Urinary symptoms and sexual function after hysterectomy secondary to cervical cancer: A prospective, cohort study.

INTRODUCTION AND HYPOTHESIS: The estimated worldwide incidence of cervical cancer (CC) is half a million cases per year. Surgical treatment is the mainstay approach for this condition. OBJECTIVES: To assess the effects of hysterectomy due to cervical cancer in urinary symptoms and sexual function and the disorder related impact on the quality of patients life. STUDY DESIGN: A cohort study was performed in Fortaleza/CE (Brazil) with 71 patients; of these, 31 were diagnosed with cervical cancer (G-CCU) and 40 with gynecological benign disease (G-PB). Sexual function (FSFI questionnaire), quality of life (SF-36 questionnaire) and urinary symptoms (KHQ instrument) were investigated in both groups at baseline (T0), one month (T1) and four months after surgery (T2). RESULTS: Both groups presented at baseline, similar urinary symptoms (p > 0.05), but this frequency doubled for the G-CCU group at T1 and remained unchanged at T2 (p = 0.012). G-PB's frequency of symptoms remained the same for 4 months after surgery. At baseline G-PB had higher risk for sexual dysfunction than G-CCU (82.5 % versus 54.8 %, p = 0.011). However for G-CCU, an increase of this percentage was perceived at T2.Women from the G-CCU group presented worse general and specific quality of life results. CONCLUSION: Women underwent to hysterectomy due to cervical cancer presented higher percentages of urinary symptoms, higher risk for sexual dysfunction and worse general and specific quality of life scores.

Can pelvic floor muscle training prevent perineal laceration? A systematic review and meta-analysis.

BACKGROUND: Pelvic floor muscle training (PFMT) is reportedly able to reduce risk factors for perineal trauma. However, the effects of these exercises on perineal injuries are unclear. OBJECTIVE: To investigate the effectiveness of PFMT in the prevention of perineal laceration. SEARCH STRATEGY: Searches were conducted in PubMed/Medline, LILACS, Scopus, Cochrane Library, Web of Science, and CINAHL. For search strategies, we combined the terms PFMT, tear, laceration, perineum, and delivery. SELECTION CRITERIA: We included randomized controlled trials that evaluated the effectiveness of PFMT for the prevention of perineal laceration during vaginal delivery. There were no period or language limitations. DATA COLLECTION AND ANALYSIS: We conducted data extraction and synthesis. We performed a quality appraisal, a qualitative synthesis, and for meta-analysis we used the Software R. MAIN RESULTS: Nine studies were included. In most studies, PFMT was performed daily, with a wide range of the number of contractions and sustainability. Prevalence of perineal laceration had a wide range and information on laceration degree was limited. Meta-analysis showed that PFMT was not effective to prevent perineal laceration. CONCLUSION: Pelvic floor muscle training does not prevent perineal laceration. Further studies are needed to investigate different protocols and interventions.

Lower urinary tract symptoms in female prison inmates: prevalence and impact on quality of life.

INTRODUCTION AND HYPOTHESIS: The objective was to estimate the prevalence and assess the impact of lower urinary tract symptoms (LUTS) on the quality of life of incarcerated women. METHODS: Cross-sectional study conducted with 307 incarcerated women from the state of Ceará, Brazil, from June to September 2018. To identify the prevalence of symptoms, an instrument was developed according to the recommendations of the International Continence Society. To assess the frequency, intensity, and impact of the identified symptoms on quality of life, the International Consultation on Incontinence Questionnaire-Short Form and King's Health Questionnaire were applied. RESULTS: The profile of the inmates was mostly young women (mean = 32.9 ± 11.8 years), Black, who had been in prison for a mean of 17.3 ± 12.0 months. Approximately half (n = 152, 49.5%) presented with storage complaints, with emphasis on urinary incontinence (n = 61, 19.9%), nocturia (n = 55, 17.9%), and urinary urgency (n = 45, 14.7%). Among the voiding symptoms (n = 71, 23.1%), dysuria (n = 39, 12.7%), and recurrent UTI (n = 44, 14.3%) were the most frequent. The complaint of incomplete bladder emptying (19.5%) was mentioned by 60 of the inmates. Sociodemographic data and environmental conditions were mainly associated with storage symptoms (p = 0.019). Women from prisons 2 and 3 presented with a greater impact on the quality of life. CONCLUSIONS: The high prevalence of LUTS in female inmates, together with unhealthy toileting behaviors within the prison units, indicate that incarceration might play a role in the occurrence of these symptoms, while also affecting quality of life. The acknowledgement and investigation of these symptoms is important for improving health care in prisons.

Knowledge, attitude, and practice instruments for urinary incontinence: A psychometric review.

AIMS: To analyze the psychometric properties of instruments measure knowledge and/or attitude and/or practice related to urinary incontinence (UI). METHODS: This review was conducted in September 2018 without restrictions regarding language and year of publication. DATA SOURCES: MEDLINE/PubMed, CINAHL, SCOPUS, PsycINFO, Web of Science, Cochrane, LILACS, and Google. The psychometric properties were evaluated using the COnsensus-based Standards for the selection of health status Measurement INstruments and the Quality Criteria for Measurement Properties. RESULTS: A total of seven articles published between 1999 and 2018 were included. The evaluation of the psychometric properties showed that the majority of the instruments presented "excellent" or "good" methodological quality; however, the description of aspects related to the validation stages was inadequate in some studies, causing the quality of the results to be evaluated as "indeterminate" in some properties. This review cannot recommend any questionnaire without reservations; however, the Urinary Incontinence Scales and the Barriers Incontinence Care Seeking Questionnaire presented better evaluations, regarding both methodological quality and the quality of the results. CONCLUSION: This review provides a strategy to select the most suitable instrument to assess knowledge, attitude, and practice regarding UI, according to the psychometric properties, guiding their use by researchers in clinical practice.