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1.
BMC Geriatr ; 21(1): 212, 2021 03 29.
Artigo em Inglês | MEDLINE | ID: mdl-33781236

RESUMO

BACKGROUND: Urinary incontinence is a common condition in the general population and, in particular, the older adults population, which reduces the quality of life of these people, so this study aims to systematically examine and meta-analyse the overall prevalence of urinary incontinence in older women around the world and the related and influential factors. METHODS: This report is a comprehensive systematic review and meta-analysis of the findings of research on urinary incontinence in older adults people across the world through looking for MEDLINE, Cochrane Library Sciencedirect, Embase, Scopus, ProQuest and Persian databases, namely iranmedex, magiran, and SID from January 2000 to April 2020, the heterogeneity of the experiments was measured using the I2 index and the data processing was done in the Systematic Meta-Analysis programme. RESULTS: In 29 studies and the sample size of 518,465 people in the age range of 55-106 years, urinary incontinence in older adults' women in the world based on a meta-analysis of 37.1% (95% CI: 29.6-45.4%) was obtained. The highest prevalence of urinary incontinence was reported in older adults' women in Asia with 45.1% (95% CI: 36.9-53.5%). Meta-regression also showed that with increasing the sample size and year of the study, the overall prevalence of urinary incontinence in the older adults women of the world decreased and increased, respectively, which were statistically significant differences (P <  0.05). According to studies, the most important factors influencing the incidence of urinary incontinence in older women are women's age (p <  0.001), obesity (p <  0.001), diabetes (p <  0.001), women's education (p <  0.001), delivery rank (p <  0.001), hypertension (p <  0.001), smoking (p <  0.001). They also have urinary tract infections (p <  0.001). CONCLUSION: Given the high prevalence of urinary incontinence in older women around the world, health policy makers must consider control and diagnostic measures in older women and prioritize treatment and rehabilitation activities.


Assuntos
Qualidade de Vida , Incontinência Urinária , Idoso , Idoso de 80 Anos ou mais , Ásia , Feminino , Humanos , Incidência , Masculino , Estudos Observacionais como Assunto , Prevalência , Incontinência Urinária/diagnóstico , Incontinência Urinária/epidemiologia
2.
Niger J Clin Pract ; 24(2): 186-192, 2021 Feb.
Artigo em Inglês | MEDLINE | ID: mdl-33605907

RESUMO

Background: Urinary incontinence (UI) paves the way for many health problems ranging from discomforts of continuous wetness and irritation to social isolation and depression in women. Aim: The aim of this study was to determine the prevalence of UI in women aged 40 and older as well as its risk factors and also its effect on quality of life. Materials and Methods: This cross-sectional study was conducted with 286 women included in the sample. Subjects were selected randomly. The data were collected using a questionnaire, which was prepared by the researchers, and the Incontinence Quality of Life Questionnaire. The data were analyzed using number, percentage, mean, Chi-square test, and binary logistic regression analysis in the SPSS program. Results: It was found that 86 (30.1%) of the women experienced the symptom of UI. The women had mostly the mixed UI. The correlations between UI and age, educational level, status of employment, the presence of chronic diseases, chronic constipation, difficult birth history, and state of menopause were significant. Total mean score of the women with UI for the Incontinence Quality of Life Questionnaire was 73.62 ± 24.36 and the most affected domain of the quality of life field was social embarrassment. Conclusions: In the present study, it was found that UI was prevalent in Turkish women and impaired their quality of life. The results can help to provide education and counseling services to women in a society-sensitive manner.


Assuntos
Qualidade de Vida , Incontinência Urinária , Adulto , Estudos Transversais , Feminino , Humanos , Pessoa de Meia-Idade , Prevalência , Fatores de Risco , Inquéritos e Questionários , Incontinência Urinária/epidemiologia
3.
Artigo em Inglês | MEDLINE | ID: mdl-33429855

RESUMO

We investigated the association between urinary incontinence and postpartum depression. Data were extracted from the Korean National Health Insurance Service-National Sample Cohort and included women who delivered between 2004 and 2013. Postpartum depression was determined using diagnostic codes during the six-month postpartum period. Urinary incontinence was identified as having a prescription of incontinence drugs or a diagnosis. Cox proportional hazard models were used to calculate adjusted hazard ratios. Of the 83,066 women, 5393 (6.49%) had urinary incontinence and 691 (0.83%) had postpartum depression. Postpartum depression was higher among women with urinary incontinence, aged 15-19 years, ≥40 years old, the lowest income level, and who underwent cesarean section delivery. In the combined analysis, women with urinary incontinence and cesarean section had an approximately three times higher risk of postpartum depression compared with those without urinary incontinence and with spontaneous delivery. Women without urinary incontinence and cesarean section, and those with urinary incontinence and spontaneous delivery were at higher risk of postpartum depression compared with the reference group. Urinary incontinence and cesarean section delivery were significantly associated with postpartum depression during the first six months after childbirth. Therefore, further research should be conducted to evaluate whether urinary incontinence contributes to postpartum depression.


Assuntos
Depressão Pós-Parto , Incontinência Urinária , Adolescente , Adulto , Cesárea , Estudos de Coortes , Parto Obstétrico , Depressão Pós-Parto/epidemiologia , Feminino , Humanos , Período Pós-Parto , Gravidez , República da Coreia/epidemiologia , Incontinência Urinária/epidemiologia , Adulto Jovem
4.
Artigo em Inglês | MEDLINE | ID: mdl-33418845

RESUMO

Urinary incontinence (UI) is a major social problem for older adults and leads to a decline in health-related quality of life (HRQoL), mental health, and physical activity. This study assessed the prevalence and symptoms of UI among older adults discharged from the hospital in Japan and investigated the association of UI symptoms with physical activity, HRQoL, and subjective well-being (SWB). By an international consultation, the Incontinence Questionnaire Short Form (ICIQ-SF) that assesses UI severity, was developed. Self-administered questionnaires were used to assess physical activity, HRQoL, SWB, and social demographic characteristics of the participants. In total, 145 participants (valid response rate, 48%; mean age, 78.6 ± 7.6 years) were included in the analysis. Multivariate logistic regression analysis was performed to identify significant factors associated with the presence of UI. Significant decreases in physical activity, HRQoL, and SWB were observed in patients with UI compared with those without UI (p < 0.05). Multivariate analysis revealed that age, number of reported conditions, and decreased SWB were associated with UI (p < 0.05). UI was associated with less physical activity and decreased mental health status in older adults (especially decreased SWB). Health-promoting measures for older adults with UI are essential for maintaining their well-being and extending healthy life expectancy.


