Efectividad del entrenamiento muscular pélvico temprano en la fuerza de suelo pélvico, síntomas de incontinencia urinaria, función sexual y calidad de vida en pacientes posprostatectomía radical: revisión sistemática de ensayos clínicos aleatorizados / Effectiveness of early pelvic muscle training on pelvic floor strength, urinary incontinence symptoms, sexual function, and quality of life in post-radical prostatectomy patients: Systematic review of randomized clinical trials

Este estudio tuvo como objetivo evaluar la efectividad del entrenamiento muscular pélvico temprano para reducir los síntomas de incontinencia urinaria, mejorar la calidad de vida, función sexual y aumentar la fuerza de suelo pélvico en pacientes posprostatectomía radical. Se realizó una búsqueda en 8 bases de datos hasta el 26 de octubre de 2022, se evaluó la calidad metodológica y el riesgo de sesgo de 14 estudios incluidos (n=1236), se calculó la evidencia y el metaanálisis. El entrenamiento redujo significativamente los síntomas de incontinencia urinaria en comparación con un grupo control (DME=−2,80; IC 95%=−5,21 a −0,39; p=0,02), con heterogeneidad significativa (I2=83%; p=<0,0001) y evidencia moderada. Además, presentó evidencia moderada para mejorar la calidad de vida, y muy baja para mejorar la función sexual y fuerza de suelo pélvico. Estos resultados deben ser observados con precaución debido a la heterogeneidad significativa de los estudios analizados. (AU)

This study aimed to evaluate the effectiveness of early pelvic muscle training in reducing urinary incontinence symptoms, improving quality of life, sexual function, and increasing pelvic floor strength in post-radical prostatectomy patients. A search was carried out in 8 databases until October 26, 2022, the methodological quality and the risk of bias of 14 included studies (n=1236) were evaluated, moreover, the evidence and the meta-analysis were calculated. The intervention significantly reduced urinary incontinence symptoms compared to a control group (SMD=−2.80, 95% CI=−5.21 to −0.39, P=.02), with significant heterogeneity (I2=83%; P=<.0001) and moderate evidence. In addition, it presented moderate evidence to improve quality of life, and very low evidence to improve sexual function and pelvic floor strength. These results should be viewed with caution due to the significant heterogeneity of the studies analysed. (AU)

Pelvic floor training to prevent stress urinary incontinence: A systematic review.

INTRODUCTION: Stress urinary incontinence (SUI) is a common disorder in women that has a negative impact on quality of life. Pregnancy and childbirth are considered important risk factors that directly affect the pelvic floor during pregnancy and labour, increasing the risk of pelvic floor dysfunction, with prevalence rates of SUI in the postpartum period ranging from 30 to 47% during the first 12 months. OBJECTIVE: To determine the effectiveness of pelvic floor muscle training (PFMT) in the prevention of SUI in women during the antenatal and postnatal period by reviewing and evaluating the available scientific literature. METHODS: This is a systematic review, using only randomised controlled trials. We searched the databases Pubmed, Scopus, Cochrane and PEDro. We reviewed 7 prospective studies in English and Portuguese, which included 1,401 pregnant women of legal age who underwent PFMT to prevent SUI. RESULTS: The results allowed us to establish that PFMT is used for pelvic floor muscles and that this intervention, applied with the appropriate methodology, can prevent or cure SUI. CONCLUSIONS: The application of PFMT in an early stage of pregnancy has positive effects on the continence capacity after delivery.

The effect of electroacupuncture applied to women with stress urinary incontinence on urinary incontinence severity and symptoms: Systematic review and meta-analysis of randomized controlled trials.

INTRODUCTION: Stress Urinary Incontinence is a condition that impairs the quality of life in women and randomized controlled trials of electroacupuncture for stress urinary incontinence have been conducted. OBJECTIVE: The aim of this systematic review and meta-analysis was to examine the effect of electroacupuncture on the severity and symptoms of urinary incontinence in women with stress urinary incontinence. METHODS: Literature searches were conducted in PubMed, CINAHL, Scopus and Science Citation Index until November 2023. This study was based on the recommendations of the Cochrane guidelines. Data were analyzed using the Review Manager computer program (Version 5.4). The methodological quality of the studies was assessed using the RoB-2 tool. RESULTS: The analysis included 888 women with stress urinary incontinence and three studies. In women with stress urinary incontinence, electroacupuncture intervention improved urinary incontinence severity and quality of life (MD: -2.37, 95% CI: -3.29 to 1.45, Z = 5.07, p < 0.001), urinary leakage (SMD: -0.79, 95% CI: -1.02 to -0.55, Z = 6.60, p = 0.001) and incontinence episode frequency (SMD: -2.24, 95% CI: -4.17 to -0.32, Z = 2.29, p < 0.02). CONCLUSION: In women with stress urinary incontinence, electroacupuncture intervention decreased the severity of urinary incontinence and improved the quality of life. Symptoms related to urinary incontinence were found to decrease urinary leakage and incontinence episode frequency. The studies included in the analysis were determined to be low-risk studies in quality assessment.

Parir después de los 50 años. Estudio piloto observacional / Birth over 50: A pilot observational study

Objetivos: Evaluar si existe una mayor tasa de resultados obstétricos adversos, incontinencia urinaria posparto y problemas sexuales entre las mujeres que dan a luz después de los 50 años.Material y métodos: Estudio observacional ambispectivo de un solo centro. Se registraron la tasa de parto por cesárea, la diabetes gestacional, la preeclampsia, la restricción del crecimiento intrauterino (RCIU), la prematuridad, la incontinencia urinaria (Cuestionario de incontinencia en formato corto [ICIQ-SF]) y la disfunción sexual (índice de función sexual femenina [FSFI-6]). Resultados: Veinticinco (0,06%) de 38.510 nacimientos ocurrieron en mujeres mayores de 50 años durante el período de estudio en nuestro centro. Hubo 16 (64%) partos por cesárea. Siete (28%) mujeres padecieron diabetes gestacional. Se diagnosticó preeclampsia en 3 (12%) mujeres. Hubo 5 (20%) casos de RCIU. Hubo 5 (20%) partos prematuros. Las diferencias en la tasa de parto por cesárea, diabetes gestacional y RCIU entre el grupo de estudio y la población total fueron estadísticamente significativas. Los resultados de los cuestionarios ICIQ-SF y FSFI-6 se obtuvieron de 17 mujeres. Se encontró algún grado de incontinencia urinaria en 7 (41,1%) y disfunción sexual en 9 (52,9%) mujeres. Conclusiones: Los embarazos en mujeres mayores de 50 años parecen estar asociados con una mayor tasa de diabetes gestacional, RCIU y preeclampsia. Hay una alta prevalencia de incontinencia urinaria y problemas sexuales entre estas mujeres.(AU)

