Escala de avaliação do uso de fraldas e absorventes: estudo metodológico / Evaluation scale for the use of adult diapers and absorbent products': methodological study / Escala de evaluación del uso de pañales y absorbentes: estudio metodológico

OBJETIVO: Validar o conteúdo da escala de avaliação do uso de fraldas e produtos absorventes (Escala AUFA) por idosos na atenção primária. MÉTODO: Estudo metodológico de validação de conteúdo com 23 especialistas em enfermagem gerontológica ou feridas pela avaliação do nome e itens da escala. A análise dos dados ocorreu por meio de índice de validação de conteúdo (IVC) e coeficiente de validação de conteúdo (CVC), percentual de concordo totalmente e concordância pelo Alfa de Cronbach, com o mínimo de 0,80 cada. RESULTADOS: Os IVC e CVC gerais foram de, respectivamente, 0,91 e 0,89. Entretanto, os percentuais de concordo completamente e Alfa de Cronbach foram de, respectivamente, 0,65 e 0,51. Após três envios e modificações da escala, a avaliação foi de 0,95 e 0,85. DISCUSSÃO: Os juízes contribuíram para o conteúdo da escala, principalmente quanto ao número de trocas CONCLUSÃO: Após as análises e sugestões dos juízes, o conteúdo foi refinado e validado.

OBJECTIVE: To validate the content of the 'Evaluation Scale for the Use of Adult Diapers and Absorbent Products' (AUFA Scale) among elderly patients in primary care. METHOD: Methodological study for validation of contente with 23 specialists in gerontological nursing and/or wounds for evaluating the name and the items of the scale. The analysis of the data was done according to the Index of Validation of Content (IVC) and the Coefficient of Validation of Content (CVC), the 'Fully Agree" percentage and the compliance to 'Cronbach's Alpha', with a minimum score of 0,80 for each. RESULTS: The general IVC and CVC were 0,91 and 0,89, respectively. However, the 'Fully Agree' and 'Cronbach's Alpha' percentages were 0,65 and 0,51, respectively. After three 3 submissions and modifications of the scale, the scores changed to 0,95 and 0,85. DISCUSSION: Judges contributed to the content of the scale, especially regarding the number of absorbent product changes CONCLUSION: After taking into account the analyses and suggetions made by the judges, the content was refined and considered validated.

OBJETIVO: Validar el contenido de la escala de evaluación para el uso de pañales y productos absorbentes (Escala AUFA) en ancianos en atención primaria. MÉTODO: Estudio metodológico de validación de contenido con 23 especialistas en enfermería gerontológica y/o heridas para la evaluación del nombre y de los ítems de la escala. El análisis de los datos se realizó mediante el Índice de Validación de Contenido (IVC) y el Coeficiente de Validación de Contenido (CVC), así como del porcentaje de la respuesta 'Totalmente de acuerdo' y del 'Alfa de Cronbach', con un puntaje mínimo de 0.80 para cada uno.RESULTADOS: Los IVC y CVC generales fueron de 0.91 y 0.89, respectivamente. Sin embargo, el porcentaje de 'Totalmente de acuerdo' y del 'Alfa de Cronbach' fue de 0.65 y 0.51, respectivamente. Después de 3 presentaciones y modificaciones de la escala, la evaluación fue de 0.95 y 0.85. DISCUSIÓN: Los jueces contribuyeron al contenido de la escala, principalmente en cuanto al número de cambios. CONCLUSIÓN: Luego del análisis y de las sugerencias de los jueces, el contenido se refino el contenido hasta considerarlo validado.

