[The development and preliminary validation of the IU-4 questionnaire for the clinical classification of urinary incontinence]. / Elaboración y validación preliminar del cuestionario para la clasificación clínica de la incontinencia urinaria IU-4.

RATIONALE: To prepare and validate a simple and self-administered questionnaire for the clinical rating of patients with urinary incontinence (UI) for use in the clinical practice. METHODS: The questionnaire was prepared based on a review of the literature on urinary incontinence and the views of 7 urodynamic urologists. The initial questionnaire UI-5 included 5 items related to UI symptoms that divided patients into three categories: stress incontinence (UEI), urge incontinence (UUI) or mixed urinary incontinence (MUI). An additional question evaluates the impact of UI type on the quality of life. The of construct validity was analyzed correlating the responses to UI-5 items and the question on quality of life. The area under the ROC curve was calculated for each UI type correlating the UI-5 scores and the results of the urodynamic test. The cut-off values for each scale were determined based on sensitivity (SE) and specificity (SP). RESULTS: The study included 188 females with UI (73.4% with UEI, 13.3% with UUI and 13.3% with MUI; based on the urodynamics). Only 4.3% patients did not answer some UI-5 items. One item related to the protective material used was excluded as it was not related to UI types, and so the final questionnaire included only 4 items (UI-4). The results show that UI-4 discriminates the different types of incontinence: UEI (SE: 0.69/SP: 0.76; 1 item), UUI (SE: 0.83/SP: 0.65; 2 items), MUI (SE: 0.72/SP: 0.65; 1 item). 100% patients with MUI, 84% with UUI and 59.9% with UEI report some impact on their quality of life. CONCLUSIONS: UI-4 is simple, valid and easy to administer, and can be particularly valuable in the clinical rating of UI in settings where urodynamic testing is not easily available such is primary health care.

[Kidney transplant in children. Our experience]. / Trasplante renal en la infancia. Nuestra experiencia.

We report on our experience comprised of 21 kidney transplant procedures (20 from cadavers and 1 from a living donor) performed at the Urology Department of our hospital. Of these, 11 remained functional 2 years following transplantation. Of the 10 transplants that failed, 3 were due to arterial thrombosis, 1 from venous thrombosis, 2 from late rejection, 1 from septic necrosis of the vascular suture area, and 1 because the arterial intima had been "swept away" by transluminal dilatation. We underscore the high incidence (33%) of arterial hypertension in these children submitted to renal transplantation and the good response to treatment with hypertensive agents and/or transluminal dilatation. We emphasize the usefulness of duplex-Doppler ultrasonography in evaluating arterial blood flow and in the diagnosis of arterial stenoses. The surgical techniques, complications, and evolution of transplanted kidney function are discussed.