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1.
Femina ; 49(5): 300-308, 20210531. ilus, tab
Article in Portuguese | LILACS | ID: biblio-1290567

ABSTRACT

Objetivo: Avaliar a prevalência dos tipos de incontinência urinária em mulheres após parto vaginal e cesárea, e identificar os fatores de risco associados à presen- ça e à gravidade da incontinência urinária nessa população. Métodos: Estudo de corte transversal com 120 mulheres, 12 a 18 meses após o parto, entrevistadas por telefone com questionários validados sobre sintomas urinários e vaginais. Para análise estatística, utilizamos qui-quadrado, teste de Mann-Whitney e Kruskal- -Wallis, e regressão uni e multivariada. Resultados: Das 120 mulheres incluídas no estudo, 68 (56,7%) tiveram parto vaginal, 23 (19,2%), cesárea eletiva e 29 (24,1%), cesárea após trabalho de parto. A prevalência de incontinência urinária foi de 52,5% e a de incontinência urinária de esforço, de 40%, sem diferença com relação ao parto (p = 0,945 e 0,770). A maioria apresentava incontinência urinária leve (80%), e não houve diferença nas médias dos questionários de incontinência urinária e sintomas vaginais e sexuais e qualidade de vida entre os tipos de parto (p = 0,691, 0,750, 0,262 e 0,779). A prevalência de incontinência urinária esteve associada com idade ≥ 30 anos (p = 0,046) e incontinência urinária durante a gestação (p < 0,001). Com relação à incontinência urinária de esforço, os fatores associados foram incontinência urinária durante a gestação (p < 0,001) e partos vaginais (p = 0,038). Conclusão: Incontinência urinária e incontinência urinária de esforço são muito prevalentes após 12-18 meses do parto, porém sem diferenças com relação à via de parto. Perda urinária durante a gestação e idade maior que 30 anos são fatores de risco para incontinência urinária e incontinência urinária de esforço. A gravidade da perda urinária está associada também a perda durante a gestação e maiores índices de massa corporal.(AU)


Objective: To evaluate the prevalence of types of urinary incontinence in women after vaginal delivery and cesarean section; and to identify the risk factors associated with the presence and severity of UI in this population. Methods: Cross-sectional study with 120 women, 12 to 18 months after delivery, telephone interviews with validated questionnaires on urinary and vaginal symptoms. For statistical analysis, we used chi-square, Mann-Whitney and Kruskal-Wallis test, uni and multivariate regression. Results: Of the 120 women included in the study, 68 (56.7%) had vaginal delivery, 23 (19.2%) cesarean section and 29 (24.1%) cesarean sections after labor. The prevalence of UI was 52.5% and SUI 40%, with no difference in relation to delivery (p = 0.945 and 0.770). The majority had mild UI (80%) and there was no difference in the mean questionnaires of urinary incontinence and vaginal, sexual and quality of life symptoms among the types of delivery (p = 0.691, 0.750, 0.262 and 0.779). The prevalence of UI was associated with age ≥ 30 years (p = 0.046) and UI during pregnancy (p < 0.001). Regarding SUI, the associated factors were UI during pregnancy (p < 0.001) and vaginal deliveries (p = 0.038). Conclusion: UI and SUI are very prevalent after 12-18 months of delivery, but no differences regarding the route of delivery. Urinary loss during pregnancy and age over 30 years are risk factors for UI and SUI. The severity of urinary loss is also associated with loss during pregnancy and higher BMI.(AU)


Subject(s)
Humans , Female , Pregnancy , Urinary Incontinence/etiology , Urinary Incontinence/epidemiology , Urinary Incontinence, Stress/etiology , Urinary Incontinence, Stress/epidemiology , Postpartum Period/physiology , Brazil/epidemiology , Cross-Sectional Studies , Risk Factors
2.
Arq. bras. med. vet. zootec. (Online) ; 73(2): 327-334, Mar.-Apr. 2021. tab, graf
Article in English | LILACS, VETINDEX | ID: biblio-1248930

ABSTRACT

Ovariohysterectomy (OHE) is the most performed elective surgery in veterinary medicine. Although this procedure brings benefits both to the animal and public health, acquired urinary incontinence is a possible complication resultant from it. The aim of this study was to determine the prevalence of urinary incontinence and evaluate size, breed, and time of surgery as risk factors in a population of spayed female dogs in the Hospital de Clínicas Veterinárias da Universidade Federal do Rio Grande do Sul, in the year of 2013, through the use of a multiple-choice screening instrument. Identified estimated prevalence was 11.27% and main risk factors were as follows: large size (OR = 7.12 IC95% = 1.42 - 35.67), Rottweiler breed (OR = 8.92; IC95% = 5.25 - 15.15), Pit-bull breed (OR = 4.14; IC95% = 2.19 - 7.83), and Labrador breed (OR = 2.73; IC95% = 1.53 - 4.87). Time of surgery was not considered a risk factor for urinary incontinence in this population (OR = 1.45; IC95% = 0.86 - 2.40). Even though most owners reported a small impact on their relationship with the animal, urinary incontinence hazard should be addressed before spaying.(AU)


A ovário-histerectomia (OHE) é a cirurgia eletiva mais realizada em medicina veterinária. Embora seja um procedimento que beneficie a saúde pública e do animal, a incontinência urinária adquirida é uma complicação possível resultante desse procedimento. O objetivo deste estudo foi determinar a prevalência de incontinência urinária e avaliar porte, raça e momento da castração como fatores de risco em uma população de cadelas castradas no HCV/UFRGS, no ano de 2013, através do uso de um instrumento de triagem de múltipla escolha. A prevalência estimada foi de 11,27% e os principais fatores de risco foram: grande porte (OR = 7,12 IC95% = 1,42 - 35,67), raça Rottweiler (OR = 8,92; IC95% = 5,25 - 15,15), raça Pitbull (OR = 4,14; IC95% = 2,19 - 7,83) e raça Labrador (OR = 2,73; IC95% = 1,53 - 4,87). O tempo da cirurgia não foi considerado fator de risco para incontinência urinária nessa população (OR = 1,45; IC95% = 0,86 - 2,40). Embora a maioria dos proprietários tenha relatado um pequeno impacto no relacionamento com o animal, a possibilidade de incontinência urinária deve ser devidamente discutida antes da castração.(AU)


Subject(s)
Animals , Female , Dogs , Urethra/pathology , Urinary Incontinence/etiology , Urinary Incontinence/veterinary , Ovariectomy/veterinary , Castration/veterinary , Hysterectomy/veterinary
4.
Rev. Assoc. Med. Bras. (1992) ; 67(2): 260-264, Feb. 2021. graf
Article in English | LILACS | ID: biblio-1287812

