The results of a 24-h pad test in Brazilian women.

INTRODUCTION AND HYPOTHESIS: The International Continence Society (ICS) adopted 1.3 g as the normative value for the 24-h pad test. We hypothesized that this cutoff value may not be valid for women who live in countries with high temperatures. METHODS: We documented the 24-h pad test values of continent women in Brazil and investigated the factors that can influence in vaginal humidity. RESULTS: The sample consisted of 257 participants. The temperatures ranged from 19°C to 27.8°C. The median increase in the weight of the pad was 1.9 g (1.4-3.0 g, 95th percentile 4.4 g). Pad test results differed significantly between pre- and postmenopausal women (p = 0.026). There was a significant difference in the pad weights of women who use hormone therapy (p = 0.003). CONCLUSIONS: The value of the 24-h pad test established by the ICS was not valid for the investigated sample. Environmental conditions, menopausal status, and use of hormone therapy can interfere with the values of the pad test.

Evaluation of demographic, clinical characteristics, and genetic polymorphism as risk factors for pelvic organ prolapse in Brazilian women.

OBJECTIVE: Verify the association between genital prolapse, other risk factors and a polymorphism in exon 31 of the collagen III-a1 gene (COL3A1). SETTING: The etiology of genital prolapse is multifactorial, and genetic defects have been proposed. Also, there is evidence that changes in collagen may be responsible for defects in pelvic floor support. The exon 31 polymorphism results in structural changes in the triple helical of the collagen and appears to lead to abnormal synthesis of type III collagen. DESIGN: Basic science study. POPULATION: The studied group consisted of 107 patients with stage III and IV genital prolapse (POP-Q). The control group included 209 women with stage 0 and I prolapse. METHODS: After extracting genomic DNA from the peripheral blood, the exon 31 COL3A1 polymorphism was typed by restriction fragment length polymorphism analysis. MAIN OUTCOME MEASURES: Association between genital prolapse and exon 31 COL3A1 polymorphism. RESULTS: No statistically significant differences in genotype and allele frequencies were found between cases and controls (P = 0.75 and 0.66, respectively). Multiple logistic regression analyses identified age (OR = 1.05; 95%CI = 1.01-1.10), BMI (OR = 1.09; 95%CI = 1.01-1.17), presence of at least one vaginal delivery (OR = 7.22; 95%CI = 1.84-28.27), positive family history of POP (OR = 2.27; 95%CI = 1.05-4.93) and a macrosomic foetus (OR = 2.91; 95%CI = 1.24-6.79) as independent risk factors for genital prolapse. In contrast, the number of caesarean deliveries was found to be an independent protective factor (OR = 0.43; 95%CI = 0.24-0.78). CONCLUSIONS: The type III collagen exon 31 polymorphism is not a risk factor for pelvic genital prolapse in this sample.

Intensive supervised versus unsupervised pelvic floor muscle training for the treatment of stress urinary incontinence: a randomized comparative trial.

INTRODUCTION AND HYPOTHESIS: Pelvic floor muscle training (PFMT) is considered to be the first-line treatment for female stress urinary incontinence (SUI). There are few studies that have tested the efficacy of unsupervised PFMT. The aim of this study was to compare the effectiveness of intensive supervised PFMT to unsupervised PFMT in the treatment of female SUI. METHODS: Sixty-two women with SUI were randomized to either supervised or unsupervised PFMT after undergoing supervised training sessions. They were evaluated before and after the treatment with the Oxford grading system, pad test, quality of life questionnaire, subjective evaluation, and exercise compliance. RESULTS: After treatment, there were no differences between the two groups regarding PFM strength (p = 0.20), International Consultation on Incontinence Questionnaire-Short Form score (p = 0.76), pad test (p = 0.78), weekly exercise compliance (p = 0.079), and subjective evaluation of urinary loss (p = 0.145). CONCLUSIONS: Both intensive supervised PFMT and unsupervised PFMT are effective to treat female SUI if training session is provided.