Instrumentos de avaliação dos eventos adversos associados ao uso de fraldas geriátricas / Instruments for assessing adverse events associated with the use of geriatric diapers

Objetivo: analisar instrumentos de avaliação dos eventos adversos associados ao uso de fraldas geriátricas. Métodos: revisão integrativa da literatura, nas bases de dados LILACS, MEDLINE, CINAHL e EMBASE, com publicações em português, inglês e espanhol. Na análise dos dados, a categorização ocorreu pela identificação dos eventos adversos e instrumentos de rastreio. Resultados: das 19 publicações, identificaram-se como eventos adversos e respectivos instrumentos: déficit motor/índice de Barthel; incontinência/Kings's Health Questionnaire e International Consultation on Incontinence Questionnaire-Short Form; umidade da pele/Transepidermal Water Loss; qualidade de vida/Hospital Anxiety and Depression Scale; dermatite associada à incontinência/Escala de Avaliação Perineal de Nix. Conclusão: foram analisados instrumentos que avaliaram os eventos adversos associados ao uso de fraldas que podem ser potencialmente utilizados na prática de enfermagem. (AU)

Comparison of the Kelly's plication and TOT simultaneously with vaginal hysterectomy, on the incontinence, and sexual functions

ABSTRACT Purpose: To compare the effect of vaginal hysterectomy-anterior/posterior colporrhaphy with Kelly's plication(VH-KP), versus vaginal hysterectomy-anterior/posterior colporrhaphy-transobturator tape(VH-TOT) surgeries on incontinence, quality of life, and sexual functions in patients with pelvic organ prolapse(POP), and concurrent obvious stress urinary incontinence(SUI). Materials and Methods: Between 2013 and 2017, fifty patients treated with VH-KP(n = 25), and VH-TOT(n = 25) due to POP and SUI, were evaluated prospective consecutively. Age, parity, duration of urinary incontinence, and the daily pad use were recorded. Patients were filled "rinary Distress Inventory-6(UDI-6)", "Incontinence Impact Questionnaire 7(IIQ-7)" and "Index of Female Sexual Function(IFSI)" questionnaire forms at preoperatively, and postoperative 6th month. No usage of pads was accepted as subjective cure rate. Intraoperative, and postoperative complications were noted. Results: There was no statistically significant difference between two groups, for the mean age of the patients, parity, duration of SUI, and the daily pad use, preoperatively (p > 0.05). Decreased UDI-6 scores, IIQ-7 scores and daily pad usage, and increased IFSF scores were found statistical significantly in each group, at the postoperative 6 th month (p < 0.05). However, VH-TOT group had higher improvement rates, on UDI-6 scores (69.5% vs 63.0%, p = 0.04). In addition, it was notable that the the rates of the patients had IFSF scores ≥ 25 was higher in VH-KP group (p = 0.05). Four (16%) patients had recurrent SUI in the VH-KP group (p = 0.039) and vaginal extrusion occurred in 2 (8%) patients in the VH-TOT group (p = 0.153), postoperatively. Conclusions: Although the effects of VH-TOT surgery are superior to conventional methods for incontinence and quality of life; negative effects on sexual functions are notable. In addition, although recurrence rates of TOT are low, complications such as vaginal extrusion are accompanied by drawbacks of mesh usage.

Telephone - delivered quality of life after 365 male stress urinary incontinence (SUI) operations

ABSTRACT Objectives: To assess patient satisfaction and quality of life and factors that may be related to these outcomes. Materials and Methods: Between 2000 and 2008 a retrospective chart review and telephone survey of all surgeries for male SUI was performed. Average age at times of operation was 69.4 ± 7.4 (median 69). As part of the survey 270 of 365 patients were available (response rate: 74%). The average follow up time (from operation to telephone survey) was 34.8 ± 22.8 months (median 32). Results: Pad use per day improved significantly after operation from 6.23±5.3 to 1.61±2.92 pads/day (p=0.001). 74.7% (n=198) declared to be continent with one safety pad and 87.7% (n=236) confirmed the postoperative improvement of incontinence. 189 (70.5%) patients were “very satisfied” and “satisfied”. In 81% (n=218) the expectation in operation could be met, therefore 84.3% (n=226) would undergo it again and 90.3% (n=243) would recommend it to others. Lower age (rs=0.211), few postoperative pads per day (rs=0.58), high reduction of pads (rs=-0.35) and physical activity level (rs=0.2) correlate significantly with better satisfaction. Conclusions: Eighty-seven pint seven percent (87.7%) of our incontinence operations (n=236) lead to an improvement, which is independent from the number of prior incontinence operations and preoperative pad count. The postoperative quality of life remains constant over the observed follow up time. Certain subgroups of patients (younger age, high physical activity level, large reduction of pads) demonstrated superior satisfaction rates.