ABSTRACT

SUMMARY OBJECTIVE: Metabolic changes caused by anxiety can interfere in both the surgery itself and the recovery process. One way to reassure the patient is to clarify how the procedure will be performed and discuss the possible complications. This study aimed to investigate the anxiety level of candidates for radical prostatectomy at a university hospital. METHODS: Thirty-four patients with a diagnosis of prostate cancer were studied prospectively. Data collection involved the administration of the Hospital Anxiety and Depression Scale and a radical prostatectomy knowledge test. RESULTS: The results showed that 94.1% of the patients reported having received clarifications from the physician or healthcare team regarding the surgery and 23.5% reported having received information on the probability of a medical error during surgery. The most cited postoperative complications were sexual impotence and urinary incontinence. A significant association was found between the total Hospital Anxiety and Depression Scale score and the complications cited (p=0.0004); patients who marked a larger number of possible complications had a higher Hospital Anxiety and Depression Scale score. CONCLUSION: The present study demonstrates that the explanations given by the multidisciplinary health team are not achieving their maximum potential in terms of lowering patient anxiety.


Subject(s)
Humans , Male , Prostatic Neoplasms/surgery , Urinary Incontinence/etiology , Anxiety/etiology , Postoperative Complications/etiology , Prostate , Prostatectomy/adverse effects , Hospitals
5.
Rev. Assoc. Med. Bras. (1992) ; 66(12): 1742-1749, Dec. 2020. tab, graf
Article in English | SES-SP, LILACS, SES-SP | ID: biblio-1143672

ABSTRACT

SUMMARY There is no pooled information about pelvic floor parameters (muscle assessment, disorders) of women with gynecologicaL endocrinopathies (eg. polycystic ovary syndrome, congenital adrenal hyperplasia, premature ovarian insufficiency). Given that, a systematic review was performed on the Pubmed, Scopus, Google Scholar, Scielo and PEDro databases regarding the main gynecological endocrinopathies [polycystic ovary syndrome (PCOS), premature ovarian insufficiency (POI), congenital adrenal hyperplasia (CAH) and hyperprolactinemia (HPL)] since their inception to April 2020. Data quality assessment was made by the Newcastle-Ottawa Scale (NOS) adapted for cross-sectional studies. A total of 4,272 results were retrieved from all databases. After excluding duplicate results and screening by title and abstract, nine studies were selected for quantitative analysis. Seven studies were performed with women with PCOS and two studies with POI. Women with PCOS presented a higher prevalence of urinary incontinence (UI) among obese women, a higher thickness of the levator ani muscle, and higher levels of muscle activity measured by surface electromyograph when compared to the control women. Regarding POI, there was no association with UI, FI, and POP. NOS found that the quality assessment for these selected studies ranged from 5 to 8. We concluded that higher pelvic muscle activity and volume were found in women with PCOS, with further studies needed to confirm this data. Literature was scant about POI, CAH, and HPL.


RESUMO Existe informação não organizada sobre a avaliação do assoalho pélvico de mulheres com endocrinopatias ginecológicas (ex. síndrome dos ovários policísticos - SOP, hiperplasia adrenal congênita - HAC, insuficiência ovariana prematura - IOP). Dessa forma, objetivamos realizar uma revisão sistemática foi realizada nas bases Pubmed, Scopus, Google Scholar, Scielo e PEDro sobre as endocrinopatias ginecológicas (SOP, HAC, IOP e hiperprolactinemia (HPL) desde a origem a abril de 2020. A avaliação da qualidade de dados foi real-izada pela escala de Newcastle-Ottawa Scale (NOS) adaptada para estudos transversais. De 4,272 resultados encontrados em todas as databases, após exclusão por duplicatas, triando por título e resumos, nove estudos foram selecionados para análise quantitativa. Sete estudos foram realizados para mulheres com SOP e dois estudos com IOP. Em suma, mulheres com SOP apresentados uma alta prevalência de incontinência urinária (IU) em mulheres obesas, alta espessura do músculo elevador do ânus, altos níveis de atividade muscular aferida por eletromiografia de superfície quando comparadas com mulheres do grupo controle. Sobre a IOP, esta não foi associada com IU, IF e POP. A escala NOS evidenciou que a qualidade dos estudos selecionados variou de 5 a 8. Concluímos que uma alta atividade e volume muscular foi encontrada em mulheres com SOP, com estudos posteriores sendo necessários para confirmar estes achados. Literatura foi escassa para IOP, HAC e HPL.


Subject(s)
Humans , Female , Polycystic Ovary Syndrome/complications , Urinary Incontinence/etiology , Urinary Incontinence/epidemiology , Prevalence , Cross-Sectional Studies , Pelvic Floor
6.
Rev. bras. ginecol. obstet ; 42(12): 787-792, Dec. 2020. tab
Article in English | LILACS | ID: biblio-1156061

ABSTRACT

Abstract Objective Urinay incontinence (UI) is amajor public health problemthat can harm women in any period of life, including during the gestational period. Urinary incontinence during pregnancy has been studied because this condition can reduce the quality of life and interfere in several aspects of the maternal-fetal binomial. The aim of this study was to determine the prevalence of UI in nullipara pregnant women and to identify risk factors associated with UI in this population. Methods This is a case-control study in which we invited nullipara women between 12 and 20 weeks of pregnancy to participate in the research. They were asked to answer a specific questionnaire, write a 3-day bladder diary, and undergo a urogynecological evaluation including pelvic organ prolapse quantification (POP-Q), empty stress supine test (ESST), and pelvic floor muscle assessment. Results A total of 70 out of 73 patients accepted to participate in the study, and the prevalence of UI in this population was 18.3%. Tobacco use was identified as an independent risk factor for UI in pregnant women (odds ratio 8.0). All other factors analyzed were not significantly associated to UI in pregnancy. Conclusion Urinary incontinence can be a major problem in pregnancy.We identified the use of tobacco as a risk factor for developing UI in pregnancy, which provides an extra reason to encourage patients to quit smoking.


Resumo Objetivo A incontinência urinária (IU) é um importante problema de saúde pública que pode trazer prejuízos àsmulheres emqualquer período da vida, inclusive durante o período gestacional. A IU durante a gravidez temsido estudada por ser capaz de reduzir a qualidade de vida e interferir em vários aspectos do binômio materno-fetal. O objetivo deste estudo foi determinar a prevalência de IU em gestantes nulíparas e identificar fatores de risco associados a essa população. Métodos Este é um estudo de caso-controle em que foram convidadas mulheres nulíparas entre 12 e 20 semanas de gravidez para participar do projeto. Elas foram submetidas a um questionário específico, diário miccional de 3 dias e avaliação uroginecológica, incluindo quantificação de prolapso de órgãos pélvicos (POP-Q), teste de esforço com volume residual e avaliação da musculatura do assoalho pélvico. Resultados Um total de 70 das 73 pacientes aceitaram participar do estudo, e a prevalência de incontinência urinária nessa população foi de 18,3%. O uso de tabaco foi identificado como fator de risco independente para a IU em gestantes (OR 8,0). Todos os outros fatores analisados não foram significativamente associados à perda urinária nessa população. Conclusão A incontinência urinária pode trazer prejuízos para pacientes durante o período da gestação. O tabagismo foi identificado como fator de risco para o desenvolvimento de IU emgestantes, o que denotamais ummotivo para encorajar as pacientes a abandonarem o hábito.


