ABSTRACT
Abstract Introduction: Pelvic floor dysfunctions have an impact on women's sexual function. A Chilean study found that 74% of women have pelvic floor dysfunctions, but there is no validated tool for them. Objective: To evaluate the psychometric properties of the Pelvic Organ Prolapse/Urinary Incontinence Sexual Questionnaire (PISQ-12) for assessing sexual function in Chilean women with pelvic floor dysfunctions. Methods: Cross-sectional study of psychometrics in 217 women with pelvic floor dysfunction, age 18 or older, and sexually active (last 6 months). Non-probability, convenience sampling. Tool: PISQ-12. Experts checked content validity, construct validity with confirmatory factor analysis, reliability with Cronbach's alpha, and discriminating capacity with Pearson and McDonald's omega. Results: Population is mainly perimenopausal, highly educated with no income and with urinary incontinence (89.4%). Psychometric analysis supports a three-factor structure: sexual response, female sexual problems, and male sexual problems, with a good (α= 0.85), acceptable (α= 0.73), and poor (α= 0.63) reliability, respectively, but McDonald's omega was acceptable for all three. These were related to age (rs: -0.33), education (rs: 0.36), number of pregnancies (rs: -0.18) and vaginal births (rs: -0.25). Conclusions: PISQ-12 is valid and reliable for measuring sexual dimension and problems. Age, education, and number of pregnancies and vaginal births are moderately correlated to sexual response.
Resumen Introducción: Las disfunciones del piso pélvico impactan la función sexual de mujeres que la padecen. En un estudio chileno un 74% de las mujeres presentó disfunción sexual sin tener un instrumento validado para esta población. Objetivo: Evaluar las propiedades psicométricas del Pelvic Organ Prolapse Urinary Incontinence Sexual Questionnaire (PISQ-12) para medir la función sexual en mujeres chilenas con disfunciones del piso pélvico. Métodos: Estudio transversal psicométrico de 217 mujeres con disfunción del piso pélvico, igual /mayor a 18 años, sexualmente activas (últimos 6 meses). Muestreo no probabilístico de conveniencia. Cuestionario: PISQ-12. Se realizó juicio de expertos para validez de contenido, análisis factorial confirmatorio para validez de constructo y el α de Cronbach para confiabilidad y capacidad discriminativa con Pearson y ω de McDonald. Resultados: Población principalmente perimenopáusica, alta escolaridad sin ingresos y con Incontinencia Urinaria (89.4%). El análisis psicométrico apoyó una estructura de tres factores: respuesta sexual, limitaciones sexuales femeninas y limitaciones sexuales masculinas, con confiabilidad buena (α= 0.85) aceptable (α= 0.73) y pobre (α= 0.63), respectivamente, aunque el ω de McDonald mostró valores aceptables para los tres. Éstos se relacionaron con edad (rs: -0.33), escolaridad (0.36), número de embarazos (-0.18) y partos vaginales (-0.25). Conclusiones: El PISQ-12 es válido y confiable, midiendo la dimensión sexual y limitaciones sexuales. La edad, escolaridad, número de embarazos y partos vaginales se correlaciona con la respuesta sexual en intensidad moderada.