Assessing variability of the 24-hour pad weight test in men with post-prostatectomy incontinence

ABSTRACT Purpose: Decision-making regarding surgery for post-prostatectomy incontinence (PPI) is challenging. The 24-hour pad weight test is commonly used to objectively quantify PPI. However, pad weight may vary based upon activity level. We aimed to quantify variability in pad weights based upon patient-reported activity. Materials and Methods: 25 patients who underwent radical prostatectomy were prospectively enrolled. All patients demonstrated clinical stress urinary incontinence without clinical urgency urinary incontinence. On three consecutive alternating days, patients submitted 24-hour pad weights along with a short survey documenting activity level and number of pads used. Results: Pad weights collected across the three days were well correlated to the individual (ICC 0.85 (95% CI 0.74–0.93), p<0.001). The mean difference between the minimum pad weight leakage and maximum leakage per patient was 133.4g (95% CI 80.4–186.5). The mean increase in 24-hour leakage for a one-point increase in self-reported activity level was 118.0g (95% CI 74.3–161.7, p<0.001). Pad weights also varied significantly when self-reported activity levels did not differ (mean difference 51.2g (95% CI 30.3–72.1), p<0.001). Conclusions: 24-hour pad weight leakage may vary significantly on different days of collection. This variation is more pronounced with changes in activity level. Taking into account patient activity level may enhance the predictive value of pad weight testing.

Urinary Retention Accompanied by Retroperitoneal Urine Leakage in Schizophrenia

We presented a case of a 46-year-old man who attended the emergency department with right flank pain. Abdominal computed tomography showed dilated renal pelvis, ureter and distended bladder. Fluid collection was seen in retroperitoneal space and pelvic cavity. He had renal insufficiency. When a urethral catheter was inserted, 1,200 mL urine was drained. He was diagnosed with schizophrenia more than 20 years prior, and had been taking anti-psychotics. He had been living in a sanatorium. He had nocturnal enuresis and had worn an incontinence pad nightly for the last 10 years. His fluid consumption was 10 L/day. After placement of an indwelling urethral catheter for relieving voiding problems and restriction of fluid intake, fluid collection in retroperitoneal spaces and pelvic cavity was removed and renal insufficiency was recovered. After training of self-clean intermittent catheterization, he was discharged.

Incontinence Pad Usage in Medical Welfare Facilities in Korea / 대한배뇨장애요실금학회지

PURPOSE: The prevalence of urinary incontinence and the usage of incontinence pads by elderly residents in Korean medical welfare facilities were investigated. METHODS: From a total of 1,832 facilities, 33 medical welfare facilities in the capital area were randomly selected; all nursing homes were excluded. All data were collected by questionnaires to investigate the residents' age and sex, the presence or absence of urinary incontinence, incontinence pad usage per month, and management methods for urinary incontinence. Surveys were also conducted from January 2010 to August 2010. RESULTS: A total number of residents in medical welfare facilities were 2,783, and all of them were selected for this study. Approximately, 65.3% of residents (1,816 individuals) had incontinence. The mean usage was 75 incontinence pads per month. Only 15.6% of residents received proper management for urinary incontinence, while the remaining 84.4% of residents did not have any experience in evaluating or managing their urinary symptoms. CONCLUSIONS: The prevalence of urinary incontinence in medical welfare facilities in Korea was about 65.3%. However, the management of urinary incontinence was insufficient. Urologists should make further efforts for the proper management of urinary incontinence in elders in these facilities.