Subject(s)
Humans , Female , Pregnancy , Adult , Young Adult , Pregnancy Complications/etiology , Prenatal Care , Urinary Incontinence/etiology , Parity , Brazil , Case-Control Studies , Surveys and Questionnaires , Risk Factors
7.
Rev. bras. anestesiol ; 70(6): 678-681, Nov.-Dec. 2020. tab
Article in English, Portuguese | LILACS | ID: biblio-1155781

ABSTRACT

Abstract Background: Opioid-free anesthesia decreases the incidence of opioid adverse events, but its optimal antinociceptive depth has not been clearly defined. Personalizing intraoperative opioid-free infusions with a nociception monitor may be the solution. Case report: We describe the feasibility and potential limitations of titrating opioid-free antinociception during major abdominal surgery using the Analgesia Nociception Index (Mdoloris, Lille, France) in an obese patient. After stabilizing the patient's nociception-antinociception balance intraoperatively we quickly reversed anesthesia and the patient did not require postoperative opioids. Conclusion: Personalizing opioid-free antinociception with a nociception monitor is feasible. It may optimize intraoperative antinociception and improve postoperative comfort.


Resumo Introdução A anestesia sem opioides diminui a incidência de eventos adversos associados aos opioides, mas a profundidade antinociceptiva ideal dessa abordagem não está claramente definida. Personalizar a infusão intraoperatória sem opioides com o uso de monitor de nocicepção pode ser a solução. Relato de caso Descrevemos a viabilidade e as eventuais limitações da titulação da antinocicepção sem opioides por meio do uso do Índice de Analgesia/Nocicepção (Mdoloris, Lille, França) durante cirurgia abdominal de grande porte em paciente com obesidade. Depois de estabilizar o equilíbrio nocicepção-antinocicepção da paciente no intraoperatório, revertemos rapidamente a anestesia e a paciente não precisou de opioides no pós-operatório. Conclusão A personalização da antinocicepção sem opioides por meio do emprego de monitor de nocicepção é factível. A abordagem pode otimizar a antinocicepção intraoperatória e melhorar o conforto pós-operatório.


Subject(s)
Humans , Female , Urinary Incontinence/surgery , Vesicovaginal Fistula/surgery , Precision Medicine/methods , Nociception , Anesthesia, Inhalation , Anesthesia, Intravenous , Urinary Incontinence/etiology , Obesity, Morbid/complications , Vesicovaginal Fistula/complications , Electroencephalography , Analgesia/instrumentation , Analgesia/methods , Analgesics, Opioid/adverse effects , Middle Aged
8.
Rev. chil. obstet. ginecol. (En línea) ; 85(3): 201-207, jun. 2020.
Article in Spanish | LILACS | ID: biblio-1126154

ABSTRACT

RESUMEN El parto vaginal se asocia con un riesgo más alto de daño perineal, incontinencia urinaria y fecal comparado con el parto cesárea. Dicho riesgo aumenta con el parto instrumental (ej. fórceps) y disminuye cuando la posición al momento del parto reduce la compresión sobre el sacro o si el parto ocurre bajo el agua. En otros factores que aumentan el riesgo de incontinencia se incluyen: la gran multiparidad, la duración del trabajo de parto, el peso fetal y tamaño de su cabeza, la edad muy joven al momento del primer parto, la inducción del trabajo de parto, la obesidad, la diabetes, la constipación, el tabaquismo y la historia de incontinencia urinaria o fecal. Factores sociales que se asocian a incontinencia incluyen la falta de educación, malas condiciones de hábitat, trabajo manual intenso, la falta de actividad física y el divorcio.


ABSTRACT Vaginal delivery is associated with a higher risk of perineal injury, and urinary and fecal incontinence as compared with caesarean delivery; The risk is higher in case of operative vaginal delivery and lower if the position at delivery takes the weight off the sacrum or is carried out under water immersion; A number of other factors increase the risk of incontinence, including higher parity, duration of labour, fetal weight or size of fetal head, younger age at first delivery, induction of labour, obesity, diabetes, constipation, smoking and history of urinary or fecal incontinence. Social factors such as lack of education, poor living environment, intense manual labour, the absence of physical exercise and divorce, are also associated with incontinence.


Subject(s)
Humans , Female , Pregnancy , Perineum/injuries , Urinary Incontinence/etiology , Cesarean Section/adverse effects , Delivery, Obstetric/adverse effects , Fecal Incontinence/etiology
9.
Fisioter. Pesqui. (Online) ; 27(1): 28-33, jan.-mar. 2020. tab
Article in Portuguese | LILACS | ID: biblio-1090415

ABSTRACT

RESUMO O objetivo deste artigo é avaliar o índice de função sexual de mulheres submetidas à histerectomia total com ooforectomia bilateral (HT-OB), a prevalência de incontinência urinária por esforço (IUE) e sua associação com a realização desse procedimento cirúrgico em um hospital de referência em Belém (PA). Foram incluídas 162 mulheres, com vida sexual ativa, alocadas em dois grupos: aquelas que realizaram HT-OB em período superior a 12 meses (n=68), e aquelas que não realizaram (n=94). Utilizou-se o questionário female sexual function index (FSFI) para avaliação da função sexual, e um questionário desenvolvido pelos pesquisadores para coletar dados sociais, econômicos e clínicos, incluindo informações quanto à presença de IUE. O valor de significância foi definido como p<0,05. Houve diferença significativa no índice de função sexual entre o grupo HT-OB e o grupo-controle, com escore geral do FSFI de 23,56 e 28,68, respectivamente (p=0,0001). Os domínios desejo, excitação, lubrificação (p<0,0001), orgasmo (p=0,04), satisfação (p=0,0006) e dor (p=0,015) apresentaram escores inferiores em mulheres histerectomizadas. A prevalência de sintomas de IUE no grupo HT-OB foi de 35,3%, sendo observada associação significativa entre a presença desses sintomas e a realização da histerectomia (p=0,02). Mulheres que realizam HT-OB têm maior risco de disfunção sexual, e este procedimento cirúrgico é associado ao desenvolvimento de IUE.


