Evaluación de desenlaces percibidos por pacientes adultos con incontinencia que utilizan pañales desechables en Colombia

R E S U M E N Introducción: La incontinencia es un problema de salud frecuente que afecta la calidad de vida de las personas, limitando la autonomía y reduciendo la autoestima. Entre el 36-54% de las personas con incontinencia severa pueden presentar deterioro moderado a extremo en su cotidianidad y confianza. Objetivo: Evaluar la percepción de pacientes adultos con incontinencia urinaria y/o incontinencia fecal severa frente al uso de los pañales desechables. Metodología: Estudio observacional de cohorte, en pacientes afiliados a programas de atención domiciliaria usuarios de tres marcas comerciales de pañales. La percepción se evaluó con el instrumento ICIQ-PadPROM®. Resultados: Participaron I79 pacientes, 68% mujeres con edad promedio 7I,9 años. El dominio de diseño de pañal y efecto físico fue el que presentó mejor calificación, siendo el pañal Content Medical® el mejor calificado, con diferencias significativas principalmente frente al grupo de Rely®; en el ítem de filtraciones del dominio carga del pañal, Content Medical® presenta mejor percepción comparado contra los otros grupos (p<0.00I). Conclusiones: Los pacientes tienen adecuada percepción de las marcas de pañal; sin embargo, los que utilizaron Content Medical® refieren mayor percepción favorable.

Introduction: Incontinence is a frequent health problem that affects the quality of life of people, limiting autonomy and reducing self-esteem. Between 36-54% of people with severe incontinence may have moderate to extreme deterioration in their daily lives and confidence. Objective: To evaluate the perception of adult patients with urinary incontinence and/or severe fecal incontinence compared to the use of disposable diapers. Methodology: Observational cohort study in patients affiliated in home care programs using three commercial brands of diapers. Perception was assessed with the ICIQ-PadPROM® instrument. Results: I79 patients participated, 68% were women and an average age of 7I.9 years. The domain of diaper design and physical effect was the one that presented the best rating, with the Content Medical® diaper being the best qualified, with significant differences mainly compared to the Rely® group; in the leakage item of the diaper loading domain, Content Medical® presents better perception compared to the other groups (p<0.00I). Conclusions: Patients have adequate perception of diaper brands; however; those who used Content Medical® reported a higher favorable perception.

Introdução: A incontinência é um problema de saúde comum que afeta a qualidade de vida das pessoas, limitando a autonomia e reduzindo a auto-estima. Entre 36-54% das pessoas com incontinência severa podem ter uma deficiência moderada a extrema em sua vida diária e confiança. Objetivo: Avaliar a percepção de pacientes adultos com incontinência urinária e/ou incontinência fecal grave em relação ao uso de fraldas descartáveis. Metodologia: Estudo de coorte observacional em pacientes afiliados a programas de cuidados domiciliares utilizando três marcas comerciais de fraldas. A percepção foi avaliada com o instrumento ICIQ-PadPROM®. Resultados: I79 pacientes participaram, 68% mulheres com uma média de idade de 7I,9 anos. O domínio de design e efeito físico das fraldas foi o mais bem avaliado, sendo a fralda Content Medical® a mais bem avaliada, com diferenças significativas principalmente em relação ao grupo Rely®; no item vazamento do domínio de carga de fraldas, Content Medical® apresentou melhor percepção em comparação com os outros grupos (p<0,00I). Conclusões: Os pacientes têm uma percepção adequada das marcas de fraldas; entretanto, aqueles que usaram Content Medical® relatam uma percepção mais favorável.

The Comparison of the Abdominal Leak Point Pressure and the 1-Hour Pad Test in Patients with Stress Urinary Incontinence / 대한비뇨기과학회지

PURPOSE: The aim of this study was to determine whether or not the 1-hour pad test demonstrates the objective severity of female stress urinary incontinence. MATERIALS AND METHODS: One hundred eighteen female patients with stress urinary incontinence symptom were prospectively evaluated with a 1-hour pad test as recommended by the International Continent Society and they also underwent videourodynamics to determine the ALPP. The patients were divided into 2 groups by the ALPP: group A (n=94) was the low leak point pressure group (ALPP100cmH2O or no leakage). A pad gain < or=2g was considered a negative pad test. Student's t-test was done to evaluate the difference of urine leakage between the two groups. RESULTS: The mean amount of urine leakage measured by the 1-hour pad test for groups A and B were 53.4+/-47.2 and 50.9+/-53.9g, respectively, and there was no statistically significant differences between two groups (p=0.839). Eighteen (15.2%) women did not leak during the ALPP measurement and 6 (5.1%) women had a negative pad test. Among the 18 women with no leakage on the ALPP, 15 had a positive pad test and 3 had a negative pad test. Among the 6 women with a negative pad test, 3 had leakage and 3 had no leakage during the ALPP measurement. One hundred fifteen patients received an operation for stress urinary incontinence. The three patients who had no leak on the ALPP and who also had a negative pad test did not receive the operation. CONCLUSIONS: These data suggest that the 1-hour pad test did not demonstrate the objective severity of stress urinary incontinence. However, the 1-hour pad test was more sensitive to demonstrate leakage than the ALPP; therefore, in the case of no leakage during the ALPP measurement, the 1-hour pad test is needed to check the leakage.

Usefulness of 1-Hour Pad-Weighing Test as Preoperative Diagnostic Assessment for Female Stress Urinary Incontinence / 대한비뇨기과학회지

PURPOSE: The 1-hour pad-weighing test was compared with the cystourethrogram as a method for the preoperative diagnostic assessment of female stress urinary incontinence. MATERIALS AND METHODS: The records of 80 women, with stress urinary incontinence that had undergone anti-incontinence surgery, were reviewed. The 1-hour pad weighing test, proposed by the International Continence Society in 1988, was performed for the objective assessment of the degree of incontinence in all patients. History taking, physical examinations and cystourethrograms were also performed and the correlation between the 1-hour pad-weighing test and the results from the above procedures evaluated. RESULTS: The urinary leakage was examined in all patients during the 1-hour pad-weighing test, with an average urine loss of 50g (5-150). In 13 patients, no urinary leakage was demonstrated during straining on the cystourethrogram. Thus, compared with the 1-hour pad-weighing test, the cystourethrography was less sensitive in the diagnosis of incontinence, with a 16% false negative rate. The bladder neck position and degree of descent were measured on the cystourethrogram during resting and straining. The position of the bladder neck averaged 2.2 (0.5-6.0) and 4.2cm (1.0-8.0) from the upper margin of the symphysis pubis at rest, and during straining, respectively. The difference between these two parameters averaged 2.0cm (0.2-4.0). The number of type III stress urinary incontinence patients, based on the Blaivas classification, was 9. There were statistically significant correlations between the 1-hour pad-weighing test and the bladder neck positions during resting (r=0.296, p=0.008) and straining (r=0.356, p=0.001) on the cystourethrograms. There was a statistically significant difference between the 1-hour pad-weighing test and bladder neck opening during resting (p=0.001). CONCLUSIONS: It seems that the 1-hour pad-weighing test is an easy, inexpensive and non-invasive method for the preoperative diagnostic assessment of female stress urinary incontinence.