Sintomas do trato urinário inferior três anos após o parto: estudo prospectivo / Lower urinary tract symptoms three years after delivery: a prospective study

OBJETIVO: avaliar a freqüência de sintomas do trato urinário inferior (STUI) três anos após o parto em mulheres previamente entrevistadas no terceiro trimestre da gestação e comparar o impacto da gestação e do parto no desencadeamento dos STUI. Analisar o desconforto social e higiênico associado às queixas miccionais. MÉTODOS: estudo prospectivo analítico. Em 2003, 340 gestantes foram selecionadas em um ambulatório de atendimento Pré-natal e responderam ao questionário pré-testado, com perguntas sobre STUI e dados obstétricos.Em 2006, três anos após o parto foi possível contatar por telefone 120 mulheres das 340 entrevistadas no primeiro estudo. As mesmas responderam ao segundo questionário, com perguntas sobre dados obstétricos, STUI e seu impacto social. Os STUI foram divididos em incontinência urinária de esforço (IUE) e sintomas urinários irritativos (SUI). Para análise foram utilizados os testes de McNemar e qui-quadrado (p<0,05). RESULTADOS: a ocorrência da IUE e de noctúria na gestação foi entre 57,5 e 80 por cento; e o surgimento destes sintomas após o parto foi entre 13,7 e 16,7 por cento, respectivamente. A urge-incontinência foi significativamente mais freqüente após o parto (30,5 por cento) do que na gestação (20,8 por cento). Apenas 35,6 por cento das mulheres com SUI sentiam desconforto social, elevando-se este índice para 91,4 por cento nas mulheres com SUI associado à IUE. CONCLUSÃO: a gestação, mais do que o parto, foi associada ao desencadeamento da IUE e de noctúria, enquanto o desencadeamento da urge-incontinência foi significativamente maior após o parto. A maioria das mulheres referiu que a presença da IUE causa problemas sociais.

PURPOSE: to evaluate the frequency of lower urinary tract symptoms (LUTS), three years after delivery in women previously interviewed at the third gestation trimester, and to compare the gestation and delivery impact on LUTS, analyzing the social and hygienic discomfort associated with micturition complaints. METHODS: analytical prospective study. In 2003, 340 pregnant women were selected in the pre-natal outpatient unit, and asked to answer a pre-tested questionnaire about LUTS and obstetric data. Three years after delivery, it was possible to get in touch by telephone with 120 of the 340 women who had been interviewed in the first study. They answered a second questionnaire about obstetric data, LUTS and its social impact. LUTS have been divided into stress urinary incontinence (SUI) and irritative urinary symptoms (IUS). McNemar's and chi-square tests were used for statistical analysis (p<0.05). RESULTS: SUI and nocturia have occurred in 57.5 and 80 percent of the pregnant women and the appearance of those symptoms after delivery, in 13.7 and 16.7 percent, respectively. Urge urinary incontinence has been significantly more frequent after delivery (30.5 percent) than in gestation (20.8 percent). Only 35.6 percent of the women with IUS presented social discomfort, but this rate has gone up to 91.4 percent in women with IUS associated with SUI. CONCLUSIONS: gestation, more than delivery, was associated with the appearance of SUI and nocturia, while the urge urinary incontinence was significantly higher after delivery. Most of the women have mentioned that SUI causes social problems.

[Lower urinary tract symptoms three years after delivery: a prospective study]. / Sintomas do trato urinário inferior três anos após o parto: estudo prospectivo.

PURPOSE: to evaluate the frequency of lower urinary tract symptoms (LUTS), three years after delivery in women previously interviewed at the third gestation trimester, and to compare the gestation and delivery impact on LUTS, analyzing the social and hygienic discomfort associated with micturition complaints. METHODS: analytical prospective study. In 2003, 340 pregnant women were selected in the pre-natal outpatient unit, and asked to answer a pre-tested questionnaire about LUTS and obstetric data. Three years after delivery, it was possible to get in touch by telephone with 120 of the 340 women who had been interviewed in the first study. They answered a second questionnaire about obstetric data, LUTS and its social impact. LUTS have been divided into stress urinary incontinence (SUI) and irritative urinary symptoms (IUS). McNemar's and chi-square tests were used for statistical analysis (p<0.05). RESULTS: SUI and nocturia have occurred in 57.5 and 80% of the pregnant women and the appearance of those symptoms after delivery, in 13.7 and 16.7%, respectively. Urge urinary incontinence has been significantly more frequent after delivery (30.5%) than in gestation (20.8%). Only 35.6% of the women with IUS presented social discomfort, but this rate has gone up to 91.4% in women with IUS associated with SUI. CONCLUSIONS: gestation, more than delivery, was associated with the appearance of SUI and nocturia, while the urge urinary incontinence was significantly higher after delivery. Most of the women have mentioned that SUI causes social problems.

[Prevalence of urinary symptoms in the third trimester of pregnancy]. / Prevalência de sintomas urinários no terceiro trimestre da gestação.

BACKGROUND: This study evaluated the prevalence of irritative bladder symptoms of women in the third trimester of pregnancy and the correlation to parity and route of delivery. METHODS: Between June and October 2003, 340 women attending the prenatal clinic at the Department of Obstetrics and Gynecology, State University of Campinas (Unicamp) were selected for study. RESULTS: On the total, 80.6% presented nocturia, 70.3% presented urinary frequency and 44.4% presented urgency. No statistic correlation was observed between irritative bladder symptoms and route of delivery however, when considering parity, nocturia and urinary frequency were significantly more frequent in multiparous women. CONCLUSION: In the population under study pregnancy per se was associated to a high prevalence of irritative bladder symptoms.

Prevalência de sintomas urinários no terceiro trimestre da gestação / Prevalence of urinary symptoms in the third trimester of pregnancy

OBJETIVO: O objetivo deste estudo foi avaliar a prevalência de sintomas urinários irritativos no terceiro trimestre da gestação e a correlação destes com a paridade e a forma de término de partos anteriores. MÉTODOS: Foram selecionadas 340 gestantes no terceiro trimestre da gestação, atendidas no Ambulatório de Pré-Natal do Hospital das Clínicas da Unicamp, entre junho e outubro de 2003. O desenho consistiu em um estudo analítico de corte transversal. RESULTADOS: Os sintomas mais prevalentes foram: noctúria (80,6 por cento); polaciúria (70,3 por cento) e urgência miccional (44,4 por cento). Embora não houvesse associação entre a prevalência de sintomas irritativos e a forma de término dos partos anteriores, observou-se correlação significativa entre multiparidade e os sintomas de enurese noturna, noctúria e freqüência urinária. CONCLUSÃO: Concluiu-se que, no grupo estudado, a gestação per se foi um fator de risco para a ocorrência de sintomas urinários irritativos.