RESUMEN El presente artículo tuvo el objetivo de evaluar el índice de función sexual de mujeres sometidas a histerectomía total con ooforectomía bilateral (HT-OB), la prevalencia de incontinencia urinaria de esfuerzo (IUE) y su asociación con la realización de este procedimiento quirúrgico en un hospital de referencia en Belém (Brasil). Se incluyeron a 162 mujeres con vida sexual activa, que fueron divididas en dos grupos: las que se sometieron a HT-OB durante el período superior a 12 meses (n=68) y las que no lo había hecho (n=94). Se les aplicaron el cuestionario female sexual function index (FSFI), para evaluar la función sexual, y un cuestionario desarrollado por investigadores para recopilar datos sociales, económicos y clínicos, con informaciones en cuanto a la presencia de IUE. El valor de significación fue de p<0,05. Hubo una diferencia significativa en el índice de función sexual entre el grupo HT-OB y el grupo control, con un puntaje general de FSFI de 23,56 y 28,68, respectivamente (p=0,0001). Los dominios deseo, excitación, lubricación (p<0,0001), orgasmo (p=0,04), satisfacción (p=0,0006) y dolor (p=0,015) tuvieron puntajes más bajos en mujeres histerectomizadas. La prevalencia de síntomas de IUE fue del 35,3% en el grupo HT-OB, además se observó una asociación significativa entre la presencia de estos síntomas y la realización de la histerectomía (p=0,02). Las mujeres que se someten a HT-OB tienen un mayor riesgo de disfunción sexual, y este procedimiento quirúrgico está asociado al desarrollo de IUE.


ABSTRACT The objective of this article was to evaluate the sexual function index of women submitted to total hysterectomy with bilateral oophorectomy (THBO), the prevalence of urinary incontinence (SUI) and its association with the performance of this surgical procedure in a reference hospital in Belém, Pará. One hundred sixty-two women with active sexual life were included in two groups: those who have undergone THBO for more than 12 months (n=68), and those who have not (n=94). The Female Sexual Function Index (FSFI) questionnaire was used to evaluate sexual function along with a questionnaire developed by the researchers to collect social, economic and clinical data, including information on the presence of SUI. The significance level was defined as p<0.05. There was a significant difference in the sexual function index between THBO group and the control group, with an FSFI overall score of 23.56 and 28.68, respectively (p=0.0001). Desire, arousal, lubrication (p<0.0001), orgasm (p=0.04), satisfaction (p=0.0006) and pain (p=0.015) domains had lower scores in hysterectomized women. The prevalence of SUI symptoms in THBO group was 35.3%, and a significant association was observed between the presence of SUI and hysterectomy (p=0.02). Women who undergo THBO have a higher risk of sexual dysfunction, and this surgical procedure is associated with the development of SUI.


Subject(s)
Humans , Female , Adult , Middle Aged , Sexual Dysfunction, Physiological/etiology , Urinary Incontinence/etiology , Hysterectomy/adverse effects , Hysterectomy/methods , Postoperative Complications , Quality of Life , Urinary Incontinence/epidemiology , Prevalence , Surveys and Questionnaires , Sexuality , Evaluation Study
10.
Rev. Col. Bras. Cir ; 47: e20202605, 2020. tab
Article in English | LILACS | ID: biblio-1136559

ABSTRACT

ABSTRACT Introduction: despite being infrequent, urinary incontinence has a huge impact on the quality of life of patients undergoing radical prostatectomy, even with the robotic-assisted technique. Objective: to assess the evolution of urinary symptoms from preoperative to 12 months after robotic-assisted radical prostatectomy. Methods: data was collected from 998 patients who underwent robotic-assisted radical prostatectomy. Demographic data, preoperative and postoperative information on patients were documented. The ICIQ and IPSS questionnaires were also applied preoperatively and after 1, 3, 6 and 12 months after the operation. Results: Out of 998 patients, 257 correctly completed all questionnaires. The mean age of the patients was 60 ± 0.74 years. We found that the total IPSS increased initially and at 6 months after the operation, it was already lower than the initial preoperative value (7.76 at 6 months vs. 9.90 preoperative, p <0.001), being that questions regarding voiding symptoms were the first to improve followed by the questions regarding post micturition and storage symptoms. As for the ICIQ variables, there was an increase with radical prostatectomy and none of them returned to the preoperative level (p<0.001). Conclusions: robotic assisted radical prostatectomy causes, at first, a worsening of urinary symptoms in the lower tract with subsequent recovery. Recovery begins with voiding symptoms, followed by post micturition and storage symptoms. The symptoms assessed by the IPSS evolve to better parameters even than those of the preoperative period, while the symptoms of incontinence assessed by the ICIQ do not reach the preoperative levels in the studied interval.


RESUMO Introdução: apesar de infrequente, a incontinência urinária gera imenso impacto na qualidade de vida dos pacientes submetidos a prostatectomia radical, mesmo com a técnica robótica-assistida. Objetivo: avaliar a evolução dos sintomas urinários desde o pré-operatório até 12 meses após a prostatectomia radical robótica-assistida. Métodos: foram coletados os dados de 998 pacientes submetidos à prostatectomia radical robótica-assistida. Foram documentados dados demográficos, informações pré-operatórias e pós-operatórias dos pacientes. Também foram aplicados os questionários ICIQ e IPSS no pré-operatório e após 1, 3, 6 e 12 meses de pós-operatório. Resultados: de 998 pacientes, 257 preencheram corretamente todos os questionários. A idade média dos pacientes foi de 60±0,74 anos. Verificou-se que o IPSS total subia inicialmente e aos 6 meses após a operação, este já se tornava inferior ao valor inicial pré-operatório (7,76 aos 6 meses vs. 9,90 pré-operatório, p<0.001), sendo que as questões referentes a sintomas de esvaziamento foram as primeiras a melhorar e posteriormente as questões referentes a sintomas pós-miccionais e de armazenamento. Quanto às variáveis do ICIQ, houve elevação com a prostatectomia radical e nenhuma delas retornou ao patamar pré-operatório (p<0,001). Conclusões: a prostatectomia radical robótica assistida causa num primeiro momento uma piora nos sintomas urinários do trato inferior com uma recuperação subsequente. A recuperação se inicia pelos sintomas de esvaziamento, seguido dos sintomas pós-miccionais e de armazenamento. Os sintomas avaliados pelo IPSS acabam evoluindo a parâmetros melhores inclusive que os do pré-operatório, enquanto os sintomas de perda urinária avaliados pelo ICIQ não atingem os níveis pré-operatórios no intervalo estudado.