Objectives: To assess whether there is a higher rate of adverse obstetric outcomes, postpartum urinary incontinence, and sexual problems among women who give birth over 50. Material and methods: A single-center ambispective observational study. Rate of cesarean birth, gestational diabetes, preeclampsia, intrauterine growth restriction (IUGR), prematurity, urinary incontinence (Incontinence Questionnaire Short Form [ICIQ-SF]), and sexual dysfunction (Female Sexual Function Index [FSFI-6]) were recorded. Results: Twenty-five (0.06%) of 38,510 births occurred in women over 50 during the study period. There were 16 (64%) cesarean births. Seven (28%) women had gestational diabetes. Preeclampsia was diagnosed in 3 (12%) women. There were 5 (20%) cases of IUGR. There were 5 (20%) preterm births. The differences in the rate of cesarean birth, gestational diabetes, and IUGR between the study group and the total population were statistically significant. The results of the ICIQ-SF and FSFI-6 questionnaires were obtained from 17 women. Some degree of urinary incontinence was found in 7 (41.1%) and sexual dysfunction in 9 (52.9%) women. Conclusions: Pregnancies in women over 50 may be associated with a higher rate of gestational diabetes, IUGR, and preeclampsia. There is a high prevalence of urinary incontinence and sexual problems among these women.(AU)

The effect of telehealth on incontinence severity given to women with urinary incontinence: A systematic review and meta-analysis of randomized controlled trials.

INTRODUCTION: Although urinary incontinence does not cause mortality, it is a global health problem that adversely affects the quality of life and health of women. OBJECTIVE: The aim of this study was to conduct a systematic review and meta-analysis of the studies investigating the effect of telehealth given to women with urinary incontinence (UI) on the severity of incontinence. METHODS: The literature review for this systematic review was conducted between August-Semptember 2023 using four electronic databases. Y-based articles were scanned using MeSH-based keywords. Randomized Controlled Trials conducted over the last decade were included in the screening. RESULTS: The analysis included six studies involving 826 women with UI. After telehealth intervention, there was a significant difference in UI symptom severity (MD: -2.14 95% CI: -2.67 to -1.62, Z=8.03, p<0.00001) and quality of life (SMD: -2.14 95% CI: -2.67 to -1.62, Z=8.03, p<0.00001) compared to the control groups. It had no effect on sexuality (MD: -4.65 95% CI: -9.60 to 0.30, Z=1.84, p=0.07), and anxiety (SMD: -0.15, 95% CI: -0.38 to 0.08, Z=1.27, p=0.21). CONCLUSION: In this analysis, it was found that telehealth interventions performed on women with UI increased the quality of life while reducing the severity of incontinence in women, but had no effect on sexuality, and anxiety.

Prevalence and management of urinary incontinece after pelvic organ prolapse surgery (sacrocolpopexy). A literature review.

INTRODUCTION: Stress urinary incontinence (SUI) is frequently associated with pelvic organ prolapse (POP) and may occur after its surgical treatment. AIM: To determine the incidence, risk factors and management of SUI during and after POP surgery through a review of the available literature. MATERIALS AND METHOD: Narrative literature review on the incidence and management of SUI after POP surgery after search of relevant manuscripts indexed in PubMed, EMBASE and Scielo published in Spanish and English between 2013 and 2023. RESULTS: Occult SUI is defined as visible urine leakage when prolapse is reduced in patients without SUI symptoms. De novo SUI develops after prolapse surgery without having previously existed. In continent patients, the number needed to treat (NNT) to prevent one case of de novo SUI is estimated to be 9 patients and about 17 to avoid repeat incontinence surgery. In patients with occult UI, the NNT to avoid repeat incontinence surgery is around 7. Patients with POP and concomitant SUI are the group most likely to benefit from combined surgery with a more favorable NNT (NNT 2). CONCLUSION: Quality studies on combined surgery for treatment SUI and POP repair are lacking. Continent patients with prolapse should be warned of the risk of de novo SUI, although concomitant incontinence treatment is not currently recommended. Incontinence surgery should be considered on an individual basis in patients with prolapse and SUI.

[Effectiveness of early pelvic muscle training on pelvic floor strength, urinary incontinence symptoms, sexual function, and quality of life in post-radical prostatectomy patients: Systematic review of randomized clinical trials]. / Efectividad del entrenamiento muscular pélvico temprano en la fuerza de suelo pélvico, síntomas de incontinencia urinaria, función sexual y calidad de vida en pacientes posprostatectomía radical: revisión sistemática de ensayos clínicos aleatorizados.

This study aimed to evaluate the effectiveness of early pelvic muscle training in reducing urinary incontinence symptoms, improving quality of life, sexual function, and increasing pelvic floor strength in post-radical prostatectomy patients. A search was carried out in 8 databases until October 26, 2022, the methodological quality and the risk of bias of 14 included studies (n=1236) were evaluated, moreover, the evidence and the meta-analysis were calculated. The intervention significantly reduced urinary incontinence symptoms compared to a control group (SMD=-2.80, 95% CI=-5.21 to -0.39, P=.02), with significant heterogeneity (I2=83%; P=<.0001) and moderate evidence. In addition, it presented moderate evidence to improve quality of life, and very low evidence to improve sexual function and pelvic floor strength. These results should be viewed with caution due to the significant heterogeneity of the studies analysed.