Correlação entre as queixas de incontinência urinária de esforço e o pad test de uma hora em mulheres na pós-menopausa / Correlation between complaints of stress urinary incontinence and the one-hour pad test in postmenopausal women

OBJETIVO: correlacionar as queixas de incontinência urinária de esforço e os resultados da aplicação do pad test de uma hora em mulheres na pré e pós-menopausa. MÉTODOS: estudo transversal, composto por 60 voluntárias na pós-menopausa, divididas em dois grupos: um com 34 mulheres com queixa de perda involuntária de urina aos esforços, outro com 26 mulheres sem queixas de perda de urina aos esforços. Há também a presença de um Grupo Controle composto por 15 mulheres na pré-menopausa, com ciclo menstrual normal e sem queixas urinárias. Todas as mulheres foram avaliadas quanto à clínica e laboratorialmente, e submetidas ao pad test por uma hora. A paciente foi considerada incontinente quando o peso do absorvente após o teste foi maior do que 1 g. Os resultados obtidos foram submetidos à estatística descritiva, ao teste paramétrico ANOVA, ao pós-teste de Turkey e à correlação de Pearson. RESULTADOS: todas as mulheres na pós-menopausa apresentaram incontinência urinária de esforço durante o pad test, tanto as que referiram perda urinária (4 g), como as sem perda urinária prévia (3,5 g). Nessas mulheres, observou-se uma forte correlação das perdas de urina com o tempo de menopausa (r=0,8; p<0,01) e com o índice de massa corpórea (IMC) (r=0,7; p= 0,01). As mulheres na pré-menopausa mantiveram-se continentes durante o pad test (0,4 g). CONCLUSÕES: os resultados obtidos com a aplicação do pad test de uma hora mostraram que todas as mulheres na pós-menopausa apresentavam incontinência urinária de esforço, inclusive aquelas que não apresentavam queixa de perda de urina aos esforços. Essa perda de urina correlaciona-se com o tempo de menopausa e com o IMC.

OBJECTIVE: to correlate complaints of stress urinary incontinence and the results of a one-hour pad test in pre- and postmenopausal women. METHODS: cross-sectional study conducted on 60 postmenopausal volunteers divided into two groups: one consisting of 34 women with involuntary loss of urine due to stress incontinence and the other consisting of 26 women without involuntary loss of urine. A control group of 15 premenopausal women with normal menstrual cycles and no urinary complaints was also used. All women underwent clinical and laboratory analysis as well as the one-hour pad test. Patients were considered to be incontinent when sanitary pad weight post-test was more than 1 g. Data were submitted to descriptive statistics, parametric ANOVA, post-hoc Tukey test and Pearson's correlation. RESULTS: all postmenopausal women presented with stress urinary incontinence during the pad test, both those with urinary loss (4 g) and with no previous loss (3.5 g). A strong correlation was observed between urinary loss and time since menopause (r=0.8; p<0.01) and body mass index (r=0.7; p=0.01). Premenopausal women were continent during the pad test (0.4 g). CONCLUSIONS: the results of the one-hour pad test showed that all postmenopausal women exhibited stress urinary incontinence, including those without urine loss on effort. Urine loss was correlated with time since menopause and body mass index.

Eficácia do Pad Test em mulheres com incontinência urinária / Efficacy of pad test in women with urinary incontinence

O objetivo desse estudo descritivo e transversal foi verificar a eficácia do pad test em pacientes com incontinência urinária (IU). Utilizou-se o protocolo da Sociedade Internacional de Continência, com volume de bexiga padrão, para a aplicação do pad test. Vinte e oito pacientes foram submetidas a avaliações médica e fisioterapêutica: 11 tiveram diagnóstico normal, 13 incontinência de esforço, uma apresentou incontinência de urgência e três mistas. entre as incontinentes, em 10 havia pad test positivo, sendo que sete eram portadoras de incontinência leve/moderada e três tinham incontinência severa. São necessários estudos mais duradouros para o diagnóstico preciso da IU, pois o pad test é insatisfatório como método de seleção para incontinência, apesar de eficiente no grau de severidade de perda urinária.