Subject(s)
Humans , Male , Aged , Prostatectomy/adverse effects , Prostatic Neoplasms/surgery , Quality of Life , Urinary Incontinence/etiology , Urination Disorders/etiology , Lower Urinary Tract Symptoms/complications , Robotic Surgical Procedures/adverse effects , Prostatectomy/methods , Urination , Treatment Outcome , Middle Aged
11.
Rev. Bras. Saúde Mater. Infant. (Online) ; 19(4): 967-974, Sept.-Dec. 2019. tab
Article in English | LILACS | ID: biblio-1057113

ABSTRACT

Abstract Objectives: to determine the prevalence of urinary incontinence (UI) during pregnancy, to identify and quantify the factors associated with gestational UI. Methods: a cross-sectional study carried out with women admitted for deliveries in all maternity wards in the city of Botucatu (São Paulo). Data were collected through a structured questionnaire, based on the literature, containing questions about the occurrence of UI, its types, risk factors and moments when urinary losses occurred. Associations between UI and the predictive variables were analyzed with logistic regression models. Results: 950 women were interviewed, out of which 472 complained of urinary losses during pregnancy, resulting in a prevalence of 49.68% (CI95%= 46.51 - 52.86). The majority (61.8%) were classified as mixed UI. Among the covariates investigated, smoking (OR= 4.56), illicit drugs use (OR= 25.14), stimulant foods (OR= 1.84), constipation (OR=1.99), hypertensive disorders during gestation (OR= 3.23), gestational diabetes mellitus (OR= 2.89), parity (OR= 1.52) and previous caesarean sections (OR= 2.56) increased the chance of urinary losses during pregnancy. Conclusions: there was a high prevalence of UI during pregnancy. This condition was strongly associated with lifestyle habits and gestational morbidities. Finally, it is worth high-lighting the fact that delivery via caesarean section increased the chance of UI in subsequent pregnancies.


Resumo Objetivos: estimar a prevalência de incontinência urinária (IU) na gestação, identificar e quantificar fatores associados à IU gestacional. Métodos: estudo transversal realizado com mulheres admitidas para o parto nas maternidades da cidade de Botucatu (São Paulo). Foi utilizado um questionário estruturado, baseado na literatura, contendo perguntas sobre a ocorrência de IU, seus tipos, fatores de riscos e momentos que ocorreram as perdas urinárias. Associações entre a ocorrência de IU e as variáveis preditoras foram analisadas por meio de modelos de regressão logística. Resultados: 950 mulheres foram entrevistadas, dessas 472 queixaram-se de perdas urinárias no período gestacional, resultando em uma prevalência de 49,68% (IC95%= 46,51 - 52,86), sendo a maioria (61,8%) classificada como IU mista. Entre as covariáveis investigadas, tabagismo (OR= 4,56), consumo drogas ilícitas (OR= 25,14), alimentos estimulantes (OR=1,84), constipação intestinal (OR= 1,99), distúrbios hipertensivos na gestação (OR=3,23), diabetes mellitus gestacional (OR= 2,89), paridade (OR=1,52) e parto cesárea (OR= 2,56) aumentaram a chance de perdas urinárias na gestação. Conclusões: houve uma alta prevalência de IU no período gestacional. Esta condição esteve fortemente associada à fatores como hábitos de vida e morbidades gestacionais. Por fim, merece destaque o achado que o parto via cesárea aumentou a chance de IU em gestação subsequente.


Subject(s)
Humans , Female , Pregnancy , Pregnancy Complications , Urinary Incontinence/etiology , Urinary Incontinence/epidemiology , Pregnancy/urine , Pregnancy/statistics & numerical data , Brazil , Cross-Sectional Studies , Risk Factors
12.
Int. braz. j. urol ; 45(6): 1196-1203, Nov.-Dec. 2019. tab, graf
Article in English | LILACS | ID: biblio-1056345

ABSTRACT

ABSTRACT Aims: Radical prostatectomy (RP) can result in urinary incontinence (UI) and erectile dysfunction (ED), which negatively impact quality of life (QoL). This study aimed to evaluate the effects of a perioperative pelvic floor muscle training (PFMT) program versus usual care on early recovery of urinary continence and erectile function after RP. Materials and Methods: Of 59 eligible men, 31 were randomly allocated into 2 groups: Group 1 (Control, N=15) received usual post-RP care; and Group 2 (Physical therapy, N=16) received two pre-RP physical therapist-guided PFMT sessions, including exercises and electromyographic biofeedback, and verbal and written instructions to continue PFMT until RP, which was then resumed after urethral catheter removal. The International Consultation on Incontinence Questionnaire - Short Form (ICIQ-SF) and the 5-item version of the International Index of Erectile Function (IIEF-5) questionnaire were used to evaluate UI and ED, respectively. Results: Demographic characteristics were similar in both groups. Three months after RP, the UI rate was 72.7% and 70.0% in Groups 1 and 2, respectively (P >0.05). The severity and frequency of UI and its impact on QoL were evaluated by the ICIQ-Short Form, with scores of 6.9±6.26 in Group 1 and 7.0±5.12 in Group 2 (P >0.05). The IIEF-5 scores were similar in Groups 1 and 2 (5.73±7.43 vs. 6.70±6.68, respectively) (P >0.05). Conclusion: Our pre-RP protocol of two physical therapist-assisted sessions of PFMT plus instructions did not significantly improve urinary continence or erectile function at 3 months after RP.


Subject(s)
Humans , Male , Aged , Prostatectomy/rehabilitation , Urinary Incontinence/rehabilitation , Pelvic Floor/physiopathology , Perioperative Care/methods , Muscle Stretching Exercises/methods , Erectile Dysfunction/rehabilitation , Prostatectomy/adverse effects , Prostatectomy/methods , Prostatic Neoplasms/surgery , Prostatic Neoplasms/pathology , Quality of Life , Urinary Incontinence/etiology , Urinary Incontinence/physiopathology , Adenocarcinoma/surgery , Adenocarcinoma/pathology , Prospective Studies , Surveys and Questionnaires , Treatment Outcome , Neurofeedback , Neoplasm Grading , Erectile Dysfunction/etiology , Erectile Dysfunction/physiopathology , Middle Aged , Muscle Contraction/physiology , Neoplasm Staging
13.
Int. braz. j. urol ; 45(2): 253-261, Mar.-Apr. 2019. tab, graf
Article in English | LILACS | ID: biblio-1002195