Knowledge of nursing staff before and after training on incontinence-associated dermatitis / Conocimientos del personal de enfermería antes y después de la formación sobre la dermatitis asociada a la incontinencia / Conhecimento da equipe de enfermagem antes e após capacitação sobre dermatite associada à incontinência

ABSTRACT Objective: To verify the knowledge of nursing staff before and after training on incontinence-associated dermatitis. Method: A study before and after an educational intervention carried out with nursing staff from the medical and surgical clinics and intensive care unit of the university hospital in June 2023. The training took place over three meetings. Data was collected using a questionnaire administered immediately before and after the training. McNemar's test for dependent samples was used to compare before and after training. Results: 25 nurses and 14 nursing technicians took part. The items that showed statistical significance were related to the identification and correct differentiation of dermatitis associated with incontinence and pressure injury; and the correct way to sanitize the skin. Conclusion: The training of the nursing team made it possible to assess their knowledge of how to identify, prevent and treat incontinence-associated dermatitis.

RESUMEN Objetivo: Verificar los conocimientos del personal de enfermería antes y después de la formación sobre la dermatitis asociada a la incontinencia. Método: Estudio antes y después de una intervención formativa realizada con personal de enfermería de las clínicas médicas y quirúrgicas y de la unidad de cuidados intensivos de un hospital universitario en junio de 2023. La formación se impartió en tres sesiones. Los datos se recogieron mediante un cuestionario aplicado inmediatamente antes y después de la formación. Se utilizó la prueba de McNemar para muestras dependientes para comparar antes y después de la formación. Resultados: Participaron 25 enfermeras y 14 técnicos de enfermería. Los ítems que mostraron significación estadística estaban relacionados con la identificación y correcta diferenciación de la dermatitis asociada a la incontinencia y al daño por presión; y la forma correcta de higienizar la piel. Conclusión: La formación del equipo de enfermería permitió evaluar los conocimientos del equipo de enfermería sobre cómo identificar, prevenir y tratar la dermatitis asociada a la incontinencia.

RESUMO Objetivo: Verificar o conhecimento da equipe de enfermagem antes e após capacitação sobre dermatite associada à incontinência. Método: Estudo antes e depois de uma intervenção educativa realizado com profissionais da equipe de enfermagem das clínicas médicas, cirúrgicas e unidade de terapia intensiva do hospital universitário, no mês de junho de 2023. A capacitação ocorreu durante três encontros. Os dados foram coletados por meio de questionário, aplicado imediatamente antes e após a capacitação. Para a comparação do antes e após capacitação, foi realizado o teste de McNemar para amostras dependentes. Resultados: Participaram 25 enfermeiros e 14 técnicos de enfermagem. Os itens que apresentaram significância estatística foram relacionados à identificação e à diferenciação correta da dermatite associada à incontinência e lesão por pressão; e a forma correta para higienização da pele. Conclusão: A capacitação da equipe de enfermagem permitiu avaliar o conhecimento da equipe de enfermagem para identificar, prevenir e tratar a dermatite associada à incontinência.

Dando voz aos homens: repercussões do viver com incontinência urinária e a prática sexual / Giving men a voice: repercussions of living with urinary incontinence and sexual practice / Dando voz a los hombres: repercusiones de vivir con incontinencia urinaria y la práctica sexual

Objetivo: compreender as repercussões da incontinência urinária na prática sexual de homens. Método: estudo descritivo, qualitativo, apoiado na teoria de Dorothea Orem, realizado em uma clínica de atenção especializada à população com incontinência urinária do Rio de Janeiro, em 2020, com 18 homens maiores de 18 anos, com esse diagnóstico médico, após aprovação pelo Comitê de Ética em Pesquisa. Para coleta dos dados, aplicou-se a entrevista semiestruturada, transcrita e submetida à análise de conteúdo. Resultados: a incontinência urinária acarreta, aos indivíduos, medo da rejeição e sentimentos de baixa autoeficácia, pois acreditam que não satisfazem seus parceiros sexuais, o que compromete os relacionamentos afetivosexuais. Bem como, interfere no desenvolvimento das atividades cotidianas ocasionando o afastamento das redes de apoio, além do sentimento de frustração e impotência, que comprometem a qualidade de vida dos homens. Conclusão: a incontinência urinária acarreta isolamento social, constrangimento, vergonha, baixa autoestima e insatisfação sexual dos homens acometidos.

Objective: to understand the repercussions of urinary incontinence in the sexual practice of men. Method: descriptive, qualitative study, supported by Dorothea Orem's theory, carried out in a polyclinic in Rio de Janeiro, in 2020, with 18 men over 18 years old, with urinary incontinence, after approval by the Research Ethics Committee. For data collection, a semi-structured interview was applied, transcribed and submitted to content analysis. Results: urinary incontinence causes in individuals fear of rejection and feelings of low self-efficacy, as they believe that they do not satisfy their sexual partners, which compromises affective-sexual relationships. As well as it interferes in the development of daily activities, causing the removal of support networks, in addition to the feeling of frustration and impotence, which compromise the quality of life of men. Conclusion: urinary incontinence causes social isolation, embarrassment, shame, low self-esteem and sexual dissatisfaction in affected men.

Objetivo: comprender las repercusiones de la incontinencia urinaria en la práctica sexual de los hombres. Método: estudio descriptivo, cualitativo, basado en la teoría de Dorothea Orem, realizado en una clínica de atención especializada a la población con incontinencia urinaria de Río de Janeiro, en 2020, con 18 hombres mayores de 18 años, con ese diagnóstico, después de la aprobación por el Comité de Ética en Investigación. La recolección de datos se hizo por medio de una entrevista semiestructurada, transcrita y sometida al análisis de contenido. Resultados: la incontinencia urinaria provoca miedo al rechazo y sentimientos de baja autoeficacia, ya que creen que no satisfacen a sus parejas, lo que comprometen las relaciones afectivosexuales. Además, interfiere en el desarrollo de las actividades cotidianas, provocando aislamiento de las redes de apoyo, y también sentimiento de frustración e impotencia, comprometiendo la calidad de vida. Conclusión: la incontinencia urinaria provoca aislamiento social, vergüenza, baja autoestima e insatisfacción sexual en los hombres afectados.

