Symptomatic and anatomic improvement of pelvic organ prolapse in vaginal pessary users.

INTRODUCTION AND HYPOTHESIS: The vaginal pessary is a conservative method for treating pelvic organ prolapse (POP). It is able to reduce symptoms with minimal complications, improving quality of life (QOL). This study's hypothesis was that the use of pessaries decreases quantitative measures and improves women's QOL. We aimed to evaluate the effects of the use of a ring pessary on the quantitative measurements of POP by the Pelvic Organ Prolapse Quantification (POP-Q) and on QOL. METHODS: Prospective cohort study divided in two stages. In stage I POP-Q and QOL were assessed prior to the use of the ring pessary and in stage II after its use for at least 4 months with pessary removal 72 h before clinical evaluation. Wilcoxon tests were performed for necessary comparisons and Spearman's tests for calculating correlations. RESULTS: One hundred thirty-six women were evaluated, of which 50 were included. There was a decrease in POP in at least one of the vaginal compartments in the women included. When assessing individual measures (Ba, Bp and C), reductions in all measures were observed. There was also an improvement in the general and specific quality of life of women. CONCLUSION: The ring pessary proved to be a good therapeutic option, with a reduction in POP-Q measurements and/or absence of POP progression in the short term and an improvement in women's QOL.

A systematic review of the prevalence, risk factors, and impact of pelvic floor dysfunctions in nurses.

AIM: To investigate the prevalence, risk factors, and impact of pelvic floor dysfunctions in female nurses. DESIGN: A systematic review. DATA SOURCES: Searches were conducted in the following five electronic databases: PubMed/Medline, LILACS, SCIELO, Cochrane Library, and CINAHL. There were no period or language limitations. REVIEW METHODS: Data extraction and synthesis were conducted and the appraisal of the quality of the studies was performed using the Joanna Briggs Institute critical appraisal tool checklist for prevalence data. RESULTS: A total of 15 studies were included. The symptoms investigated were lower urinary tract symptoms, including urinary incontinence and its subtypes, sexual dysfunctions, constipation, faecal incontinence, and dual incontinence. Overall, prevalence ranged from 9.9% to 89.6%. Associated factors related to occupational roles were lifting heavy weights and poor bladder habits. Quality of life was significantly worse for nurses with pelvic floor disorders. CONCLUSION: Pelvic floor dysfunctions are very common among female nurses, considerably affecting their quality of life. Additional studies are needed to investigate the impact on work productivity, causal relationships with the occupation and the performance of prevention and treatment interventions directed toward this population.

Pelvic floor muscle function and quality of life in postmenopausal women with and without pelvic floor dysfunction.

INTRODUCTION: This study aims to compare pelvic floor muscle (PFM) function in postmenopausal women with and without pelvic floor dysfunction (PFD) and the relation between PFM function and quality of life. MATERIAL AND METHODS: A case-control study with 216 postmenopausal women with (n = 126) and without (n = 90) PFD. PFM function was assessed by digital vaginal palpation using the PERFECT scale. Specific quality of life was evaluated using the King's Health Questionnaire for women with urinary incontinence and the Prolapse Quality-of-Life Questionnaire for women with pelvic organ prolapse. We analyzed women with PFD into two categories: Oxford's grade ≤2 or ≥3 using a chi-squared test. RESULTS: Out of 126 womem with PFD 44 (34.9%) presented stress urinary incontinence, 21 (16.6%) had pelvic organ prolapse and 61 (48.4%) had urinary incontinence + pelvic organ prolapse. Strength had a median value 2 (0-5) in all women studied and most of them had insufficient strength, reduced endurance and repetition without statistical difference between groups. Incontinent women with strength ≤2 had worse perception of general health domain of King's Health Questionnaire (p = 0.007). No association was found between PFM function and Prolapse Quality-of-Life Questionnaire. CONCLUSIONS: PFM function assessed by bidigital palpation in postmenopausal women was not sufficiently sensitive to differentiate between women with vs. women without PFM dysfunction and was not related with specific quality of life in women with urinary incontinence and pelvic organ prolapse, respectively. These data should be used to reinforce the widespread recommendation that PFM training is essencial in PFD treatment.

Conhecimento, Atitude e Prática de Gestantes Sobre Incontinência Urinária: Estudo Observacional / Knowledge, Attitude, and Practice of Pregnant Women About Urinary Incontinence: Observational Study / Conocimiento, Actitud y Práctica De Gestantes Sobre la Incontinencia Urinaria: Estudio Observacional