ABSTRACT

ABSTRACT Purpose: To evaluate safety, efficacy and functional outcomes after open vesicourethral re - anastomosis using different approaches based on previous urinary continence. Materials and Methods: Retrospective study of patients treated from 2002 to 2017 due to vesicourethral anastomosis stricture (VUAS) post radical prostatectomy (RP) who failed endoscopic treatment with at least 3 months of follow-up. Continent and incontinent patients post RP were assigned to abdominal (AA) or perineal approach (PA), respectively. Demographic and perioperative variables were registered. Follow-up was completed with clinical interview, uroflowmetry and cystoscopy every 4 months. Success was defined as asymptomatic patients with urethral lumen that allows a 14 French flexible cystoscope. Results: Twenty patients underwent open re-anastomosis for VUAS after RP between 2002 and 2017. Mean age was 63.7 years (standard deviation 1.4) and median follow-up was 10 months (range 3 - 112). The approach distribution was PA 10 patients (50%) and AA 10 patients (50%). The mean surgery time and median hospital time were 246.2 ± 35.8 minutes and 4 days (range 2 - 10), respectively with no differences between approaches. No significant complication rate was found. Three patients in the AA group had gait disorder with favorable evolution and no sequels. Estimated 2 years primary success rate was 80%. After primary procedures 89.9% remained stenosis - free. All PA patients remained incontinent, and 90% AA remained continent during follow-up. Conclusion: Open vesicourethral re - anastomosis treatment is a reasonable treatment option for recurrent VUAS after RP. All patients with perineal approach remained incontinent while incontinence rate in abdominal approach was rather low.


Subject(s)
Humans , Male , Prostatectomy/methods , Urethra/surgery , Urethral Stricture/etiology , Urinary Bladder/surgery , Postoperative Complications/etiology , Prostatectomy/adverse effects , Urethral Stricture/surgery , Urinary Incontinence/etiology , Urinary Bladder Neck Obstruction/surgery , Anastomosis, Surgical , Retrospective Studies , Follow-Up Studies , Treatment Outcome , Erectile Dysfunction/etiology , Middle Aged
14.
Einstein (Säo Paulo) ; 17(4): eRW4508, 2019. tab, graf
Article in English | LILACS | ID: biblio-1039724

ABSTRACT

ABSTRACT Urinary incontinence after prostatectomy has a significant negative impact on the quality of life of the patient. The surgical treatment includes several models of male slings, such as adjustable slings. The objective of this study was to evaluate the effectiveness and safety of adjustable sling in the treatment of post-prostatectomy urinary incontinence. This is a systematic review of literature. The following electronic databases were searched until January 2018: PubMed®, Embase, CENTRAL and LILACS. The keywords used in the search strategies were: "prostatectomy" [Mesh], "urinary incontinence" [Mesh] and "suburethral slings" [Mesh]. Randomized clinical trials and observational studies, with or without Control Group, and follow-up of more than 12 months were included. Only one randomized study with high risk of bias was included and it concluded the effectiveness equivalence between adjustable and non-adjustable slings. All other studies were cases series with patients of varying levels of incontinence intensity and history of pelvic radiation therapy and previous surgeries. The meta-analysis for 0 pad in 24 hours demonstrated an effectiveness of 53%. For the 0 to 1 pad test in 24 hours, the meta-analysis resulted in an effectiveness of 69%. Risk factors for surgery failure include prior radiation, severity of post-prostatectomy urinary incontinence, and previous surgeries. The meta-analysis of the extrusion rate was 9.8% and the most commonly reported adverse effects were pain and local infection. Evidence of low quality indicates that adjustable slings are effective for treating post-prostatectomy urinary incontinence, with frequency of adverse events similar to the surgical option considered gold standard (the artificial urinary sphincter implant).


RESUMO A incontinência urinária pós-prostatectomia tem importante impacto negativo na qualidade de vida do portador. O tratamento cirúrgico inclui slings masculinos e, entre os diversos modelos, os slings ajustáveis. O objetivo deste estudo foi avaliar a efetividade e a segurança do sling ajustável no tratamento da incontinência urinária pós-prostatectomia. Trata-se de revisão sistemática de literatura. Foram pesquisadas as seguintes bases de dados eletrônicas até janeiro de 2018: PubMed®, Embase, CENTRAL e LILACS. As palavras-chaves utilizadas nas estratégias de busca foram: "prostatectomy" [Mesh], "urinary incontinence" [Mesh] e "suburethral slings" [Mesh]. Foram incluídos ensaios clínicos randomizados e estudos observacionais controlados ou não com seguimento maior que 12 meses. Apenas um estudo randomizado com alto risco de viés foi localizado e concluiu a equivalência de efetividade de slings ajustáveis e não ajustáveis. Todos os outros estudos foram série de casos com pacientes de variados níveis de intensidade da incontinência e histórico de radioterapia pélvica e cirurgias prévias. A metanálise para 0 pad em 24 horas demonstrou efetividade de 53%. Para o desfecho 0 a 1 pad em 24 horas, a metanálise resultou em efetividade de 69%. Os fatores de risco para insucesso da cirurgia incluem radiação prévia, gravidade da incontinência urinária pós-prostatectomia e cirurgias anteriores. A metanálise da taxa de extrusão foi de 9,8%, e os efeitos adversos mais relatados foram dor e infecção local. Evidências de baixa qualidade indicam que os slings ajustáveis são efetivos para o tratamento da incontinência urinária pós-prostatectomia, com frequência de eventos adversos semelhantes à opção cirúrgica considerada padrão-ouro (o implante de esfíncter urinário artificial).


Subject(s)
Humans , Male , Prostatectomy/adverse effects , Urinary Incontinence/etiology , Suburethral Slings/standards , Randomized Controlled Trials as Topic , Reproducibility of Results , Risk Factors , Treatment Outcome
15.
Einstein (Säo Paulo) ; 17(2): eRW4320, 2019. tab, graf
Article in English | LILACS | ID: biblio-1001904

ABSTRACT

ABSTRACT Objective: To evaluate the best surgical approach for the female urinary incontinence. Methods: Systematic review conducted in MEDLINE® Cochrane, EMBASE and LILACS database up to September 1st, 2017. Articles were selected according to study type, type of intervention and outcomes. Articles were selected by more than one researcher based on title, abstract and full text. The SIGN checklist was used for bias assessment. Results: A total of 165 articles were retrieved from MEDLINE® . Twenty-five studies were elected for full text reading, and 11 of them were selected for the final text analysis. The heterogeneity between questionnaires used in different studies precluded a meta-analysis of results. Conclusion: This study yielded evidences supporting the hypothesis that total and subtotal hysterectomy have different impacts on urinary function of patients with benign uterine diseases. Articles revealed higher frequency of urinary incontinence following subtotal compared to total hysterectomy.