Assuntos
Exercício Físico , Saúde Mental/estatística & dados numéricos , Qualidade de Vida , Incontinência Urinária/epidemiologia , Idoso , Idoso de 80 Anos ou mais , Estudos Transversais , Feminino , Humanos , Lactente , Japão/epidemiologia , Masculino , Prevalência , Inquéritos e Questionários , Incontinência Urinária/diagnóstico , Incontinência Urinária/etnologia
5.
Int J Clin Pract ; 75(5): e13965, 2021 May.
Artigo em Inglês | MEDLINE | ID: mdl-33368941

RESUMO

OBJECTIVE: This study was conducted to determine the frequency of incontinence in elderly people living in nursing homes and the effect of incontinence on the quality of life and sleep quality. MATERIAL AND METHOD: This study was carried out with a total of 1150 individuals aged 65 and over, living in four nursing homes. Pittsburg Sleep Quality Index (PSQI), International Consultation on Incontinence Questionnaire Short Form (ICIQ-SF), and Incontinence Quality of Life Scale (IQOL) were used as data collection tools. The data were collected after obtaining ethics committee and institutional approvals and written consents of the elderly participants. RESULTS: The mean age of 1150 elderly individuals included in the study was 75.49 ± 8.62 years. The mean PSQI score of the elderly was 8.33 ± 4.16 and 83.5% of them had poor sleep quality. It was determined that 87.0% of the elderly woke up at night and the most common reason for waking up was the need to use the toilet (60.0%). It was found that the mean ICIQ-SF score of the individuals was 10.65 ± 4.40 and 80.9% of them had bothersome urinary incontinence. The average IQOL score of individuals with incontinence was 63.39 ± 11.26. CONCLUSION: It was determined that almost all of the elderly people included in the present study had sleep problems and 20.0% had incontinence. It was found that sleep quality is not affected by incontinence in the elderly, but the quality of life decreases because of incontinence.


Assuntos
Qualidade de Vida , Incontinência Urinária , Idoso , Idoso de 80 Anos ou mais , Humanos , Casas de Saúde , Sono , Inquéritos e Questionários , Incontinência Urinária/epidemiologia
6.
J Urol ; 205(1): 219-225, 2021 Jan.
Artigo em Inglês | MEDLINE | ID: mdl-32856986

RESUMO

PURPOSE: Little is known about the fall risk of older adults with overactive bladder, especially in the absence of urgency incontinence. We evaluated the impacts of overactive bladder with and without urgency incontinence (overactive bladder wet and overactive bladder dry) on the fall risk in older adults, and investigated the importance of overactive bladder as a predictor of falls by using tree based models. MATERIALS AND METHODS: This prospective cohort study included 630 community dwelling, independent older adults 75 years old or older who attended a health checkup in 2017 with a 1-year followup. The associations of overactive bladder dry and overactive bladder wet with a fall history, and future fall risk compared to no overactive bladder were assessed using logistic regression models. The contribution of overactive bladder as a predictor of falls was examined using a random forest and decision tree approach. RESULTS: Of the 577 analyzed participants (median age 79 years), 273 (47%) were men. The prevalence of overactive bladder dry and overactive bladder wet at baseline was 15% and 14%, respectively. Multivariable logistic regression analysis revealed that both overactive bladder dry and overactive bladder wet were associated with a higher likelihood of prior falls (adjusted ORs vs no overactive bladder 2.03 and 2.21, respectively; 95% CI 1.23-3.37 and 1.29-3.78, respectively). Among the 363 participants without a fall history, the adjusted ORs (95% CIs) of overactive bladder dry and overactive bladder wet for the occurrence of falls during the 1-year followup were 2.74 (1.19-6.29) and 1.35 (0.47-3.87), respectively. The tree based approach used for all participants showed that overactive bladder was an important predictor of falls in adults without a fall history, and the model had 83.6% accuracy and 81.8% AUC. CONCLUSIONS: Overactive bladder, even in the absence of urgency incontinence, is an important predictor of falls in older adults with a low absolute fall risk.


Assuntos
Acidentes por Quedas/estatística & dados numéricos , Vida Independente/estatística & dados numéricos , Bexiga Urinária Hiperativa/epidemiologia , Incontinência Urinária/epidemiologia , Idoso , Idoso de 80 Anos ou mais , Feminino , Seguimentos , Humanos , Japão/epidemiologia , Masculino , Prevalência , Estudos Prospectivos , Medição de Risco/estatística & dados numéricos , Fatores de Risco , Autorrelato/estatística & dados numéricos , Bexiga Urinária Hiperativa/complicações , Incontinência Urinária/complicações
7.
J Urol ; 205(1): 174-182, 2021 Jan.
Artigo em Inglês | MEDLINE | ID: mdl-32856988

RESUMO

PURPOSE: There is a lack of data on true long-term functional outcome of orthotopic bladder substitution. The primary study objective was to report our 35-year clinical experience. MATERIALS AND METHODS: Since October 1985, 259 male patients from a large single center radical cystectomy series with complete followup of more than 60 months (median 121, range 60-267) without recurrence, irradiation or undiversion that might have affected the functional outcome, were included. RESULTS: Median age at radical cystectomy and at survey was 63 (range 23-81) and 75 (range 43-92) years, respectively. Overall 87% of patients voided spontaneously and residual-free. This rate decreased with increasing age at the time of surgery (less than 50 years old 94%, 70 years old or older 82%). Overall day/nighttime continence rates were 90%/82%. These rates decreased with increasing age at the time of surgery from 100%/88% to 87%/80%. The overall pad-free rate was 71%/47%. Bicarbonate use decreased from 51% (5 years) to 19% (25 years). Patients with a followup of more than 20 years had the lowest rate of residual urine and clean intermittent catheterization (0.0%) as well as use of more than 1 pad at daytime/nighttime (6.3%/12.5%) and mucus obstruction (0.0%). Serum creatinine showed only the age related increase. The surgical complication rate was 27% and correlated inversely with functional results (chi-squared 11.227, p <0.005), even when the younger age at the time of surgery (younger than 60 years) was related to higher rates of surgical complications (chi-squared 6.80, p <0.05). CONCLUSIONS: The ileal neobladder represents an excellent long-term option for urinary diversion with an acceptable complication rate.