ABSTRACT
Abstract Objective To investigate the feasibility of pelvic floor muscle training (PFMT) through gametherapy for relieving urinary symptoms of climacteric women with stress ormixed urinary incontinence (UI). Methods Randomized clinical trial, divided into two groups: Gametherapy (G_Game) and Control (G_Control). Both groups received recommendations about unsupervised PFMT, and G_Game also received supervised PFMT through gametherapy. After 5 consecutive weeks, the feasibility was investigated considering participant adherence, urinary symptoms (evaluated by the International Consultation on Incontinence Questionnaire-Urinary Incontinence Short Form [ICIQ-UI-SF] questionnaire), and pelvic floor function (PERFECT Scheme: power, endurance, repetition and fast). The Fisher exact, Kruskal-Wallis, Wilcoxon sign paired, and Mann-Whitney U tests were used by intention-to-treat analysis, using STATA 15.1 (StataCorp, College Station, TX, USA) software. Results The present study included 20 women per group and observed a higher adherence in G_Game. In the intragroup analysis, a decrease in the ICIQ-UI-SF score was observed in both groups (14.0 to 10.0; 13.5 to 0), associated with increased endurance (2.5 to 3.5; 2.5 to 4.0) in G_Control and G_Game, respectively. Moreover, there was a concomitant increase in pelvic floor muscles (PFMs) power (2.0 to 3.0), repetition (3.0 to 5.0), and fast (10.0 to 10.0) in G_Game. In the intergroup analysis, a reduction of UI was observed (p<0.001; r=0.8), as well an increase in PFM power (p=0.027, r=0.2) and endurance (p=0.033; r=0.3) in G_Game. Conclusion The feasibility of supervised PFMT through gametherapy was identified by observing participant adherence, relief of urinary symptoms, and improvement in PFM function.
Resumo Objetivo Investigar a viabilidade do treinamento dos músculos do assoalho pélvico (TMAP) por meio de gameterapia no alívio de sintomas urinários em mulheres climatéricas com incontinência urinária (IU) de esforço ou mista. Métodos Ensaio clínico randomizado, dividido em dois grupos: Gameterapia (G_Game) e Controle (G_Controle). Ambos os grupos receberam recomendações sobre TMAP não supervisionado, e G_Gametambém recebeu TMAP supervisionado por meio de gameterapia. Após 5 semanas consecutivas, a viabilidade foi investigada considerando a aderência das participantes, sintomas urinários (avaliados pelo questionário International Consultation on Incontinence Questionnaire-Urinary Incontinence Short Form [ICIQ-UI-SF]) e função do assoalho pélvico (esquema PERFECT: power, endurance, repetition, fast). Os testes exatos de Fisher, Kruskal-Wallis, sinal de Wilcoxon pareado e Mann-Whitney U foram usados pela análise de intenção de tratar, usando o software STATA 15.1 (StataCorp, College Station, TX, EUA). Resultados O presente estudo incluiu 20 mulheres por grupo e observou uma maior adesão no G_Game. Na análise intragrupo, foi observada diminuição no escore do ICIQUI- SF emambos os grupos (de 14,0 para 10,0; de 13,5 para 0), associada ao aumento da resistência (de 2,5 para 3,5; de 2,5 para 4,0) em G_Control e G_Game, respectivamente. Além disso, houve um aumento concomitante no power (de 2,0 para 3,0), repetition (de 3,0 para 5,0) e fast (de 10,0 para 10,0) dosmúsculos do assoalho pélvico (MAPs) no G_Game. Na análise intergrupos, foi observada redução da IU (p<0,001; r=0,8), assim como do power (p=0,027; r=0,2) e da endurance (p=0,033; r=0,3) dos MAPs no G_Game. Conclusão A viabilidade do TMAP supervisionado por meio de gameterapia foi identificada pela observação da aderência das participantes, pelo alívio dos sintomas urinários e pela melhora da função dos MAPs.
Subject(s)
Humans , Female , Urinary Incontinence/therapy , Urinary Incontinence, Stress/therapy , Climacteric , Feasibility Studies , Treatment Outcome , Pelvic Floor , Exercise TherapyABSTRACT
INTRODUCCIÓN: La prevalencia de las disfunciones de piso pélvico (DPP) puede llegar hasta un 25%, y esta incrementando con los años. El objetivo de este estudio es mostrar las características clínicas de pacientes sintomáticas sometidas a cistometría simple en el Hospital La Florida, entre diciembre del 2015 y marzo 2020. MÉTODOS: Es un estudio retrospectivo transversal. Se evaluaron los datos de todos los resultados de cistometrías simples de pacientes derivadas por sintomatología de piso pélvico entre los años 2015 y 2020. RESULTADOS: Se evaluaron 1.211 cistometrías simples. El motivo de derivación más frecuente fue prolapso de órganos pélvicos + incontinencia de orina (IO) (39.6%). 13.5% tuvieron resultado normal. 58% presentó test de esfuerzo positivo. 22.5% tenían prueba de estrés con vejiga vacía positiva. 17.6% presentó IO oculta. 21.9% de IO mixta. De las pacientes derivadas por vejiga hiperactiva o IO mixta, en el 14.2% se constató la presencia de contracciones no inhibidas y en el 34.8% la presencia de urgencia. CONCLUSIONES: Nuestro estudio aporta información sobre las DPP en la mujer chilena en un hospital universitario.
