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INTRODUCTION: Obesity is a well-known risk factor for lower urinary tract disorders. Lifestyle plays an essential role in the etiology of the symptoms, negatively affecting self-esteem and quality of social, professional, and sexual life. OBJECTIVES: To assess the prevalence of lower urinary tract symptoms and urodynamic patterns in obese women and to compare to nonobese volunteers. METHODS: Overactive bladder (OAB) questionaries (International Consultation on Incontinence Questionnaire [ICIQ]-OAB) and stress urinary incontinence (SUI) (ICIQ-short form) were applied to the participants. They underwent a physical exam and urodynamics except for the control group. RESULTS: A total of 109 women completed the protocol and 20 were in the control group. The average age was 43.0 years, and the average body mass index was 45.12 ± 7.64 kg/m2 and control was 44.5 years, and 29.95 ± 5.08 kg/m2 . The OAB symptoms in the obese group were 31.20%, 55.95% higher than the control group (20.0%). The prevalence of SUI in the obese group was 20.20%, an increase of 34.53% compared with the control group (15.00%). The urodynamic study (UDS) showed that the morbidly obese women have a first sensation earlier than the obese or severely obese, as well as the first desire to void. The Valsalva leak point pressure of morbidly obese women was significantly higher than the others. CONCLUSION: Among obese women, either the prevalence of SUI or OAB is significantly higher than the nonobese female population. Regarding UDS, the pattern is similar to the clinic diagnostic. The grade of obesity is directly associated with an impairment of the patient's cystometric capacity.
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Obesidade Mórbida , Bexiga Urinária Hiperativa , Incontinência Urinária por Estresse , Adulto , Feminino , Humanos , Prevalência , Bexiga Urinária Hiperativa/diagnóstico , Bexiga Urinária Hiperativa/epidemiologia , Incontinência Urinária por Estresse/diagnóstico , Incontinência Urinária por Estresse/epidemiologia , UrodinâmicaRESUMO
AIMS: This study was focused on the clinical test of an improved and portable version of a previously described urethral connector (UC), designed for minimally invasive measurement of vesical pressure and diagnosis of infravesical obstruction in men. METHODS: The conventional pressure-flow study (PFS) and the test with the new version of UC were applied to individuals reporting lower urinary tract symptoms (LUTS), who were then classified as obstructed or non-obstructed/equivocal based on the bladder outlet obstruction index (BOOI) from PFS data. Two-way analysis of variance was used to compare the values of urine flow rate and vesical pressure between methods and diagnoses. RESULTS: Vesical pressure and urine flow values were not significantly different between methods (P > 0.05), while the former was greater in the group classified as obstructed. CONCLUSION: The present results showed that the UC test can support the diagnosis of infravesical obstruction in a comparable way as that of the conventional urodynamic method, however with the advantages of simplicity and minimal invasiveness, having thus the potential to be an alternative method for long term follow-up of individuals reporting LUTS.
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Obstrução do Colo da Bexiga Urinária/diagnóstico , Adulto , Idoso , Desenho de Equipamento , Humanos , Sintomas do Trato Urinário Inferior/diagnóstico , Masculino , Pessoa de Meia-Idade , Hiperplasia Prostática , Uretra/fisiopatologia , Obstrução do Colo da Bexiga Urinária/fisiopatologia , UrodinâmicaRESUMO
Interstitial cystitis/bladder pain syndrome (IC/BPS) is a chronic inflammatory disease without consistently effective treatment. Among the many mediators implicated in cystitis, the overproduction of reactive oxygen species (ROS) seems to play a key role, although the main source of ROS remains unclear. This study aimed to investigate the contribution of NADPH oxidase (NOX) isoforms in ROS generation and the voiding dysfunction of cyclophosphamide (CYP, 300 mg/Kg, ip, 24 h)-induced cystitis in adult female mice, a well-recognized animal model to study IC/BPS, by using GKT137831 (5 mg/Kg, ip, three times in a 24 h period) or GSK2795039 (5 mg/Kg, ip, three times in a 24 h period) to inhibit NOX1/4 or NOX2, respectively. Our results showed that treatment with GSK2795039 improved the dysfunctional voiding behavior induced by CYP, reduced bladder edema and inflammation, and preserved the urothelial barrier integrity and tight junction occludin expression, besides inhibiting the characteristic vesical pain and bladder superoxide anion generation. In contrast, the NOX1/4 inhibitor GKT137831 had no significant protective effects. Taken together, our in vivo and ex vivo data demonstrate that NOX2 is possibly the main source of ROS observed in cystitis-induced CYP in mice. Therefore, selective inhibition of NOX2 by GSK2795039 may be a promising target for future therapies for IC/BPS.