Manejo Clínico da Incontinência Urinária em Mulheres Por Enfermeiros da Estratégia de Saúde da Família / Clinical Management of Urinary Incontinence in Women by Family Health Strategy Nurses / Manejo Clínico de la Incontinencia Urinaria en la Mujer Por Enfermeras de la Estrategia de Salud de la Familia

Objetivo:Analisar a atuação dos enfermeiros da Estratégia de Saúde da Família (ESF) no manejo clínico da incontinência urinária em mulheres numa área de planejamento do município do Rio de Janeiro (RJ). Método:Pesquisa descritiva, com abordagem quantitativa, realizada em sete Unidades Básicas de Saúde, no município do Rio de Janeiro. A amostra foi composta de 27 enfermeiros que atuavam na ESF. A análise dos dados deu-se por meio de estatística descritiva simples, com descrição de frequência relativa e absoluta. Resultados: Evidenciaram-se fragilidades na identificação dos aspectos que envolvem a abordagem precoce, os fatores de risco para o seu desenvolvimento, o tratamento e as atividades educativas. Conclusão: Apesar de se reconhecer que a ESF possui os recursos para o tratamento da incontinência urinária não complicada, algumas ações não são realizadas pelo enfermeiro, como envolver a equipe no cuidado das mulheres com esse acometimento, prescrever exercícios de fortalecimento do assoalho pélvico e avaliar e realizar o tratamento não farmacológico, bem como a investigação das mulheres sem queixa de perda urinária. Portanto, os resultados indicam a necessidade premente de capacitação dos enfermeiros que atuam na ESF.

Objective:To analyze the performance of nurses from the Family Health Strategy (ESF) in the clinical management of urinary incontinence in women in a planning area in the city of Rio de Janeiro (RJ), Brazil. Method:Descriptive research, with a quantitative approach, was carried out in seven Basic Health Units, in the city of Rio de Janeiro. The sample consisted of 27 nurses who worked in the ESF. Data analysis was performed using simple descriptive statistics, with a description of relative and absolute frequency. Results: Weaknesses were shown in the identification of aspects involving an early approach, risk factors for its development, treatment, and educational activities. Conclusion: Despite recognizing that the ESF has the resources for the treatment of uncomplicated urinary incontinence, some actions are not carried out by the nurses, such as involving the team in the care of women with this condition, prescribing exercises to strengthen the pelvic floor and evaluating and carry out non-pharmacological treatment, as well as the investigation of women without complaints of urinary loss. Therefore, the results indicate the urgent need for training of nurses who work in the ESF

Síndromes geriátricos y abandono

Fundamento: el abandono en la vejez es un condicionante de muchos trastornos de salud y constituye en mayor medida una condición de gran incidencia a nivel mundial. Objetivo: comparar los síndromes geriátricos y el abandono en pacientes adultos mayores. Métodos: se realizó un estudio transversal, descriptivo, analítico y correlacional, en la Unidad de Medicina Familiar No. 33 del Instituto Mexicano del Seguro Social de Tabasco. La muestra se conformó con 203 pacientes de 60 años y más, que acudieron a consulta de Medicina Familiar y Atención Médica Continua. Se aplicaron 3 instrumentos: la escala de Pfeiffer, el International Consultation on Incontinence Questionnaire Short-Form, la Escala de Percepción de Abandono del Adulto Mayor y se interrogó sobre el consumo de medicamentos prescritos y automedicados. Resultados: existió relación entre los síndromes geriátricos y el abandono, como se comprobó en la correlación entre las variables analizadas. El deterioro cognitivo leve, moderado y severo, se encontró en bajas proporciones. El 40,7 % de los pacientes aceptó tener incontinencia urinaria. La presencia de polifarmacia se encontró en altas proporciones. Conclusiones: los síndromes geriátricos presentes en el estudio fueron: deterioro cognitivo, polifarmacia e incontinencia urinaria, más la presencia de ser soltero, viudo o divorciado muestran una relación significativa para sufrir abandono.

Foundation: abandonment in old age is a condition of many health disorders and is, to a greater extent, a condition of high incidence worldwide. Objective: to compare geriatric syndromes and abandonment in older adult patients. Methods: a cross-sectional, descriptive, analytical and correlational study was carried out in the Family Medicine Unit No. 33 of the Mexican Social Security Institute of Tabasco. The sample was made up of 203 patients aged 60 and over, who attended Family Medicine and Continuing Medical Care consultations. Three instruments were applied: the Pfeiffer scale, the International Consultation on Incontinence Questionnaire Short-Form, the Perception of Abandonment Scale for the Elderly, and questions were asked about the consumption of prescribed and self-medicated medications. Results: there is a relationship between geriatric syndromes and abandonment, as verified in the correlation between the variables analyzed. Mild, moderate and severe cognitive impairment was found in low proportions. 40.7 % of the patients accepted having urinary incontinence. The presence of polypharmacy was found in high proportions. Conclusions: the geriatric syndromes present in the study such as: cognitive impairment, polypharmacy and urinary incontinence, plus the presence of being single, widowed or divorced show a significant relationship to suffering abandonment.

Proposta de protocolo clínico para tratamento conservador da incontinência urinária de urgência / Proposal for a clinical protocol for the conservative treatment of urge urinary incontinence / Propuesta de protocolo clínico para el tratamiento conservador de la incontinencia urinaria de urgencia

Objetivo:Apresentar proposta de protocolo clínico para tratamento conservador da incontinência urinária de urgência (IUU). Método: Relato de experiência fundamentado nas evidências científicas existentes e na experiência clínica dos autores que realizam consultas de enfermagem a pessoas com IUU, delineada conforme proposição do Ministério da Saúde para elaboração de protocolos clínicos. Resultados: Foi proposto um protocolo clínico com diagnóstico e intervenções de enfermagem baseados na North American Nursing Diagnosis Association (NANDA) e na Nursing Interventions Classifications, com etapas sistematizadas em verificar presença de fatores relacionados ou condições associadas ao diagnóstico, sendo eles: assoalho pélvico hiperativo, ansiedade, constipação, infecção urinária, baixa ingestão hídrica, comportamento sanitário inadequado, diabetes mellitus, prolapso de órgão pélvico, alto consumo de potenciais irritantes vesicais e persistência de sintomas. Logo após, as ações que devem ser implementadas pelo enfermeiro são descritas de forma detalhada. Conclusão: Considera-se que o fluxo e o detalhamento das ações apresentadas possam ser adotados pelos enfermeiros de forma a identificarem e tratarem pessoas com IUU, minimizando assim a prevalência do problema e fomentando a qualidade de vida dessas pessoas.