Assuntos
Íleo/cirurgia , Complicações Pós-Operatórias/epidemiologia , Neoplasias da Bexiga Urinária/cirurgia , Derivação Urinária/efeitos adversos , Incontinência Urinária/epidemiologia , Coletores de Urina/efeitos adversos , Adulto , Fatores Etários , Idoso , Idoso de 80 Anos ou mais , Cistectomia/efeitos adversos , Feminino , Seguimentos , Humanos , Incidência , Tampões Absorventes para a Incontinência Urinária/estatística & dados numéricos , Cateterismo Uretral Intermitente/estatística & dados numéricos , Masculino , Pessoa de Meia-Idade , Complicações Pós-Operatórias/diagnóstico , Complicações Pós-Operatórias/etiologia , Complicações Pós-Operatórias/terapia , Estudos Prospectivos , Índice de Gravidade de Doença , Resultado do Tratamento , Bexiga Urinária/patologia , Bexiga Urinária/cirurgia , Neoplasias da Bexiga Urinária/patologia , Derivação Urinária/métodos , Incontinência Urinária/diagnóstico , Incontinência Urinária/etiologia , Incontinência Urinária/terapia , Adulto Jovem
8.
J Urol ; 205(1): 129-136, 2021 Jan.
Artigo em Inglês | MEDLINE | ID: mdl-33119421

RESUMO

PURPOSE: Focal instead of whole gland ablation for prostate cancer has been proposed to decrease treatment morbidity. We sought to determine differences in erectile function and urinary continence after focal and whole gland ablation for prostate cancer. MATERIALS AND METHODS: From 2009 to 2018, 346 patients underwent high intensity focused ultrasound or cryotherapy for prostate cancer. Urinary continence was defined as use of no pads and sexual potency as enough erection for sexual penetration. Logistic regressions to treatment groups and covariates age, prostate specific antigen, International Society of Urological Pathology grading, prostate volume and energy modality were performed to access the effect of focal therapy in sexual potency and urinary continence after 3 and 12 months. IIEF-5 (International Index of Erectile Function) and I-PSS (International Prostate Symptom Score) questionnaires were evaluated. Propensity score matching was performed to adjust for potential baseline differences between groups. RESULTS: After exclusion, 195 post-focal therapy and 105 post-whole gland therapy patients were included in analysis. No significant difference was seen in baseline I-PSS and IIEF-5 scores. In multivariate models focal therapy was the most important factor related to sexual potency at 3 (OR 7.7) and 12 months (OR 3.9). Median IIEF-5 score at 3 months was 12 and 5 (p <0.001), and at 12 months was 13 and 9 (p=0.04) in focal therapy and whole gland therapy groups, respectively. Focal therapy was the only factor related to continence (OR 0.7, p <0.001). Results remained significant after propensity score matching. CONCLUSIONS: Focal ablation instead of whole gland therapy is the most important factor related to better sexual and urinary continence recovery after high intensity focused ultrasound and cryotherapy for prostate cancer.


Assuntos
Técnicas de Ablação/efeitos adversos , Criocirurgia/efeitos adversos , Disfunção Erétil/diagnóstico , Ablação por Ultrassom Focalizado de Alta Intensidade/efeitos adversos , Complicações Pós-Operatórias/diagnóstico , Neoplasias da Próstata/cirurgia , Incontinência Urinária/diagnóstico , Técnicas de Ablação/métodos , Idoso , Criocirurgia/métodos , Disfunção Erétil/epidemiologia , Disfunção Erétil/etiologia , Disfunção Erétil/prevenção & controle , Seguimentos , Ablação por Ultrassom Focalizado de Alta Intensidade/métodos , Humanos , Masculino , Pessoa de Meia-Idade , Complicações Pós-Operatórias/epidemiologia , Complicações Pós-Operatórias/etiologia , Complicações Pós-Operatórias/prevenção & controle , Próstata/patologia , Próstata/cirurgia , Neoplasias da Próstata/diagnóstico , Neoplasias da Próstata/patologia , Índice de Gravidade de Doença , Resultado do Tratamento , Incontinência Urinária/epidemiologia , Incontinência Urinária/etiologia , Incontinência Urinária/prevenção & controle
9.
Gerokomos (Madr., Ed. impr.) ; 31(4): 221-225, dic. 2020. tab
Artigo em Espanhol | IBECS | ID: ibc-198741

RESUMO

OBJETIVO: Determinar la frecuencia de factores de riesgo de maltrato en personas ancianas asistidas por la unidad móvil de emergencias extrahospitalarias de Segovia. METODOLOGÍA: Se trata de un estudio descriptivo, con el fin de describir los factores de riesgo presentes en las personas ancianas de la investigación. La muestra está formada por 365 participantes mayores de 65 años. RESULTADOS: La muestra es homogénea por género (188 hombres y 177 mujeres); el grupo mayoritario es el de 71 a 90 años (67,9%). La edad media es de 80 años (σ = 8,91); el estado de salud mayoritario es de grado medio (41,6%); los grados de dependencia leve y moderado suponen en total un 56,7%; la presencia de deterioro cognitivo es del 50,4%; la frecuencia de incontinencia urinaria es de un 72,1%; el aislamiento social lo padecen el 24,4%; la situación actual es en el 51,2%, el 24,4% tienen depresión, abusan del alcohol el 13,2%, pocos viven en instituciones (15,6%) y la relación con el cuidador es buena en el 86% de los casos. CONCLUSIONES:La población seleccionada es bastante envejecida, lo que en sí ya supone más riesgo de padecer maltrato. Las personas con riesgo de maltrato por estado de salud general, deterioro cognitivo y dependencia suponen casi la mitad de la muestra. La incontinencia urinaria es el factor más común. Los trastornos depresivos no son frecuentes, al igual que el consumo de alcohol, pero su ponderación es muy elevada. Cabe destacar que la demora en solicitar ayuda es alta, muchos son hiperfrecuentadores, y algunos están malnutridos y se caen de forma repetida