Objetivo:avaliar o conhecimento, a atitude e a prática (CAP) de gestantes sobre incontinência urinária (IU), identificar a prevalência de IU durante a gestação, avaliar seu impacto na qualidade de vida (QV) e identificar os fatores associados ao CAP inadequados em relação à IU. Metodologia: Estudo observacional realizado de maio a novembro de 2019 na cidade de Fortaleza, Ceará. Utilizaram-se dois instrumentos para coleta de dados: um para avaliação sociodemográfica, obstétrica e de perdas urinárias e outro para avaliação do CAP sobre IU. Resultados: Participaram 237 gestantes. A prevalência de IU foi de 49,3% e observou-se baixo impacto na QV. A maioria apresentou conhecimento (89,6%) e prática inadequados tanto para prevenir (89,2%) quanto para tratar (78,8%) a IU. Identificaram-se baixos percentuais de acerto relacionados ao conhecimento sobre fatores de risco (46,8%), prevenção (43,8%) e tratamento da IU (42,8%). Apesar disso, a atitude foi considerada adequada para a maioria das mulheres (98,5%). Ausência de orientação sobre o preparo do períneo para o parto durante o pré-natal (p = 0,019), baixa escolaridade (p < 0,001), casos mais leves de IU (p = 0,027) e gestação de alto risco (p = 0,004) associaram-se a prática inadequada. Conclusão: o conhecimento sobre causas, prevenção e tratamento da IU é insuficiente e interfere no manejo dessa condição.perineum for childbirth during prenatal care (p = 0.019), low education (p < 0.001), milder cases of UI (p = 0.027) and high-risk pregnancy (p = 0.004) were associated with inappropriate practice. Conclusions: knowledge about the causes, prevention and treatment of UI is insufficient and interferes with the management of this condition.

Objectives:To assess the knowledge, attitude and practice (KAP) of pregnant women about urinary incontinence (UI), identify the prevalence of UI, assess its impact on quality of life (QoL) and identify factors associated with inadequate KAP in relation to UI. Methodology: Observational study carried out from May to November 2019 in the city of Fortaleza, Ceará, Brazil. Two instruments were used for data collection: one for sociodemographic, obstetric and urinary loss assessment and another for KAP assessment on UI. Results: 237 pregnant women participated. The prevalence of UI was 49.3% and a low impact on QoL was observed. Most had knowledge (89.6%) and inadequate practice both to prevent (89.2%) and to treat (78.8%). Low percentages of correct answers were identified related to knowledge about risk factors (46.8%), prevention (43.8%) and treatment of UI (42.8%). Despite this, the attitude was considered adequate for most women (98.5%). Absence of guidance on preparation of the perineum for childbirth during prenatal care (p = 0.019), low education (p < 0.001), milder cases of UI (p = 0.027) and high-risk pregnancy (p = 0.004) were associated with inappropriate practice. Conclusions: knowledge about the causes, prevention and treatment of UI is insufficient and interferes with the management of this condition.

Objetivos:evaluar el conocimiento, la actitud y la práctica (CAP) de las gestantes sobre la incontinencia urinaria (IU), identificar la prevalencia de la IU, evaluar su impacto en la calidad de vida (CV) e identificar los factores asociados a una PAC inadecuada en relación con la IU. Metodología: estudio observacional realizado de mayo a noviembre de 2019 en la ciudad de Fortaleza/CE. Se utilizaron dos instrumentos para la recolección de datos: uno para la evaluación sociodemográfica, obstétrica y de pérdidas urinarias y otro para la evaluación del CAP en la IU. Resultados: Participaron 237 gestantes. La prevalencia de IU fue del 49,3% y se observó un bajo impacto en la CV. La mayoría tenía conocimiento (89,6%) y práctica inadecuada tanto para prevenir (89,2%) como para tratar (78,8%). Se identificaron bajos porcentajes de aciertos relacionados con el conocimiento sobre factores de riesgo (46,8%), prevención (43,8%) y tratamiento de la IU (42,8%). A pesar de ello, la actitud fue considerada adecuada por la mayoría de las mujeres (98,5%). La ausencia de orientación sobre la preparación del perineo para el parto durante el control prenatal (p = 0,019), la baja escolaridad (p < 0,001), los casos más leves de IU (p = 0,027) y el embarazo de alto riesgo (p = 0,004) se asociaron con una atención inadecuada. práctica. Conclusión: el conocimiento sobre las causas, la prevención y el tratamiento de la IU es insuficiente e interfiere con el manejo de esta condición.

Quality of life of Brazilian women with urinary incontinence and the impact on their sexual function.

INTRODUCTION AND OBJECTIVE: Sexual function may be affected in women with urinary incontinence (UI), but data regarding this association are controversial. The aim of this study was to assess the impact of sociodemographic characteristics in the sexual function of Brazilian women with UI. STUDY DESIGN: Cross-sectional study with 251 women with UI in the period from April to June 2014. Firstly, sociodemographic and pelvic floor dysfunctions (PFD) characteristics were compared between groups of women with and without sexual activity. Secondly, we compared the variables above with the total score of Pelvic Organ Prolapse and/or Urinary Incontinence Sexual Questionnaire (PISQ-12). For continuous variables, we used the Mann-Whitney or Kruskal-Wallis test; for categorical variables we used the chi-square statistic considering the difference of p<0.05. RESULTS: Women with sexual activity tend to be younger, to be premenopausal, have a steady partner and not be hypertensive. The mean total score of PISQ-12 was 27.30. Women who attended elementary school, with coital UI, with moderate constipation and symptomatic prolapse have worse sexual function. Premenopausal women with mixed urinary incontinence have worse sexual function than those with stress urinary incontinence. CONCLUSION: The association between sexual dysfunction and UI deserves special attention from health professionals. The care of the maintenance or restoration of sexual well-being should be offered to all women, regardless of age, since UI may affect sexual life and QoL of these women.