Objective: To present a proposal for a clinical protocol for the conservative treatment of urge urinary incontinence. Method: Experience report based on existing scientific evidence and clinical experience of authors who perform nursing consultations for people with urge urinary incontinence, outlined in accordance with the Brazilian Ministry of Health's proposal for the elaboration of clinical protocols. Results: A clinical protocol was proposed with nursing diagnosis and interventions based on the North American Nursing Diagnosis Association (NANDA) and Nursing Interventions Classifications (NIC), with systematized steps to verify the presence of related factors or conditions associated with the diagnosis, namely: hyperactive pelvic floor, anxiety, constipation, urinary tract infection, low fluid intake, inadequate sanitary behavior, diabetes mellitus, pelvic organ prolapse, high consumption of potential bladder irritants and persistence of symptoms. Soon after, the actions that should be implemented by the nurse were described in detail. Conclusion: It is considered that the flow and detailing of the actions presented can be adopted by nurses in order to identify and treat people with urge urinary incontinence, thus minimizing the prevalence of the problem and promoting the quality of life of these people.

Objetivo:Presentar una propuesta de protocolo clínico para el tratamiento conservador de la incontinencia urinaria de urgencia. Método: Relato de experiencia basado en evidencia científica existente y experiencia clínica de autores que realizan consultas de enfermería a personas con incontinencia urinaria de urgencia, perfilado de acuerdo con la propuesta del Ministerio de Salud para la elaboración de protocolos clínicos. Resultados: Se propuso un protocolo clínico con Diagnósticos e Intervenciones de Enfermería basado en las Clasificaciones de Intervenciones de Enfermería y Diagnósticos de Enfermería de América del Norte, con pasos sistematizados para verificar la presencia de factores relacionados o condiciones asociadas al diagnóstico, a saber: piso pélvico hiperactivo , ansiedad, estreñimiento, infección del tracto urinario, baja ingesta de líquidos, conducta sanitaria inadecuada, diabetes mellitus, prolapso de órganos pélvicos, alto consumo de potenciales irritantes vesicales y persistencia de los síntomas. Posteriormente, se describieron en detalle las acciones que debe implementar la enfermera. Conclusión: Se considera que la fluidez y el detalle de las acciones presentadas pueden ser adoptadas por los enfermeros para identificar y tratar a las personas con incontinencia urinaria de urgencia, minimizando así la prevalencia del problema y promoviendo la calidad de vida de esas personas.DESCRIPTORES:Estomaterapia. Incontinencia urinaria. Enfermería.

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.

[Home therapeutic adherence of pelvic floor muscle exercises in urinary incontinence]. / Adherencia terapéutica domiciliaria de ejercicios musculares del suelo pélvico en incontinencia urinaria.

Background: Urinary incontinence (UI) is a medical and social problem that has a great impact on the quality of life of women. Pelvic floor muscle strengthening exercises have been shown to be a form of conservative treatment. However, there is still high failure in this treatment. Objective: To analyze the factors associated with low home therapeutic adherence to pelvic floor exercises in patients with UI. Material and methods: An analytical cross-sectional prolective study was carried out in women aged 20-85 years, with UI and under conservative treatment with pelvic floor muscle exercises. They were questioned about their demographic data; the Morisky Green therapeutic adherence questionnaire and the Likert-type satisfaction scale were applied on the results of the questionnaire. Results: 235 women with UI and with a prescription for pelvic floor muscle exercises, with a median of 55 (46-64) years, were analyzed. The lack of adherence to pelvic floor exercises was observed in 130 (55.32%), whose causes were their work (37.69%), forgetfulness (23.08%) and lack of interest (12.08%). The risk factors for non-adherence were having 3 or less children (OR 1.81 [95% CI 1.10-3.23], p = 0.02), and not feeling satisfied with the exercises (OR 6.70 [95% CI 3.75-11.97], p < 0.001. Conclusion: The factors associated with low home therapeutic adherence to pelvic floor exercises in patients with urinary incontinence were having 3 or less children and not being satisfied with the results.

Introducción: la incontinencia urinaria (IU) es un problema médico y social que causa gran impacto en la calidad de vida de las mujeres. Se ha evidenciado que los ejercicios de fortalecimiento muscular del suelo pélvico (SP) son una forma de tratamiento conservador; sin embargo, aun hay elevado fracaso en este tratamiento. Objetivo: analizar los factores asociados a la baja adherencia terapéutica domiciliaria de los ejercicios del suelo pélvico en pacientes con IU. Material y métodos: estudio transversal analítico prolectivo en mujeres de 20-85 años de edad, con IU y en tratamiento conservador con ejercicios musculares de SP. Se les interrogó sobre sus datos demograficos; se aplicó el Cuestionario de adherencia terapéutica de Morisky-Green y la escala de satisfacción tipo Likert sobre los resultados del cuestionario. Resultados: se analizaron 235 mujeres con IU y prescripción de ejercicios musculares de SP, con una mediana de 55 años (46-64). Hubo falta de adherencia a los ejercicios del SP en 130 (55.32%), cuyas causas fueron actividades laborales (37.69%), olvido (23.08%) y falta de interés (12.08%). Los factores de riesgo para no adherencia fueron: tener tres hijos o menos (RM 1.81 [IC 95% 1.10-3.23], p = 0.02) y no sentirse satisfecha con los resultados de los ejercicios respecto a los síntomas de IU (RM 6.70 [IC 95% 3.75-11.97], p < 0.001). Conclusión: los factores asociados a la baja adherencia terapéutica domiciliaria de los ejercicios del SP en pacientes con IU fueron tener 3 hijos o menos y no sentirse satisfecha con los resultados sobre la mejoría en los síntomas de IU.