OBJECTIVE: to determine the frequency of risk factors of abuse in elderly people assisted by the emergency mobile unit of extra-hospital emergencies in Segovia. METHODOLOGY: it ́s a descriptive study with the purpose of describing the risk factors present in the elderly people of the research. The sample consists of 365 participants over 65 years. RESULTS: the sample is homogeneous by gender (188 men and 177 women), the majority group is 71 to 90 years (67.9%). The average age is of 80 years (σ = 8.91), the majority health status is of medium degree (41.6%), the degree of media dependence and the moderate one suppose a total of 56.7%, the presentation of a cognitive is 50.4%. The frequency of urinary incontinence is 72.1%, social isolation appears in 24.4, the current situation is 51.2%, 24.4%, alcohol abuse, 13.2%, few they live in institutions (15.6%). The relationship with the caregiver is good in 86% of cases. CONCLUSIONS: the population has been quite old, what is already in it ́s more risk of suffering abuse. People at risk of abuse by general health status, cognitive knowledge and dependence, account for almost half of the sample. Urinary incontinence is the most common factor. Depressive disorders are not frequent, as is the consumption of alcohol, but its weight is very high. Highlight that the delay in requesting help is high, being many hyperusers, and some are malnourished and fall repeatedly


Assuntos
Humanos , Masculino , Feminino , Idoso , Idoso de 80 Anos ou mais , Maus-Tratos ao Idoso/prevenção & controle , Ambulâncias , Incontinência Urinária/epidemiologia , Disfunção Cognitiva/epidemiologia , Cuidadores/estatística & dados numéricos , Maus-Tratos ao Idoso/estatística & dados numéricos , Unidades Móveis de Saúde , Isolamento Social , Fatores de Risco , Unidades de Terapia Intensiva , Estudos Transversais , Inquéritos e Questionários
10.
Rev. Assoc. Med. Bras. (1992) ; 66(12): 1742-1749, Dec. 2020. tab, graf
Artigo em Inglês | LILACS, Sec. Est. Saúde SP | ID: biblio-1143672

RESUMO

SUMMARY There is no pooled information about pelvic floor parameters (muscle assessment, disorders) of women with gynecologicaL endocrinopathies (eg. polycystic ovary syndrome, congenital adrenal hyperplasia, premature ovarian insufficiency). Given that, a systematic review was performed on the Pubmed, Scopus, Google Scholar, Scielo and PEDro databases regarding the main gynecological endocrinopathies [polycystic ovary syndrome (PCOS), premature ovarian insufficiency (POI), congenital adrenal hyperplasia (CAH) and hyperprolactinemia (HPL)] since their inception to April 2020. Data quality assessment was made by the Newcastle-Ottawa Scale (NOS) adapted for cross-sectional studies. A total of 4,272 results were retrieved from all databases. After excluding duplicate results and screening by title and abstract, nine studies were selected for quantitative analysis. Seven studies were performed with women with PCOS and two studies with POI. Women with PCOS presented a higher prevalence of urinary incontinence (UI) among obese women, a higher thickness of the levator ani muscle, and higher levels of muscle activity measured by surface electromyograph when compared to the control women. Regarding POI, there was no association with UI, FI, and POP. NOS found that the quality assessment for these selected studies ranged from 5 to 8. We concluded that higher pelvic muscle activity and volume were found in women with PCOS, with further studies needed to confirm this data. Literature was scant about POI, CAH, and HPL.


RESUMO Existe informação não organizada sobre a avaliação do assoalho pélvico de mulheres com endocrinopatias ginecológicas (ex. síndrome dos ovários policísticos - SOP, hiperplasia adrenal congênita - HAC, insuficiência ovariana prematura - IOP). Dessa forma, objetivamos realizar uma revisão sistemática foi realizada nas bases Pubmed, Scopus, Google Scholar, Scielo e PEDro sobre as endocrinopatias ginecológicas (SOP, HAC, IOP e hiperprolactinemia (HPL) desde a origem a abril de 2020. A avaliação da qualidade de dados foi real-izada pela escala de Newcastle-Ottawa Scale (NOS) adaptada para estudos transversais. De 4,272 resultados encontrados em todas as databases, após exclusão por duplicatas, triando por título e resumos, nove estudos foram selecionados para análise quantitativa. Sete estudos foram realizados para mulheres com SOP e dois estudos com IOP. Em suma, mulheres com SOP apresentados uma alta prevalência de incontinência urinária (IU) em mulheres obesas, alta espessura do músculo elevador do ânus, altos níveis de atividade muscular aferida por eletromiografia de superfície quando comparadas com mulheres do grupo controle. Sobre a IOP, esta não foi associada com IU, IF e POP. A escala NOS evidenciou que a qualidade dos estudos selecionados variou de 5 a 8. Concluímos que uma alta atividade e volume muscular foi encontrada em mulheres com SOP, com estudos posteriores sendo necessários para confirmar estes achados. Literatura foi escassa para IOP, HAC e HPL.


Assuntos
Humanos , Feminino , Síndrome do Ovário Policístico/complicações , Incontinência Urinária/etiologia , Incontinência Urinária/epidemiologia , Prevalência , Estudos Transversais , Diafragma da Pelve
11.
Rev Assoc Med Bras (1992) ; 66(12): 1742-1749, 2020 Dec.
Artigo em Inglês | MEDLINE | ID: mdl-33331587

RESUMO

There is no pooled information about pelvic floor parameters (muscle assessment, disorders) of women with gynecologicaL endocrinopathies (eg. polycystic ovary syndrome, congenital adrenal hyperplasia, premature ovarian insufficiency). Given that, a systematic review was performed on the Pubmed, Scopus, Google Scholar, Scielo and PEDro databases regarding the main gynecological endocrinopathies [polycystic ovary syndrome (PCOS), premature ovarian insufficiency (POI), congenital adrenal hyperplasia (CAH) and hyperprolactinemia (HPL)] since their inception to April 2020. Data quality assessment was made by the Newcastle-Ottawa Scale (NOS) adapted for cross-sectional studies. A total of 4,272 results were retrieved from all databases. After excluding duplicate results and screening by title and abstract, nine studies were selected for quantitative analysis. Seven studies were performed with women with PCOS and two studies with POI. Women with PCOS presented a higher prevalence of urinary incontinence (UI) among obese women, a higher thickness of the levator ani muscle, and higher levels of muscle activity measured by surface electromyograph when compared to the control women. Regarding POI, there was no association with UI, FI, and POP. NOS found that the quality assessment for these selected studies ranged from 5 to 8. We concluded that higher pelvic muscle activity and volume were found in women with PCOS, with further studies needed to confirm this data. Literature was scant about POI, CAH, and HPL.


