al rechazo y sentimientos de baja autoeficacia, ya que creen que no satisfacen a sus parejas, lo que comprometen las relaciones afectivosexuales. Además, interfiere en el desarrollo de las actividades cotidianas, provocando aislamiento de las redes de apoyo, y también sentimiento de frustración e impotencia, comprometiendo la calidad de vida. Conclusión: la incontinencia urinaria provoca aislamiento social, vergüenza, baja autoestima e insatisfacción sexual en los hombres afectados(AU)

Malla suburetral retropúbica (TVT): experiencia clínica y análisis de datos en el Hospital El Carmen de Maipú / Retropubic suburethral mesh (TVT): clinical experience and data analysis at the Hospital El Carmen de Maipú

La incontinencia urinaria de esfuerzo es la pérdida involuntaria de orina durante una maniobra de esfuerzo físico, ejercicio, estornudo o tos. Afecta aproximadamente al 15% de las mujeres de 30-60 años y su prevalencia es del 30-41%. Aunque existen terapias conservadoras para su manejo, muchas pacientes terminarán necesitando cirugía para su resolución. Las mallas suburetrales son alternativas para el manejo quirúrgico, existiendo dos vías de instalación, la transobturadora (TOT o TVT-O) y la retropúbica (del inglés tension-free vaginal tape o TVT), siendo esta última la que presenta mejores resultados y menos complicaciones posoperatorias. Objetivo: evaluar la tasa de efectividad y las complicaciones de la TVT en la Unidad de Piso Pélvico Femenino del Hospital El Carmen de Maipú entre los años 2015 y 2020. Materiales y Métodos: Se obtuvieron 715 registros de pacientes que fueron sometidas a TVT y se logró contactar telefónicamente con el 60,69% de ellas. Resultados: Los resultados muestran una tasa de efectividad del 94,8% y una tasa de complicaciones del 2,3%. Conclusión: Este estudio aporta evidencia local de los resultados posoperatorios en la IOE en pacientes que requirieron la instalación de una malla suburetal retropúbica, demostrando ser una cirugía altamente efectiva y segura.

Stress urinary incontinence is the involuntary loss of urine during physical exertion, exercise, sneezing, or coughing. It affects approximately 15% of women aged 30-60, with a prevalence of 30-41%. Although there are conservative therapies for its management, many patients will eventually require surgery for resolution. Suburethral sling are considered for surgical management, and there are two installation alternatives, transobturator (TOT or TVT-O) and retropubic (tension-free vaginal tape or TVT), with the latter presenting better results and fewer postoperative complications. Objetive: to evaluate effectiveness rate and complications of the TVT in the Female Pelvic Floor Unit of Hospital El Carmen de Maipú between 2015 and 2020. Materials and Methods: A total of 715 patient records were obtained for those who underwent TVT, and 60.69% of them were successfully contacted by telephone. Results: The results show an effectiveness rate of 94.8% and a complication rate of 2.3%. Conclusion: This study provides local evidence for the results of stress urinary incontinence that required the placement of a retropubic suburethral sling, proving to be a highly effective and safe surgery.

Desgarro agudo del esfínter anal postparto con reparación inmediata / Immediate repair of acute postpartum anal sphincter tear: case report

Las lesiones obstétricas del esfínter anal pueden ocurrir durante el parto vaginal espontáneamente o secundariamente a la episiotomía. Su riesgo se estima en un 26% y son la causa más frecuente de incontinencia anal en mujeres jóvenes. Las lesiones de grado 4 de Sultan, también llamadas cloaca traumática, implican la ruptura completa del esfínter y la comunicación de la cavidad vaginal con el canal anal. La reparación es siempre quirúrgica, para lo que se han descrito diferentes técnicas, aunque ninguna ha demostrado ser superior. Presentamos el caso de una paciente primípara de 23 años con una cloaca traumática posparto. La reparación quirúrgica se realizó de inmediato con una técnica de overlapping. El postoperatorio fue sin complicaciones y al año presenta continencia anal completa. (AU)

Obstetric anal sphincter injuries can occur spontaneously or as a consequence of an episiotomy during vaginal delivery. Their risk is estimated at 26% and they are the most frequent cause of anal incontinence in young women. Sultan grade 4 injuries, also called traumatic cloaca, involve complete rupture of the sphincter and communication of the vaginal cavity with the anal canal. The repair is always surgical, for which different techniques have been described, although none have proven to be superior. We present the case of a 23-year-old primiparous patient with a postpartum traumatic cloaca. Surgical repair was performed immediately with an overlapping technique. The postoperative period was without complications and one year later she presents complete anal continence. (AU)