Implante endoscópico de mioblastos autólogos en el tratamiento de la incontinencia urinaria de esfuerzo y evaluación de su eficacia en conejos sometidos a esfinterotomía / Endoscopic implantation of autologous myoblasts for stress urinary incontinence and evaluation of its efficacy in sphincterotomized rabbits

Introducción La incontinencia urinaria de esfuerzo (IUE) constituye uno de los problemas de salud con mayor impacto en la vida de las personas. El objetivo del presente trabajo fue desarrollar una terapia para IUE dentro de la ingeniería de tejidos mediante aislamiento y cultivo de mioblastos autólogos (MAC), su implante endoscópico y el estudio de su eficacia en un modelo de incontinencia por esfinterotomía desarrollado en conejos. Materiales y métodos Se utilizaron conejos Nueva Zelanda, machos, sanos. Los animales fueron primero sangrados para obtención del plasma pobre en plaquetas (PPP) y biopsiados para el aislamiento de mioblastos. Posesfinterotomía, fueron divididos en dos grupos: grupo tratado (representado por aquellos animales que recibieron MAC resuspendidos en PPP) y grupo control (representado por aquellos animales que recibieron solo PPP). Se utilizó el punto de presión de pérdida (LPP) para medir la continencia de ambos grupos en diferentes instancias. Los resultados se evaluaron con modelos de regresión lineal jerárquica. Se efectuaron también estudios histológicos sobre los esfínteres de los conejos una vez finalizado el seguimiento. Resultados No se observaron diferencias estadísticamente significativas entre los valores basales de LPP de cada grupo. Los valores posesfinterotomía de ambos grupos estuvieron por debajo del 50% del valor basal, condición necesaria para considerarlos sujetos incontinentes. Los valores posimplante del grupo tratado fueron superiores al 50% del valor basal, permitiendo suponer una recuperación de la continencia. Se observó una diferencia estadísticamente significativa en los valores de LPP entre los dos grupos de tratamiento (p=0,003). El estudio histológico en el grupo tratado reveló islas interconectadas formadas por fibras musculares, mientras que en el grupo control se observó tejido conectivo periférico a la luz de la uretra e infiltrado inflamatorio. Discusión y conclusiones ... (AU)

Introduction Stress urinary incontinence (SUI) is one of the health problems with more impact on patients’ lives. The aim of the present work was to develop a therapy for SUI using tissue engineering by isolation and culture of autologous myoblasts (CAM) followed by endoscopic implantation. We also evaluated the efficacy of this therapy in a rabbit model of incontinence after sphincterotomy. Materials and methods We used healthy male New Zealand rabbits. The animals were first bled to obtain platelet-poor plasma (PPP) and biopsied for myoblast isolation. Post-sphincterotomy, they were divided into two groups: the treatment group (including animals that received CAM resuspended in PPP) and the control group (including animals receiving only PPP). The leak-point pressure (LPP) was used to measure continence in both groups at different time points. The results were evaluated with hierarchical linear regression models. Histological evaluation of the rabbits’ sphincters was also performed at the end of follow-up. Results No statistically significant differences were observed between the baseline LPP values of each group. The post-sphincterotomy values of both groups were below 50% of the baseline value, which was a mandatory condition for incontinence. The post-implantation values of the treatment group were higher than 50% of the baseline value, which led us to assume continence recovery. A statistically significant difference was observed in the LPP values between the two treatment groups (p=0.003). Histological study revealed interconnected islands formed by muscle fibers in the treatment group, and connective tissue surrounding the urethral lumen and inflammatory infiltrate in the control group. Discussion and conclusions The implantation of CAM significantly improved LPP values in the treatment group, and the improvement remained throughout the evaluation period. ... (AU)

Malla suburetral retropúbica (TVT): experiencia clínica y análisis de datos en el Hospital El Carmen de Maipú / Retropubic suburethral mesh (TVT): clinical experience and data analysis at the Hospital El Carmen de Maipú

La incontinencia urinaria de esfuerzo es la pérdida involuntaria de orina durante una maniobra de esfuerzo físico, ejercicio, estornudo o tos. Afecta aproximadamente al 15% de las mujeres de 30-60 años y su prevalencia es del 30-41%. Aunque existen terapias conservadoras para su manejo, muchas pacientes terminarán necesitando cirugía para su resolución. Las mallas suburetrales son alternativas para el manejo quirúrgico, existiendo dos vías de instalación, la transobturadora (TOT o TVT-O) y la retropúbica (del inglés tension-free vaginal tape o TVT), siendo esta última la que presenta mejores resultados y menos complicaciones posoperatorias. Objetivo: evaluar la tasa de efectividad y las complicaciones de la TVT en la Unidad de Piso Pélvico Femenino del Hospital El Carmen de Maipú entre los años 2015 y 2020. Materiales y Métodos: Se obtuvieron 715 registros de pacientes que fueron sometidas a TVT y se logró contactar telefónicamente con el 60,69% de ellas. Resultados: Los resultados muestran una tasa de efectividad del 94,8% y una tasa de complicaciones del 2,3%. Conclusión: Este estudio aporta evidencia local de los resultados posoperatorios en la IOE en pacientes que requirieron la instalación de una malla suburetal retropúbica, demostrando ser una cirugía altamente efectiva y segura.

Stress urinary incontinence is the involuntary loss of urine during physical exertion, exercise, sneezing, or coughing. It affects approximately 15% of women aged 30-60, with a prevalence of 30-41%. Although there are conservative therapies for its management, many patients will eventually require surgery for resolution. Suburethral sling are considered for surgical management, and there are two installation alternatives, transobturator (TOT or TVT-O) and retropubic (tension-free vaginal tape or TVT), with the latter presenting better results and fewer postoperative complications. Objetive: to evaluate effectiveness rate and complications of the TVT in the Female Pelvic Floor Unit of Hospital El Carmen de Maipú between 2015 and 2020. Materials and Methods: A total of 715 patient records were obtained for those who underwent TVT, and 60.69% of them were successfully contacted by telephone. Results: The results show an effectiveness rate of 94.8% and a complication rate of 2.3%. Conclusion: This study provides local evidence for the results of stress urinary incontinence that required the placement of a retropubic suburethral sling, proving to be a highly effective and safe surgery.