Assuntos
Síndrome do Ovário Policístico , Incontinência Urinária , Estudos Transversais , Feminino , Humanos , Diafragma da Pelve , Síndrome do Ovário Policístico/complicações , Prevalência , Incontinência Urinária/epidemiologia , Incontinência Urinária/etiologia
12.
BMJ ; 371: m3503, 2020 10 07.
Artigo em Inglês | MEDLINE | ID: mdl-33028540

RESUMO

OBJECTIVE: To assess treatment related changes in quality of life up to 15 years after diagnosis of localised prostate cancer. DESIGN: Population based, prospective cohort study with follow-up over 15 years. SETTING: New South Wales, Australia. PARTICIPANTS: 1642 men with localised prostate cancer, aged less than 70, and 786 controls randomly recruited from the New South Wales electoral roll into the New South Wales Prostate Cancer Care and Outcomes Study (PCOS). MAIN OUTCOME MEASURES: General health and disease specific quality of life were self-reported at seven time points over a 15 year period, using the 12-item Short Form Health Survey scale, University of California, Los Angeles prostate cancer index, and expanded prostate cancer index composite short form (EPIC-26). Adjusted mean differences were calculated with controls as the comparison group. Clinical significance of adjusted mean differences was assessed by the minimally important difference, defined as one third of the standard deviation (SD) from the baseline score. RESULTS: At 15 years, all treatment groups reported high levels of erectile dysfunction, depending on treatment (62.3% (active surveillance/watchful waiting, n=33/53) to 83.0% (non-nerve sparing radical prostatectomy, n=117/141)) compared with controls (42.7% (n=44/103)). Men who had external beam radiation therapy or high dose rate brachytherapy or androgen deprivation therapy as primary treatment reported more bowel problems. Self-reported urinary incontinence was particularly prevalent and persistent for men who underwent surgery, and an increase in urinary bother was reported in the group receiving androgen deprivation therapy from 10 to 15 years (year 10: adjusted mean difference -5.3, 95% confidence interval -10.8 to 0.2; year 15: -15.9; -25.1 to -6.7). CONCLUSIONS: Patients receiving initial active treatment for localised prostate cancer had generally worse long term self-reported quality of life than men without a diagnosis of prostate cancer. Men treated with radical prostatectomy faired especially badly, particularly in relation to long term sexual outcomes. Clinicians and patients should consider these long term quality of life outcomes when making treatment decisions.


Assuntos
Antagonistas de Androgênios , Braquiterapia , Efeitos Adversos de Longa Duração , Prostatectomia , Neoplasias da Próstata , Qualidade de Vida , Idoso , Antagonistas de Androgênios/efeitos adversos , Antagonistas de Androgênios/uso terapêutico , Austrália/epidemiologia , Braquiterapia/efeitos adversos , Braquiterapia/métodos , Estudos de Coortes , Disfunção Erétil/epidemiologia , Disfunção Erétil/etiologia , Humanos , Efeitos Adversos de Longa Duração/epidemiologia , Efeitos Adversos de Longa Duração/etiologia , Masculino , Pessoa de Meia-Idade , Estadiamento de Neoplasias , Estudos Prospectivos , Prostatectomia/efeitos adversos , Prostatectomia/métodos , Neoplasias da Próstata/epidemiologia , Neoplasias da Próstata/patologia , Neoplasias da Próstata/psicologia , Neoplasias da Próstata/terapia , Risco Ajustado , Incontinência Urinária/epidemiologia , Incontinência Urinária/etiologia
13.
Arch Esp Urol ; 73(7): 582-592, 2020 Sep.
Artigo em Espanhol | MEDLINE | ID: mdl-32886073

RESUMO

OBJECTIVE: To determine the prevalence of Urinary Incontinence (UI) in a hospitalization unit. METHODS: Descriptive cross-sectional study, with patients in a hospitalization unit in Ferrol. The prevalence, the type of UI, the UI assessment and the impact of UI on daily life were estimated with the questionnaires: IU-4 (by sex), the severity tool ICIQ-SF and the IIQ. RESULTS: 302 patients participated in the study. The prevalence of UI was 41.4%. Regarding the type of incontinence, 35% suffer stress UI, 27% urge UI, 14.6% mixed UI, 8.8% functional UI and 2.2% Reflex UI. We can affirm that being a woman is a risk factor for UI [p<0.001; OR 5.0-95% CI (2.8-8.9)] . On the other hand, medium physical activity is objectified as a protective factor to suffer UI (p=0.003). CONCLUSION: The impact on the quality of life of the UI is high. Establishing more real data of predictive factors may help to identify patients. Using standardized methods of study such as validated questionnaires when assessing our patients is also of interest. The need to manage UI should be reinforced as a priority for nursing professionals, not only during hospital admissions, but also at the community level or in emergencies, due to the high prevalence described.


Assuntos
Qualidade de Vida , Incontinência Urinária/epidemiologia , Estudos Transversais , Feminino , Hospitalização , Humanos , Prevalência , Inquéritos e Questionários
14.
Arch. esp. urol. (Ed. impr.) ; 73(7): 582-592, sept. 2020. tab
Artigo em Espanhol | IBECS | ID: ibc-195956

RESUMO

OBJETIVO: Determinar la prevalencia de IU (Incontinencia Urinaria) en una unidad de hospitalización, identificar el tipo más prevalente, la severidad de los síntomas asociados y su impacto en la calidad de vida de los pacientes afectados, así como la identificación de los factores asociados a la misma. MÉTODOS: Estudio descriptivo de corte transversal, con pacientes en una unidad de hospitalización en Ferrol. Se estimó la prevalencia, el tipo de IU, la valoración de IU y el impacto de la IU en la vida diaria con los cuestionarios: IU-4 (por sexo), la herramienta de severidad ICIQ-SF y el IIQ. RESULTADOS: Participaron 302 pacientes, cuya prevalencia de IU es 41,4%; un 35% padecen IU de esfuerzo, un 27% IU de Urgencia, un 14,6% IU Mixta, un 8,8% IU Funcional y un 2,2% IU Refleja. Al 41,6% las pérdidas de orina le afecta a su salud emocional (nerviosismo, depresión, etc.). Podemos afirmar que ser mujer, es un factor de riesgo para padecer IU [p < 0,001; OR 5,0 - 95% IC (2,8-8,9)]. Por otro lado, la actividad física se objetiva como un factor protector para padecer IU (p = 0,003). CONCLUSIÓN: El impacto en la calidad de vida de la IU es alto, por lo que se debe reforzar la necesidad del manejo de la IU como una prioridad para las enfermeras, durante los ingresos hospitalarios, desde el ámbito comunitario o en situaciones de urgencias, debido a la alta prevalencia descrita