INTRODUCTION: Prevalence of pelvic floor dysfunctions (PFD) can be as high as 25%, and it is increasing over the years. The objective if this study is to show the clinical characteristics of symptomatic patients undergoing simple cystometry at La Florida Hospital, between December 2015 and March 2020. METHODS: This is a cross-sectional study. The data of all simple cystometries of patients derived for pelvic floor symptoms between 2015 and 2020 were evaluated. RESULTS: 1211 simple cystometries were evaluated. The most frequent reason for referral was pelvic organ prolapse + urinary incontinence (UI) (39.6%). 13.% had a normal result. 58% presented positive stress test. 22.% had a positive empty stress test. 17.6% had occult UI. 21.9% mixed UI. Of the patients referred by overactive bladder or mixed UI, 12.2% had detrusor contractions and 34.8% had urgency. CONCLUSIONS: Our study provides information on PFD in Chilean women in a university hospital. .
Subject(s)
Humans , Female , Middle Aged , Aged , Pelvic Floor Disorders/diagnosis , Urinary Incontinence/diagnosis , Chile , Retrospective Studies , Diagnostic Techniques, Urological , Urinary Bladder, Overactive/diagnosis , Pelvic Organ Prolapse/diagnosisABSTRACT
OBJETIVO: Presentar nuestra experiencia en la corrección de las disfunciones del suelo pélvico con bandas de polipropileno monofilamento libres de tensión transvaginal colocadas por delante del agujero obturador. MÉTODOS: Entre enero de 2004 y diciembre de 2009 se realizó corrección de disfunciones del suelo pelviano en un total de 63 pacientes atendidos en el servicio de Cirugía General del Hospital General Docente Dr. Carlos J. Finlay. En todos los casos las bandas de polipropileno fueron colocadas a través del agujero obturador (TVT-O), previa evaluación clínico funcional del piso pélvico. RESULTADOS: Las pacientes más afectadas se encontraban entre los 60 y 69 años. El cistocele resultó ser la disfunción del suelo pélvico más frecuente. Previamente 21 pacientes habían sido intervenidas. La complicación más frecuente resultó ser la sepsis urinaria en 4 pacientes. Se obtuvo curación de las disfunciones tratadas en el 100 por ciento de las pacientes. No se han presentado recurrencias hasta la fecha actual. CONCLUSIONES: La utilización de mallas protésicas, de polipropileno monofilamento en la corrección integral de las disfunciones del suelo pélvico, con bandas de polipropileno por técnica libre de tensión, resultó ser un procedimiento seguro y eficaz
OBJECTIVE: To present our experience in the pelvic floor dysfunctions with the use of transvaginal tension-free mono-filament polypropylene bands placed in front of the obturator hole. METHODS: Between January, 2004 and December, 2009 a correction of pelvic floor dysfunctions in a total of 63 patients seen in the General Surgery Service of the Dr. Carlos J. Finlay Teaching General Hospital. In all the cases the polypropylene bands were placed through the obturator hole (TVT-O) previous clinical functional assessment of the pelvic floor. RESULTS: The patients more involved were aged between 60 and 69. Previously, 21 patients were operated on. The more frequent complication was the urinary sepsis in 4 patients. All dysfunctions treated in the 100 percent of patients were cured. There were not recurrences up to nowadays. CONCLUSIONS: Use of monofilament prosthetic polypropylene networks in integral correction of pelvic floor dysfunctions with polypropylene bands by free-tension technique was a safe and effective procedure