RESUMO
Urinary incontinence is a dysfunction that affects 20%-50% of the women in Spain, depending on age. Even though it does not involve a prognosis of severity, it reduces self-esteem, limits independence and clear deteriorates quality of life. The diagnosis is generally made following the international criteria collected in the clinical practice guidelines. Even if it is true that the symptoms make it possible to suspect the nature of the functional disorder, this is not always sufficient or conclusive and there may be errors even in the clearest cases. Even so, the need to conduct a urodynamic study in the assessment of women with urinary incontinence diagnosed according to the symptoms mentioned continues to be debatable and there are no unified and defined criteria in our setting in regards to when it is necessary to request urodynamic tests.
Assuntos
Incontinência Urinária/diagnóstico , Feminino , Humanos , Inquéritos e Questionários , UrodinâmicaRESUMO
La incontinencia urinaria es una disfunción que afecta en España al 20%-50% de las mujeres dependiendo de la edad, y a pesar de que no implica un pronóstico de gravedad, reduce la autoestima, limita la autonomía y deteriora sensiblemente la calidad de vida. El diagnóstico se realiza generalmente siguiendo los criterios internacionales recogidos en las guías de práctica clínica, y si bien es verdad que la clínica permite sospechar la naturaleza del desorden funcional, ésta no siempre es suficiente ni concluyente e incluso en los casos más claros puede haber errores. Aun así, la necesidad de realizar estudio urodinámico en la valoración de las mujeres con incontinencia urinaria diagnosticada según la sintomatología referida sigue siendo controvertido y no existe en nuestro medio criterios unificados y definidos en cuanto a cuándo es preciso solicitar pruebas de urodinamia
Urinary incontinence is a dysfunction that affects 20%-50% of the women in Spain, depending on age. Even though it does not involve a prognosis of severity, it reduces self-esteem, limits independence and clear deteriorates quality of life 1. The diagnosis is generally made following the international criteria collected in the clinical practice guidelines. Even if it is true that the symptoms make it possible to suspect the nature of the functional disorder, this is not always sufficient or conclusive and there may be errors even in the clearest cases. Even so, the need to conduct a urodynamic study in the assessment of women with urinary incontinence diagnosed according to the symptoms mentioned continues to be debatable and there are no unified and defined criteria in our setting in regards to when it is necessary to request urodynamic tests
Assuntos
Feminino , Humanos , Incontinência Urinária/diagnóstico , Inquéritos e Questionários , UrodinâmicaRESUMO
OBJECTIVES: Presentation of two clinical cases of partial deficiency in hydroxylase 21 (PD in H21), examination of their clinical characteristics and discussion on the value of diagnostic hormonal determinations. SETTING: Narón health centre, La Coruña. PATIENTS: Two clinical cases who attended our centre in 1991 and 1992 because of the appearance of facial hair and facial acne, respectively. MEASUREMENTS AND MAIN RESULTS: Basal determinations of cortisol, dehydroepiandrosterone sulphate (DHEA-S), 4-androstendion (A), 17-hydroxyprogesterone (17-HP), free testosterone (T-1), LH and FSH were performed. The first four were then also determined after an injection of 0.25 mg of ACTH. According to the findings, the first case was a clear PD in H21, whereas the second was a light form of the disorder. CONCLUSIONS: PD in H21 accounts for a considerable percentage of patients who attend because of hirsutism. For its diagnosis it is advisable to perform a stimulation test with ACTH and then obtain the 17-HP levels, along with the increment, 30 minutes after the injection. The levels should be triple that of the values for normal women.