RESUMO Objetivo: Avaliar qual a melhor conduta cirúrgica na incontinência urinária feminina. Métodos: Revisão sistemática conduzida no MEDLINE®, Cochrane, EMBASE e LILACS até 1º de setembro de 2017. Os artigos foram escolhidos de acordo com o tipo de estudo e de intervenção, e seus resultados. Os artigos foram selecionados por mais de um pesquisador, com base no título, no resumo e no texto completo. O checklist SIGN foi usado para avaliar vieses. Resultados: No MEDLINE®, foram recuperados 165 artigos. Foram escolhidos 25 estudos para leitura do texto completo, e somente 11 foram escolhidos para análise do texto final. Não foi realizada metanálise dos resultados devido à heterogeneidade dos questionários usados em cada estudo. Conclusão: Encontrou-se evidência que suporta a hipótese de que as histerectomias total e subtotal causam impactos diferentes na função urinária de pacientes com doença uterina benigna. Os artigos mostraram maior frequência de incontinência urinária após histerectomia subtotal quando comparada à total.


Subject(s)
Humans , Female , Postoperative Complications , Urinary Incontinence/etiology , Hysterectomy/adverse effects , Hysterectomy, Vaginal/adverse effects , Time Factors , Uterine Diseases/surgery , Randomized Controlled Trials as Topic , Surveys and Questionnaires
16.
Rev. bras. enferm ; 72(supl.2): 284-293, 2019. tab, graf
Article in English | LILACS, BDENF | ID: biblio-1057676

ABSTRACT

ABSTRACT Objective: to identify factors inherent in hospital care that favor urinary incontinence in the elderly. Method: an integrative review with Scopus, CINAHL and Pubmed searches. Includes original articles, no language restriction, published between 2008 and 2018. Rated level of recommendation and level of evidence were assessed using the Oxford Center for Evidence-Based Medicine classification. Exploited content through thematic analysis in light of the Donabedian model. Results: 13 articles constituted the sample. There were factors such as the unjustified and indiscriminate use of devices such as the geriatric diaper; hospital structure adversely affecting the needs of the elderly; and deficit in screening, risk identification and underreporting of the problem favor urinary incontinence in the hospitalized elderly. Conclusion: modifiable factors related to hospital structures and care processes favor both the onset and worsening of urinary incontinence in the elderly.


RESUMEN Objetivo: identificar los factores inherentes al cuidado hospitalario que favorecen el surgimiento de incontinencia urinaria en ancianos. Método: revisión integrativa con búsqueda en las bases Scopus, CINAHL y Pubmed. Incluidos artículos originales, sin restricción de idioma, publicados entre 2008 y 2018. Se evaluó el grado de recomendación y nivel de evidencia a través de la clasificación del Oxford Centre for Evidence-Based Medicine. Explorado contenido a través del análisis temático a la luz de la teoría de Avedis Donabedian. Resultados: 13 artículos constituyeron la muestra. Factores, como el uso no justificado e indiscriminado de dispositivos, como el pañal geriátrico; la estructura hospitalaria es contraria a las necesidades de la persona mayor; y el déficit en el rastreo, identificación de riesgo y subnotificación del problema favorecen el surgimiento de incontinencia urinaria en la persona anciana hospitalizada. Conclusión: factores modificables relacionados a las estructuras hospitalarias y procesos de cuidado favorecen tanto el surgimiento como el empeoramiento de la incontinencia urinaria en la persona anciana.


RESUMO Objetivo: identificar os fatores inerentes ao cuidado hospitalar que favorecem o surgimento de incontinência urinária em pessoas idosas. Método: revisão integrativa com busca nas bases Scopus, CINAHL e Pubmed. Incluídos artigos originais, sem restrição de idioma, publicados entre 2008 e 2018. Avaliado o grau de recomendação e nível de evidência por meio da classificação do Oxford Centre for Evidence-Based Medicine. Explorado conteúdo por meio da análise temática à luz da teoria de Avedis Donabedian. Resultados: 13 artigos constituíram a amostra. Fatores, como o uso não justificado e indiscriminado de dispositivos, como a fralda geriátrica; a estrutura hospitalar adversa às necessidades da pessoa idosa; e o déficit no rastreio, identificação de risco e subnotificação do problema favorecem o surgimento de incontinência urinária na pessoa idosa hospitalizada. Conclusão: fatores modificáveis relacionados às estruturas hospitalares e processos de cuidado favorecem tanto o surgimento quanto a piora da incontinência urinária na pessoa idosa.


Subject(s)
Humans , Male , Female , Aged , Aged, 80 and over , Urinary Incontinence/etiology , Delivery of Health Care/methods , Urinary Incontinence/physiopathology , Delivery of Health Care/standards , Geriatrics/methods , Geriatrics/standards
17.
Int. braz. j. urol ; 44(6): 1215-1223, Nov.-Dec. 2018. tab, graf
Article in English | LILACS | ID: biblio-975663

ABSTRACT

ABSTRACT Purpose: The objective of the present study is to test the efficiency and practicality of a new artificial sphincter "BR - SL - AS - 904" in the control of urinary incontinence in post - PR patients and to evaluate their complications. Patients and Methods: Fifteen patients with incontinence after one year of radical prostatectomy were included prospectively. All patients underwent artificial urethral sphincter (AUS) implant "BR - SL - AS - 904" according to established technique. Independent variables such as free urinary flow, PAD weight test, ICIQ - SF score and urinary symptoms through the IPSS score were compared in different follow-up moments. Results: Patients submitted to AUS implantation did not present trans - operative or post - operative complications related to the surgical act such as: infection, hematoma, erosion or urinary retention. Device was inert to the body during the follow-up, showing an excellent adaptation of the patients, besides the easy handling. The mean age was 68.20 years 40% of the patients had systemic arterial hypertension, 6.7% diabetes mellitus, 6.7% were hypertensive and diabetic, 13.4% were hypertensive, had diabetes and hypercholesterolemia and 26.7% patients had no comorbidities. It was evidenced that the urinary flow peak during the follow-up remained stable. Decreased averages and median PAD weight test were 135.19 to 75.72 and 106.00 to 23.50, respectively. The IPSS score decreased and the quality of life increased (12.33 to 3.40 and 2.50 to 3.20 respectively). The ICQF - SF questionnaire score also showed a decrease, ranging from 16, 71 to 7.33. Conclusion: The artificial sphincter implant "BR - SL - AS 904" was reproducible, safe and effective in the control of urinary incontinence in post - PR patients.