OBJECTIVE: To determine the prevalence of Urinary Incontinence (UI) in a hospitalization unit. METHODS: Descriptive cross-sectional study, with patients in a hospitalization unit in Ferrol. The prevalence, the type of UI, the UI assessment and the impact of UI on daily life were estimated with the questionnaires: IU-4 (by sex), the severity tool ICIQ-SF and the IIQ. RESULTS: 302 patients participated in the study. The prevalence of UI was 41.4%. Regarding the type of incontinence, 35% suffer stress UI, 27% urge UI, 14.6% mixed UI, 8.8% functional UI and 2.2% Reflex UI. We can affirm that being a woman is a risk factor for UI [p < 0.001; OR 5.0-95% CI (2.8-8.9)]. On the other hand, medium physical activity is objectified as a protective factor to suffer UI (p = 0.003). CONCLUSION: The impact on the quality of life of the UI is high. Establishing more real data of predictive factors may help to identify patients. Using standardized methods of study such as validated questionnaires when assessing our patients is also of interest. The need to manage UI should be reinforced as a priority for nursing professionals, not only during hospital admissions, but also at the community level or in emergencies, due to the high prevalence described


Assuntos
Humanos , Masculino , Feminino , Pessoa de Meia-Idade , Idoso , Idoso de 80 Anos ou mais , Incontinência Urinária/epidemiologia , Incontinência Urinária/fisiopatologia , Qualidade de Vida , Estudos Transversais , Prevalência , Índice de Gravidade de Doença , Modelos Logísticos , Inquéritos e Questionários , Perfil de Impacto da Doença , Espanha/epidemiologia
15.
Med Clin North Am ; 104(5): 827-842, 2020 Sep.
Artigo em Inglês | MEDLINE | ID: mdl-32773048

RESUMO

The prevalence of urinary incontinence and other lower urinary tract symptoms increases with older age. These symptoms are more noticeable in men after the seventh decade of life and in women after menopause. Constipation and fecal incontinence are major causes of symptoms in elderly patients and can significantly impair quality of life. This article summarizes the current literature regarding the occurrence and implications of lower urinary tract and bowel symptoms in the geriatric population.


Assuntos
Enteropatias , Qualidade de Vida , Doenças Urológicas , Idoso , Constipação Intestinal/epidemiologia , Incontinência Fecal/epidemiologia , Avaliação Geriátrica , Humanos , Enteropatias/diagnóstico , Enteropatias/fisiopatologia , Enteropatias/psicologia , Prevalência , Incontinência Urinária/epidemiologia , Doenças Urológicas/diagnóstico , Doenças Urológicas/fisiopatologia , Doenças Urológicas/psicologia
16.
PLoS One ; 15(8): e0237518, 2020.
Artigo em Inglês | MEDLINE | ID: mdl-32810136

RESUMO

The study assessed the prevalence and determinants of non-fistulous urinary incontinence among gynaecologic care seekers as well as its interference with everyday life activities of affected women. A cross-sectional study involving 400 women was conducted in a tertiary facility in Ghana. Urinary incontinence was assessed using the International Consultation on Incontinence Questionnaire-short form (ICIQ-SF) which has not been validated locally. The questionnaire was administered mostly in the Asante Twi language with translation done at the time of the interview. The data was analysed for proportions and associations between selected variables. The prevalence of urinary incontinence was 12%, the common types being urgency (33.3%), stress (22.9%), and mixed (20.8%). Age ≥60 years compared to 18-39 years (OR 3.66 95%CI 1.48-9.00 P = 0.005), and a history of chronic cough (OR 3.80 95% CI 1.36-10.58 P = 0.01) were associated with urinary incontinence. Women with education beyond the basic level were 72% less likely to experience urinary incontinence (OR 0.28 95%CI 0.08-0.96 P = 0.04). Urinary incontinence interferes with everyday life activities of most affected women. Non-fistulous urinary incontinence is relatively common among gynaecologic care seekers yet very few women were referred with such a diagnosis. Advocacy measures aimed at urging affected women to report the condition and educating the general population on potential causes, prevention and treatment are needed.


Assuntos
Aceitação pelo Paciente de Cuidados de Saúde , Incontinência Urinária/epidemiologia , Incontinência Urinária/etiologia , Atividades Cotidianas , Adolescente , Adulto , Idoso , Idoso de 80 Anos ou mais , Estudos Transversais , Feminino , Gana/epidemiologia , Ginecologia/estatística & dados numéricos , Hospitais de Ensino , Humanos , Pessoa de Meia-Idade , Aceitação pelo Paciente de Cuidados de Saúde/estatística & dados numéricos , Qualidade de Vida , Encaminhamento e Consulta/estatística & dados numéricos , Fatores de Risco , Inquéritos e Questionários , Incontinência Urinária/diagnóstico , Adulto Jovem
17.
Cochrane Database Syst Rev ; 8: CD013641, 2020 08 18.
Artigo em Inglês | MEDLINE | ID: mdl-32813279