Factores pronósticos del resultado del tratamiento rehabilitador en la incontinencia urinaria femenina / Prognostic factors and treatment outcomes for female urinary incontinence rehabilitation

Introducción La incontinencia urinaria es la pérdida involuntaria de orina. Presenta una alta prevalencia en el sexo femenino y un gran impacto biopsicosocial. Son numerosos los factores de riesgo asociados con esta entidad. El tratamiento rehabilitador se establece como de primera línea, aunque su uso no ha sido protocolizado. Objetivo Identificar qué factores de riesgo personales y tipo de tratamiento aplicado se encuentran relacionados estadísticamente con la mejoría de las pacientes. Material y método Estudio de cohortes retrospectivas de las pacientes de sexo femenino diagnosticadas de incontinencia urinaria y que acudieron a la consulta de Rehabilitación de Suelo Pélvico del Hospital Universitario Río Hortega de Valladolid, recibiendo tratamiento rehabilitador a lo largo del año 2021. El periodo de seguimiento mínimo fue de 12 semanas, evaluando la mejoría o no según 7 variables objetivas y subjetivas, estableciendo la mejoría como la evolución positiva en al menos 5 de las 7. Resultados Se analizaron 114 mujeres con incontinencia urinaria. Los tipos de incontinencia más frecuentes fueron: de esfuerzo (53%) y mixta (36%). Los factores de riesgo y enfermedad asociada más importantes fueron la episiotomía (68%), infecciones de orina de repetición (61%) y el estreñimiento (40,9%). Ninguno de estos factores demostró una relación estadísticamente significativa con la mejoría de las pacientes con una p>0,05. El tratamiento rehabilitador más empleado fue cinesiterapia+biofeedback (51%), que demostró una relación estadísticamente significativa con la mejoría de estas pacientes (p=0,037), junto con biofeedback+electroestimulación del nervio tibial posterior (p=0,044). Conclusión Los resultados están en consonancia con los de otros estudios publicados. El biofeedback junto con la cinesiterapia o la electroestimulación del nervio tibial posterior se establecen como los procedimientos rehabilitadores más efectivos (AU)

Background Urinary incontinence is the involuntary loss of urine. It is highly prevalent in women and has a great biopsychosocial impact. Numerous risk factors are associated with this entity. Rehabilitative treatment is established as the first line, although its use has not been protocolized. Aim To identify which personal risk factors and type of treatment applied are statistically related to patient improvement. Methods Retrospective cohort study of female patients diagnosed with urinary incontinence who attended the Pelvic Floor Rehabilitation Clinic of the Río Hortega University Hospital of Valladolid, receiving rehabilitation treatment during the year 2021. The minimum follow-up period was 12 weeks, evaluating improvement or not according to 7 objective and subjective variables, establishing improvement as positive evolution in at least 5 of the 7. Results A total of 114 women with urinary incontinence were analyzed. The most frequent types of incontinence were stress (53%) and mixed (36%). The most important risk factors and associated pathology were episiotomy (68%), repeated urinary tract infections (61%), and constipation (40.9%). None of these factors showed a statistically significant relationship with patient improvement with a p>0.05. The most used rehabilitative treatment was kinesitherapy+biofeedback (51%), which showed a statistically significant relationship with the improvement of these patients (p=0.037), together with biofeedback+posterior tibial nerve electrostimulation (p=0.044). Conclusion The results are in line with other published studies. Biofeedback together with kinesitherapy or posterior tibial nerve electrostimulation are established as the most effective rehabilitative procedures (AU)

La banda transobturadora en el tratamiento de mujeres con incontinencia urinaria / Transobturator tape in the treatment of women with urinary incontinence i: en

El tratamiento en mujeres con incontinencia urinaria es diferente del que se efectúa en los hombres. Al respecto, actualmente se emplean las técnicas de cinta vaginal libre de tensión y cinta transobturadora para levantar la vejiga o la uretra, o ambas, hacia la posición normal. El procedimiento quirúrgico con banda transobturadora de polipropileno de monofilamento trenzado figura entre las cirugías mayores ambulatorias y se muestra como un tratamiento eficaz y seguro, cuyos riesgos son mínimos. En este trabajo se comunican brevemente algunos aspectos sobre la incontinencia en féminas, su diagnóstico, prevención y factores de riesgo asociados, así como todo el proceso de aplicación de dicha técnica.

Treatment in women with urinary incontinence is different from that in men. In this regard, the techniques of tension-free vaginal tape and transobturator tape are currently used to lift the bladder or urethra, or both, back to the normal position. The surgical procedure with a monofilament braided polypropylene transobturator band is among the major outpatient surgeries and is shown to be an effective and safe treatment, with minimal risks. In this paper, some aspects of incontinence in women, its diagnosis, prevention and associated risk factors are briefly reported, as well as the entire process of applying this technique.