The objectivo of this study is to verifify the efficacy of the pad test in patients with urinary incontinence. A transversal descriptive study. A transversal descriptive study. Using the International Continence Society protocol with the standard bladder volume to the application of the pad test: 28 patients, physicians and physiotherapists evaluation: 11 were diagnosed normal, 13 with stress incontinence, one urge incontinence and three mixed. Among the incontinent ones, 10 presented positive pad test being seven classified with slight/moderate and three severe incontinence. Concluding, longer studies are necessary to a more precise diagnose of urinary incontinence because the pad test is unsatisfactory as a selection method, however the test made is efficient to verify the demade is efficient to verify the degree of severity of this pathology.

Pad-test: uma revisão sobre conceitos e utilização / Pad-test: a review on concepts and use

O pad-test é considerado um método de medida simples, não invasivo e eficaz para avaliar a incontinência urinária, inclusive aquelas que não são facilmente detectadas no exame clínico ou na avaliação urodinâmica. Há várias versões desse teste, com variação de duração de 1 minuto a 72 horas e com diferentes formas de aplicação, sendo o de 1 hora e o de 24 horas os mais utilizados. A partir da medida da perda de urina em absorvente íntimo padronizado, é possível classificar a incontinência urinária em leve, moderada e grave. Este trabalho objetiva examinar as publicações mais recentes relacionadas a formas de aplicação e medida da incontinência urinária com o pad-test. Foi realizada uma busca eletrônica em dois bancos de dados (Pubmed e Scielo), examinando-se as publicações que abordassem a utilização do pad-test como forma de medida da incontinência urinária. O emprego desse teste parece ser uma forma de medida simples, prática e rápida para quantificação da perda de urina. Entretanto, é necessário que haja padronização quanto às formas de aplicação, principalmente na avaliação da confiabilidade e reprodutibilidade do exame. O pad-test de uma hora pode ser uma opção de baixo custo, rápida e controlada.

Impacto da reeducação postural global no tratamento da incontinência urinária de esforço feminina / Impact of global postural reeducation for treatment of female stress urinary incontinence

OBJETIVO: Avaliar os efeitos da reeducação postural global (RPG) nos sintomas de incontinência urinária de esforço (IUE) e a qualidade de vida em um grupo de mulheres incontinentes. MÉTODOS: Ensaio clínico aberto, tipo antes e depois, prospectivo, não randomizado. Foram selecionadas 26 mulheres com queixa clínica e estudo urodinâmico compatível com IUE, do Ambulatório de Uroginecologia do Hospital das Clínicas da UNICAMP. A idade média foi de 50,76 anos (23 a 72 anos). Todas as mulheres foram avaliadas por anamnese, exames clínicos e uroginecológico, avaliação postural. Todas foram submetidas a tratamento com RPG, em sessões individuais de 50 minutos semanais por três meses e quinzenais por mais três meses. As pacientes foram submetidas a posturas de alongamento propostas pela técnica, em que se coloca em tensão as cadeias musculares responsáveis pela postura estática e estrutura do corpo. O trabalho ativo da paciente nas correções, aliado à atuação do fisioterapeuta, levam ao reequilíbrio das tensões musculares e reestruturação do corpo, o que pode favorecer as funções, especificamente as relacionadas ao assoalho pélvico. Ao término do tratamento, e após seis meses, as pacientes foram reavaliadas através do questionário de impressão geral de melhora, dos domínios relacionados à IUE do King's Health Questinnaire: impacto da incontinência, em que se avaliam os prejuízos na qualidade de vida; percepção geral da saúde, qual a classificação que a paciente dá para sua saúde no momento e a presença do sintoma de perda por esforço; avaliação funcional do assoalho pélvico (AFA) e número de trocas de protetores diários. RESULTADOS: No término do tratamento, quatro pacientes (16 por cento) estavam curadas, dezoito (72 por cento) melhoraram significativamente e três (12 por cento) falharam. Após seis meses, seis pacientes (24 por cento) estavam curadas, 16 (64 por cento) melhoraram e três (12 por cento) falharam (p <0,001). Ao avaliarmos a qualidade de vida das pacientes, observamos melhora significativa (p <0,05) em todos os domínios questionados, destacando-se percepção geral da saúde, impacto da incontinência e número de episódios de perda. A avaliação do funcional do assoalho pélvico (AFA) e do teste do absorvente (número de troca/dia) também mostrou melhora significativa (p<0,001) nos diferentes tempos de coleta. CONCLUSÃO: Os resultados mostram que a RPG pode ser uma alternativa para o tratamento da IUE.