RESUMO

BACKGROUND: Robotic-assisted laparoscopic prostatectomy (RALP) is widely used to surgically treat clinically localized prostate cancer. It is typically performed using an approach (standard RALP) that mimics open retropubic prostatectomy by dissecting the so-called space of Retzius anterior to the bladder. An alternative, Retzius-sparing (or posterior approach) RALP (RS-RALP) has been described, which is reported to have better continence outcomes but may be associated with a higher risk of incomplete resection and positive surgical margins (PSM). OBJECTIVES: To assess the effects of RS-RALP compared to standard RALP for the treatment of clinically localized prostate cancer. SEARCH METHODS: We performed a comprehensive search of the Cochrane Library, MEDLINE, Embase, three other databases, trials registries, other sources of the grey literature, and conference proceedings, up to June 2020. We applied no restrictions on publication language or status. SELECTION CRITERIA: We included trials where participants were randomized to RS-RALP or standard RALP for clinically localized prostate cancer. DATA COLLECTION AND ANALYSIS: Two review authors independently classified and abstracted data from the included studies. Primary outcomes were: urinary continence recovery within one week after catheter removal, at three months after surgery, and serious adverse events. Secondary outcomes were: urinary continence recovery six and 12 months after surgery, potency recovery 12 months after surgery, positive surgical margins (PSM), biochemical recurrence-free survival (BCRFS), and urinary and sexual function quality of life. We performed statistical analyses using a random-effects model. We rated the certainty of evidence using the GRADE approach. MAIN RESULTS: Our search identified six records of five unique randomized controlled trials, of which two were published studies, one was in press, and two were abstract proceedings. There were 571 randomized participants, of whom 502 completed the trials. Mean age of participants was 64.6 years and mean prostate-specific antigen was 6.9 ng/mL. About 54.2% of participants had cT1c disease, 38.6% had cT2a-b disease, and 7.1 % had cT2c disease. Primary outcomes RS-RALP probably improves continence within one week after catheter removal (risk ratio (RR) 1.74, 95% confidence interval (CI) 1.41 to 2.14; I2 = 0%; studies = 4; participants = 410; moderate-certainty evidence). Assuming 335 per 1000 men undergoing standard RALP are continent at this time point, this corresponds to 248 more men per 1000 (137 more to 382 more) reporting continence recovery. RS-RALP may increase continence at three months after surgery compared to standard RALP (RR 1.33, 95% CI 1.06 to 1.68; I2 = 86%; studies = 5; participants = 526; low-certainty evidence). Assuming 750 per 1000 men undergoing standard RALP are continent at this time point, this corresponds to 224 more men per 1000 (41 more to 462 more) reporting continence recovery. We are very uncertain about the effects of RS-RALP on serious adverse events compared to standard RALP (RR 1.40, 95% CI 0.47 to 4.17; studies = 2; participants = 230; very low-certainty evidence). Secondary outcomes There is probably little to no difference in continence recovery at 12 months after surgery (RR 1.01, 95% CI 0.97 to 1.04; I2 = 0%; studies = 2; participants = 222; moderate-certainty evidence). Assuming 982 per 1000 men undergoing standard RALP are continent at this time point, this corresponds to 10 more men per 1000 (29 fewer to 39 more) reporting continence recovery.  We are very uncertain about the effect of RS-RALP on potency recovery 12 months after surgery (RR 0.98, 95% CI 0.54 to 1.80; studies = 1; participants = 55; very low-certainty evidence).  RS-RALP may increase PSMs (RR 1.95, 95% CI 1.19 to 3.20; I2 = 0%; studies = 3; participants = 308; low-certainty evidence) indicating a higher risk for prostate cancer recurrence. Assuming 129 per 1000 men undergoing standard RALP have positive margins, this corresponds to 123 more men per 1000 (25 more to 284 more) with PSMs. We are very uncertain about the effect of RS-RALP on BCRFS compared to standard RALP (hazard ratio (HR) 0.45, 95% CI 0.13 to 1.60; I2 = 32%; studies = 2; participants = 218; very low-certainty evidence). AUTHORS' CONCLUSIONS: Findings of this review indicate that RS-RALP may result in better continence outcomes than standard RALP up to six months after surgery. Continence outcomes at 12 months may be similar. Downsides of RS-RALP may be higher positive margin rates. We are very uncertain about the effect on BCRFS and potency outcomes. Longer-term oncologic and functional outcomes are lacking, and no preplanned subgroup analyses could be performed to explore the observed heterogeneity. Surgeons should discuss these trade-offs and the limitations of the evidence with their patients when considering this approach.


Assuntos
Tratamentos com Preservação do Órgão/métodos , Complicações Pós-Operatórias/prevenção & controle , Prostatectomia/métodos , Neoplasias da Próstata/cirurgia , Procedimentos Cirúrgicos Robóticos/métodos , Incontinência Urinária/prevenção & controle , Idoso , Humanos , Calicreínas/sangue , Laparoscopia/efeitos adversos , Laparoscopia/métodos , Masculino , Margens de Excisão , Pessoa de Meia-Idade , Tratamentos com Preservação do Órgão/efeitos adversos , Ereção Peniana , Complicações Pós-Operatórias/epidemiologia , Antígeno Prostático Específico/sangue , Prostatectomia/efeitos adversos , Neoplasias da Próstata/sangue , Neoplasias da Próstata/patologia , Ensaios Clínicos Controlados Aleatórios como Assunto , Procedimentos Cirúrgicos Robóticos/efeitos adversos , Fatores de Tempo , Resultado do Tratamento , Incontinência Urinária/epidemiologia
18.
J Urol ; 204(6): 1263-1269, 2020 Dec.
Artigo em Inglês | MEDLINE | ID: mdl-32614256

RESUMO

PURPOSE: Management of pregnancy and delivery in women with lower urinary tract reconstruction is challenging and the currently available literature is insufficient to guide clinical practice. We report pregnancy and delivery outcomes in this specific population. MATERIALS AND METHODS: We conducted a national multicenter retrospective study (16 centers) including 68 women with 96 deliveries between 1998 and 2019. These women had at least 1 successful pregnancy and delivery after augmentation enterocystoplasty, catheterizable channel creation and/or artificial urinary sphincter implantation. Maternal and fetal complications during pregnancy and delivery were reported, as well as postpartum functional outcomes, according to the delivery mode. The chi-square test and Student's t-test were used to compare categorical and continuous variables, respectively. RESULTS: Overall 32% of reported pregnancies were complicated by febrile urinary tract infections, 13.5% by renal colic and 14.6% required upper urinary tract diversion. In addition, 10% of patients reported transient self-catheterization difficulties and 13.5% reported de novo or increased urinary incontinence. The preterm delivery rate was 35.3%. Elective C-section was performed in 61% of pregnancies. Twenty complications occurred during delivery (20%), including 19 during elective C-section. Urinary continence at 1 year was unchanged for 93.5% of deliveries. Delivery mode (p=0.293) and multiparity (p=0.572) had no impact on urinary continence. CONCLUSIONS: In this population C-section appeared to be associated with a high risk of complications. In the absence of any obstetric or neurological contraindications, vaginal delivery should be proposed as the first line option to the majority of these women.