Validación para la población portuguesa de la “international consultation on incontinence questionnaire-urinary incontinence short form” (ICIQ-UI SF) / Validação para a população portuguesa do “international consultation on incontinence questionnaire-urinary incontinence short form” (ICIQ-UI SF) / Validation of the “International Consultation on Incontinence Questionnaire – Urinary Incontinence Short form (ICIQ-UISF) for the Portuguese population

Introducción: La Incontinencia urinaria puede considerarse una condición común asociada con el proceso de envejecimiento con síntomas extremadamente incapacitantes, siendo de dos a tres veces más frecuente en mujeres que en hombres. El uso de instrumentos validados para el diagnóstico inicial de la incontinencia urinaria es fundamental para obtener uniformidad y sistematización en la valoración de esta condición. Objetivo: Adaptar y validar el International Consultation Questionnaire Urinary Incontinence Short Form (ICIQ-UI SF) para la población portuguesa. Método: Dos traducciones independientes del ICIQ-UI SF fueron realizadas por traductores portugueses con fluidez en inglés. Después de armonizarlos, la traducción resultante fue retrotraduzida de forma independiente por dos traductores ingleses que hablan portugués con fluidez. La versión final del ICIQ-UI SF al portugués se aplicó a 90 usuarios de la consulta externa de urología, ingresados de urología y consulta de ginecología de un hospital ubicado en Gaia. Se evaluaron las propiedades psicométricas y la fiabilidad del cuestionario. Resultados: No se observaron cambios en el formato original del ICIQ-UI SF al final del proceso de traducción y adaptación del instrumento. La edad promedio de los participantes fue de 55 años. La consistencia interna fue alta, como lo demuestra el coeficiente alfa de Cronbach (0,85). El coeficiente de Pearson para las preguntas 3 y 4 fue de 0,88 y para las preguntas 4 y 5 fue de 0,82. La evaluación se consideró satisfactoria y estadísticamente significativa. Conclusión: La versión portuguesa del ICIQ-UI SF se validó con éxito, lo que permitió aplicarlo a la población portuguesa con confiabilidad y validez de constructo satisfactorias. (AU)

Introduction: Urinary incontinence can be considered a common condition associated with the aging process with extremely disabling symptoms, being two to three times more prevalent in women than in men. The use of validated instruments for the initial diagnosis of urinary incontinence is essential to obtain uniformity and systematization in the assessment of this condition. Objective: To adapt and validate the International Consultation Questionnaire Urinary Incontinence Short Form (ICIQ-UI SF) for the Portuguese population. Methodology: Two independent translations of the ICIQ-UI SF were performed by Portuguese translators fluent in English. After harmonizing them, the resulting translation was independently back translated by two English translators fluent in Portuguese. The final version of the ICIQ-UI SF into Portuguese was applied to 90 users of the outpatient urology, urology and gynecology inpatient clinic of a hospital located in Gaia. The psychometric properties and reliability of the questionnaire were evaluated. Results: No changes to the original format of the ICIQ-UI SF were observed at the end of the instrument's translation and adaptation process. The average age of participants was 55 years. Internal consistency was high, as demonstrated by Cronbach's alpha coefficient (0.85). Pearson's coefficient for questions 3 and 4 was 0.88 and for questions 4 and 5 it was 0.82. The evaluation was considered satisfactory and statistically significant. Conclusion: The Portuguese version of the ICIQ-UI SF was successfully validated, making it possible to apply it to the Portuguese population with satisfactory reliability and construct validity. (AU)

Introdução: A incontinência urinária pode ser considerada como uma condição comum associada ao processo de envelhecimento com sintomas extremamente incapacitantes, sendo duas a três vezes mais prevalente nas mulheres do que nos homens. A utilização de instrumentos validados para o diagnóstico inicial da incontinência urinária, é fundamental para obter uma uniformização e sistematização na avaliação desta condição. Objetivo: Adaptar e validar para a população portuguesa o International Consultation Questionnaire Urinary Incontinence Short Form (ICIQ-UI SF)Metodologia: Foram realizadas duas traduções independentes do ICIQ-UI SF por tradutores portugueses, fluentes na língua inglesa. Após harmonização das mesmas, a tradução resultante foi retrotraduzida de forma independente por dois tradutores ingleses, fluentes em português. A versão final do ICIQ-UI SF para o português foi aplicado a 90 utentes da consulta externa de urologia, internamento de urologia e de ginecologia de um hospital, localizado em Gaia. Foram avaliadas as propriedades psicométricas e a confiabilidade do questionário. Resultados: Nenhuma alteração ao formato original do ICIQ-UI SF foi observada no final do processo de tradução e adaptação do instrumento. A idade média dos participantes foi de 55 anos. A consistência interna foi alta, como demonstrado pelo coeficiente de alfa de Cronbach (0,85). O coeficiente de Pearson para as perguntas 3 e 4 foi de 0,88 e para as perguntas 4 e 5 foi de 0,82. A avaliação foi considerada satisfatória e estatisticamente significativa. Conclusão: A versão para português do ICIQ-UI SF foi validada com sucesso tornando possível a sua aplicação na população portuguesa com satisfatória confiabilidade e validade de construto. (AU)

Endoscopic implantation of autologous myoblasts for stress urinary incontinence and evaluation of its efficacy in sphincterotomized rabbits.

INTRODUCTION: Stress urinary incontinence (SUI) is one of the health problems with more impact on patients' lives. The aim of the present work was to develop a therapy for SUI using tissue engineering by isolation and culture of autologous myoblasts (CAM) followed by endoscopic implantation. We also evaluated the efficacy of this therapy in a rabbit model of incontinence after sphincterotomy. MATERIALS AND METHODS: We used healthy male New Zealand rabbits. The animals were first bled to obtain platelet-poor plasma (PPP) and biopsied for myoblast isolation. Post-sphincterotomy, they were divided into two groups: the treatment group (including animals that received CAM resuspended in PPP) and the control group (including animals receiving only PPP). The leak-point pressure (LPP) was used to measure continence in both groups at different time points. The results were evaluated with hierarchical linear regression models. Histological evaluation of the rabbits' sphincters was also performed at the end of follow-up. RESULTS: No statistically significant differences were observed between the baseline LPP values of each group. The post-sphincterotomy values of both groups were below 50% of the baseline value, which was a mandatory condition for incontinence. The post-implantation values of the treatment group were higher than 50% of the baseline value, which led us to assume continence recovery. A statistically significant difference was observed in the LPP values between the two treatment groups (p=0.003). Histological study revealed interconnected islands formed by muscle fibers in the treatment group, and connective tissue surrounding the urethral lumen and inflammatory infiltrate in the control group. DISCUSSION AND CONCLUSIONS: The implantation of CAM significantly improved LPP values in the treatment group, and the improvement remained throughout the evaluation period. It may be associated with the consistency of the implant and its stability at the injection site. Longer follow-up studies and human clinical investigations are required to consider CAM implantation as an alternative treatment for stress urinary incontinence.