OBJECTIVE: To evaluate the effect of global postural reeducation (GPR) on stress urinary incontinence (SUI) and quality of life in SUI female patients METHODS: The study design was a prospective non-randomized clinical trial. Twenty-six patients with symptoms of SUI were selected from the Urogynecology Outpatient Clinics of the State University of Campinas (Unicamp), state of São Paulo, Brazil. Age ranged from 23 to 72 years old (mean 50.8). All women were submitted to anamnesis, physical exam, postural evaluation and urodynamic testing. Patients were treated by the GPR in individual 50 minute sessions weekly for three months and twice a month for the next three months. All patients were re-evaluated at the end of treatment and six months later by means of General Impression of Improvement, Incontinence Impact, General Perception of Health, Functional Evaluation of the Pelvic Floor, Number of Leaking Episodes and Pad Use. RESULTS: At the end of treatment 4 (16 percent) of the patients were cured, 18 (72 percent) had improved significantly and 3 (12 percent) failed. At 6 months, 6 (24 percent) were cured, 16 (64 percent) improved and 3 (12 percent) failed (p<0.001). Quality of Life questionnaires presented significant improvement (p<0.05) in all domains, with emphasis on General Perception of Health, Incontinence Impact and number of leaking episodes. The Functional Evaluation of the Pelvic Floor and Pad Use also presented significant (p<0.001) improvement. CONCLUSION: These results may demonstrate that GPR is an efficient alternative for treatment of stress urinary incontinence.

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.

Sensibilidade de dados da história clínica na detecçäo da incontinência urinária de esforço do tipo esfincteriana / Sensitivity of clinical history data in detection of sphincteric stress urinary incontinence

Foram avaliadas 78 mulheres portadoras de incontinência urinária de esforço, para identificar dados da história clínica (esforçco físico e número de absorventes vaginais em 24 horas), que pudessem predizer casos de incontinência urinária esfincteriana. Submetemos todas as pacientes ao estudo urodinâmico completo para a determinaçäo da pressäo de perda sob manobra de Valsalva. A distribuiçäo dos tipos de incontinência foi a seguinte: 22 classificadas como incontinência urinária tipo I, 26 tipo II e 30 tipo III. Do total de pacientes 45 pacientes, 45 mulheres (57,6 porcento) foram submetidas previamente a cirurgias, e entre essas 17 (37,7 porcento) apresentavam incontinência urinária esfincteriana. A associaçäo de incontinência urinária tipo III e cirurgia prévia mostrou-se näo significativa estatisticamente. O uso de 2 ou mais absorventes em 24 horas foi estatisticamente significativo para as pacientes com incontinência esfincteriana. Nossos resultados demonstram que mulheres com perdas aos pequenos esforços e uso de 2 ou mais absorventes vaginais apresentam alta probabilidade de lesäo esfincteriana (p<0,05). Entretanto, o estudo urodinâmico é o único exame comprovativo do diagnóstico de incontinência urinária esfincteriana