Subject(s)
Humans , Male , Aged , Prostatectomy/adverse effects , Urinary Incontinence/surgery , Urinary Sphincter, Artificial , Prosthesis Implantation/methods , Quality of Life , Urinary Incontinence/etiology , Case-Control Studies , Prospective Studies , Treatment Outcome
18.
Rev. bras. ginecol. obstet ; 40(9): 534-539, Sept. 2018. tab
Article in English | LILACS | ID: biblio-977821

ABSTRACT

Abstract Objective To analyze the prevalence of urinary incontinence (UI) in female patients with an indication for bariatric surgery, to investigate the potential risk factors and the impact on quality of life. Methods A cross-sectional study with female patients with obesity. The evaluation consisted of a structured interview, a specific study form and quality of life questionnaires. The Poisson regression was performed to identify independent risk factors related to UI. Results A total of 221 patients were enrolled; 118 of the study participants (53.4%) reported UI episodes. Mixed UI (MUI), stress UI (SUI) only, and urgency UI (UUI) only were reported by 52.5% (62), 33.9% (40) , and 13.5% (16) of these patients respectively. The prevalence of UI was increased by 47% among the women who had given birth vaginally and by 34% of the women who had entered menopause. Vaginal delivery and menopause were identified as independent risk factors related to UI. The mean International Consultation on Incontinence Questionnaire - Short Form (ICIQ-SF) score was 9.36 ± 4.9. The severity of symptoms was considered moderate in 53.3% (63) of the patients with UI. Conclusion Urinary incontinence impacts quality of life negatively, and the prevalence of UI is high among obese patients. In the present study, vaginal delivery and menopause were independently associated with UI.


Resumo Objetivo Analisar a prevalência de incontinência urinária (IU), os fatores de risco e o impacto na qualidade de vida em pacientes femininas comindicação para realização de cirurgia bariátrica. Métodos Estudo transversal com pacientes femininas obesas. A avaliação consistiu em entrevista estruturada, com questionários de estudo específico e de qualidade de vida. A regressão de Poisson foi utilizada para identificar os fatores de risco independentes para IU. Resultados Um total de 221 pacientes foram incluídos; 118 participantes (53.4%) relataram episódios de IU. Incontinência urinária mista, IU de esforço e IU de urgência foram relatadas por 52.5% (62), 33.9% (40) e 13.5%(16) das pacientes, respectivamente. A prevalência de IU foi 47%maior emmulheres que tiveramparto vaginal, e 34% maior em mulheres que já entraram no período da menopausa. Parto vaginal e menopausa foram identificados como fatores de risco independentes para IU. A média da pontuação do International Consultation on Incontinence Questionnaire - Short Form (ICIQ-SF) foi de 9.36 ± 4.9. A severidade dos sintomas foi considerada moderada em 53.3% (63) das pacientes com IU. Conclusão A IU impacta negativamente a qualidade de vida, e a prevalência de IU é maior empacientes obesas. Neste estudo, parto vaginal e menopausa foram fatores de risco independentes para a ocorrência de IU.


Subject(s)
Humans , Female , Adult , Quality of Life , Urinary Incontinence/etiology , Urinary Incontinence/epidemiology , Obesity, Morbid/complications , Prevalence , Cross-Sectional Studies , Risk Factors
19.
Int. braz. j. urol ; 44(3): 536-542, May-June 2018. tab
Article in English | LILACS | ID: biblio-954047

ABSTRACT

ABSTRACT Objective: To evaluate urodynamic alterations after sub-urethral sling surgery (SSU) in patients with post-prostatectomy urinary incontinence (PPUI). Materials and Methods: We evaluated data of 22 patients submitted to radical prosta- tectomy (RP) or transurethral resection of prostate (TURP) that presented post-surgical urinary incontinence and were treated with SSU implant in a pilot study previously performed in our institution. Methods: Those patients with PPUI were evaluated by urodynamic exam (UD) before and after surgery, and the parameters were compared, including uroflow, cystometry and micturition study. Exclusion criteria included patients without pre-operatory urodynamic study, those with urethral stenosis, those not healed of prostate cancer, pa- tients without clinical conditions to be submitted to urodynamic study and those with severe neurological diseases or that refused to sign the consent form. Results were analyzed statistically by Fisher, Wilcoxon or Mann-Whitney tests. Results: During free uroflow, none parameters showed any statistical significant differ- ences. During cystometry, there were also no statistical differences and the same was observed at pressure versus flow study; the exception was at maximal flow detrusor pressure (PdetQmax), that was lower at post-operatory (p=0.028). In relation to the presence of urinary dysfunctions associated to PPUI, we observed a significant reduc- tion of detrusor overactivity (p=0.035) in relation to pre-operatory period. Conclusion: SSU surgery significantly reduced detrusor overactivity and PdetQMax; however, there were no alterations of other evaluated urodynamic parameters.


Subject(s)
Humans , Male , Prostatectomy/adverse effects , Urinary Incontinence/surgery , Urinary Incontinence/etiology , Urodynamics/physiology , Suburethral Slings , Postoperative Period , Reference Values , Urinary Incontinence/physiopathology , Urination/physiology , Urinary Bladder/physiopathology , Retrospective Studies , Treatment Outcome , Statistics, Nonparametric , Prosthesis Implantation/methods , Preoperative Period , Middle Aged
20.
Int. braz. j. urol ; 44(2): 330-337, Mar.-Apr. 2018. tab
Article in English | LILACS | ID: biblio-892991

ABSTRACT

ABSTRACT Objective The main objective of the present study was to evaluate the presence of overactive bladder (OAB) syndrome, nocturia, urgency, and urge incontinence in patients with obstructive sleep apnea syndrome (OSAS), and measure bladder wall thickness (BWT) in these patients. Materials and Methods The patient group was composed of 38 patients with OSAS. The control group was composed of 15 healthy individuals. All patients were evaluated using the Epworth Sleepiness Scale (ESS) and Overactive Bladder Symptom Score (OABSS). The bladder wall thickness was measured by transabdominal ultrasound (US). The presence of nocturia, urinary urgency, and urge incontinence were also evaluated. Results The mean OABSS was significantly higher in the patient group compared with the control group (p=0.048). The minimum oxygen saturation (Min.SO2) of patients with urgency was found to be significantly lower (p=0.014). The time spent below 90% of oxygen saturation (SO2) was significantly longer in patients with urinary urgency (p=0.009). There was no difference in BWT measurements between the patient group and the control group. There was a significant relationship between BWT values and OABSS in patients with OSAS (p=0.002). Conclusion The results of the present study suggest that OSAS is associated with OAB syndrome. As a key symptom of OAB, urgency correlates with hypoxia in cases with OSAS. Although the present study did not observe any difference in BWT measurements between the patients and the control group, there was a correlation between BWT measurements and OABSS in patients with OSAS.


Subject(s)
Humans , Male , Female , Urinary Incontinence/etiology , Urinary Bladder/diagnostic imaging , Sleep Apnea, Obstructive/etiology , Urinary Bladder, Overactive/complications , Nocturia/etiology , Urinary Incontinence/diagnostic imaging , Urinary Bladder/pathology , Severity of Illness Index , Case-Control Studies , Polysomnography , Sleep Apnea, Obstructive/diagnostic imaging , Urinary Bladder, Overactive/diagnostic imaging , Nocturia/diagnostic imaging
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