Assuntos
Cesárea/efeitos adversos , Complicações Pós-Operatórias/epidemiologia , Complicações na Gravidez/epidemiologia , Nascimento Prematuro/epidemiologia , Procedimentos Cirúrgicos Reconstrutivos/efeitos adversos , Adolescente , Adulto , Cesárea/estatística & dados numéricos , Feminino , França/epidemiologia , Humanos , Esclerose Múltipla/cirurgia , Complicações Pós-Operatórias/etiologia , Gravidez , Complicações na Gravidez/etiologia , Complicações na Gravidez/cirurgia , Nascimento Prematuro/etiologia , Cólica Renal/epidemiologia , Cólica Renal/etiologia , Estudos Retrospectivos , Traumatismos da Medula Espinal/cirurgia , Disrafismo Espinal/cirurgia , Bexiga Urinária/anormalidades , Bexiga Urinária/cirurgia , Derivação Urinária/estatística & dados numéricos , Incontinência Urinária/epidemiologia , Incontinência Urinária/etiologia , Esfíncter Urinário Artificial/efeitos adversos , Infecções Urinárias/epidemiologia , Infecções Urinárias/etiologia , Adulto Jovem
19.
PLoS One ; 15(6): e0234338, 2020.
Artigo em Inglês | MEDLINE | ID: mdl-32511254

RESUMO

Urinary incontinence (UI) is a common condition that causes significant harm to the well-being and quality of life of pregnant women. This cross-sectional population-based study aimed to estimate the prevalence and identify factors associated with the occurrence of UI during pregnancy in women living in the municipality of Rio Grande (RS), Southern Brazil, between January 1 and December 31 of 2016, and included all puerperae living in this municipality that had a child in one of the two local maternity hospitals. The previously trained interviewers used a single standardized questionnaire, within 48 hours after delivery to retrieve information on maternal demographic, behavioral and reproductive/obstetric history, as well as socioeconomic status of the household and care received during pregnancy and childbirth. The multivariate analysis followed a previously defined hierarchical model using Poisson regression with robust variance adjustment and prevalence ratio (PR) as a measure of effect. As a result, 2,716 puerperae were identified, of which 2,694 (99.2%) participated in this study. The prevalence of urinary incontinence in the gestational period was 14.7% (95%CI: 13.4%-16.1%). After adjusted analysis, the likelihood of UI occurring varied significantly as per women's characteristics. For example, the PR for the occurrence of UI among women over 30 years of age was 2.05 (95% CI: 1.39-3.01) compared to adolescents. In two other groups of women who had their first pregnancy before the age of 20 or after the age of 30, the PR for UI was 1.36 (95% CI: 1.04-1.76) and 1.59 (95% CI: 1.01-2.51), respectively, when compared to those who became pregnant for the first time between 20 and 29 years of age. Finally, in two other groups of women, namely, those who reached 90 kg and over at the end of pregnancy and those who performed regular physical exercise and reported frequent urinary urgency, the PR was 2.49 (95% CI: 1.74-3.57), and 2.90 (95% CI: 2.10-4.00) compared to those who did not exercise and did not report urinary urgency, respectively. The authors concluded that UI showed a high prevalence in the study population. The identified risk factors can be well administered at primary health care level. The recommendation of regular physical exercise in pregnancy must be reviewed and better investigated with more robust designs because of possible facilitators for the occurrence of UI in this period.


Assuntos
Complicações na Gravidez/epidemiologia , Incontinência Urinária/complicações , Incontinência Urinária/epidemiologia , Adolescente , Adulto , Brasil/epidemiologia , Criança , Estudos Transversais , Feminino , Humanos , Idade Materna , Análise Multivariada , Gravidez , Prevalência , Fatores de Risco , Inquéritos e Questionários , Adulto Jovem
20.
J Urol ; 204(6): 1236-1241, 2020 12.
Artigo em Inglês | MEDLINE | ID: mdl-32568605

RESUMO

PURPOSE: Prior studies suggest that nationally endorsed quality measures for prostate cancer care are not linked closely with outcomes. Using a prospective, population based cohort we measured clinically relevant variation in structure, process and outcome measures in men undergoing radical prostatectomy. MATERIALS AND METHODS: The Comparative Effectiveness Analysis of Surgery and Radiation (CEASAR) Study enrolled men with clinically localized prostate cancer diagnosed from 2011 to 2012 with 1,069 meeting the final inclusion criteria. Quality of life was assessed using the Expanded Prostate Index Composite (EPIC-26) and clinical data by chart review. Six quality measures were assessed, including pelvic lymphadenectomy with risk of lymph node involvement 2% or greater, appropriate nerve sparing, negative surgical margins, urinary and sexual function, treatment by high volume surgeon, and 30-day and 1-year complications. Receipt of high quality care was compared across categories of race, age, surgeon volume and surgical approach via multivariable analysis. RESULTS: There were no significant differences in quality across race, age or surgeon volume strata, except for worse urinary incontinence in Black men. However, robotic surgery patients experienced fewer complications (3% vs 9.3% short-term and 11% vs 16% long-term), were more likely to be treated by a high volume surgeon (47% vs 25%) and demonstrated better sexual function. CONCLUSIONS: In this cohort we did not identify meaningful variation in quality of care across racial groups, age groups and surgeon volume strata, suggesting that men are receiving comparable quality of care across these strata. However, we did find variation between open and robotic surgery with fewer complications, improved sexual function and increased use of high volume surgeons in the robotic group, possibly reflecting differences in quality between approaches, differences in practice patterns and/or biases in patient selection.


Assuntos
Medidas de Resultados Relatados pelo Paciente , Prostatectomia/estatística & dados numéricos , Neoplasias da Próstata/cirurgia , Qualidade de Vida , Procedimentos Cirúrgicos Robóticos/estatística & dados numéricos , Adulto , Idoso , Humanos , Masculino , Margens de Excisão , Pessoa de Meia-Idade , Ereção Peniana/fisiologia , Complicações Pós-Operatórias/epidemiologia , Complicações Pós-Operatórias/etiologia , Estudos Prospectivos , Próstata/patologia , Próstata/cirurgia , Prostatectomia/efeitos adversos , Prostatectomia/normas , Neoplasias da Próstata/patologia , Neoplasias da Próstata/fisiopatologia , Procedimentos Cirúrgicos Robóticos/efeitos adversos , Procedimentos Cirúrgicos Robóticos/normas , Resultado do Tratamento , Incontinência Urinária/epidemiologia , Incontinência Urinária/etiologia
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