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AIMS: Chronic blockade of nitric oxide (NO) synthesis leads to detrusor smooth muscle overactivity. This study aimed to evaluate the protective effects of BAY 41-2272, a soluble guanlylate cyclase activator, on changes in cystometric parameters in NO-deficient rats. METHODS: Rats were divided into the following groups: (a) control, (b) DMSO, (c) N(ω)-nitro-L-arginine methyl ester hydrochrolide (L-NAME), (d) BAY 41-2272 alone, and (e) L-NAME + BAY 41-2272. The NO synthase blocker L-NAME (20 mg/rat/day) was giving in the drinking water concomitantly or not with BAY 41-2272 (10 mg/kg/day, given by gavage). RESULTS: Chronic L-NAME treatment markedly increased the mean arterial blood pressure (MABP), and co-treatment with BAY 41-2272 nearly reversed L-NAME-induced rise on MABP. Non-void contractions were significantly increased in L-NAME group (0.90 ± 0.1 number/min) compared with either DMSO or control group (0.49 ± 0.1 number/min), which were prevented by co-treatment with BAY 41-2271 (0.56 ± 025 number/min; P < 0.05). The threshold pressure and peak pressure increased by 70% and 44% after chronic L-NAME treatment, while co-treatment with BAY 41-2272 largely attenuated both of these effects (27% and 22% increase, respectively). The frequency of micturition cycles decreased by about of 50% in L-NAME-treated rats compared with control animals, and co-treatment with BAY 41-2272 normalized this parameter. CONCLUSIONS: Our data show that long-term oral administration of BAY 41-2272 counteracts the bladder dysfunction seen in NO-deficient rats, indicating that restoration of the NO-cGMP pathway by this compound may be of beneficial value to treat bladder symptoms.
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Inibidores Enzimáticos/administração & dosagem , Guanilato Ciclase/antagonistas & inibidores , Óxido Nítrico/deficiência , Pirazóis/administração & dosagem , Piridinas/administração & dosagem , Receptores Citoplasmáticos e Nucleares/antagonistas & inibidores , Bexiga Urinária Hiperativa/prevenção & controle , Bexiga Urinária/efeitos dos fármacos , Administração Oral , Análise de Variância , Animais , Pressão Sanguínea/efeitos dos fármacos , Modelos Animais de Doenças , Esquema de Medicação , Guanilato Ciclase/metabolismo , Masculino , NG-Nitroarginina Metil Éster , Óxido Nítrico Sintase/antagonistas & inibidores , Óxido Nítrico Sintase/metabolismo , Pressão , Ratos , Ratos Wistar , Receptores Citoplasmáticos e Nucleares/metabolismo , Guanilil Ciclase Solúvel , Fatores de Tempo , Bexiga Urinária/enzimologia , Bexiga Urinária/fisiopatologia , Bexiga Urinária Hiperativa/enzimologia , Bexiga Urinária Hiperativa/fisiopatologia , Micção/efeitos dos fármacos , Urodinâmica/efeitos dos fármacosRESUMO
PURPOSE: To evaluate in a prospective study the impact of the "three-drug therapy" (antimuscarinic, alpha-blocker and tricyclic antidepressants) on the treatment of refractory detrusor overactivity (DO). METHODS: Data from 27 consented patients with refractory DO were available for study. They were asked to complete a daily urinary chart and underwent urodynamic evaluation (UD) before and 60 days after treatment. Response to treatment was considered the presence of one or less involuntary detrusor contractions (IDC) on post-treatment UD. Statistical analysis was performed with Fisher and Mann-Whitney tests, besides Spearman's correlation. P values <0.05 were considered significant. RESULTS: The mean follow-up was 15 months. The comparison of the daily urinary chart before and after treatment showed significant increase on bladder capacity and decreases on urgency, urge-incontinence and frequency. Objective data from UD showed that the mean maximum bladder capacity (MBC) ranged from 200 to 300 mL (P < 0.001) with treatment. The same trend was observed with the other UD variables. When compared to baseline, the questionnaire OAB-v8 showed significant improvement (P < 0.01). Main side effects comprised dry mouth and constipation (40%), with average scores of 5.16 and 3.08, respectively (visual scale from 0 to 10). CONCLUSIONS: Triple therapy may be an effective, easily employed and well-tolerated option to refractory DO treatment. More studies are necessary to achieve more consistent data on the matter.
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Antagonistas Adrenérgicos alfa/uso terapêutico , Antidepressivos Tricíclicos/uso terapêutico , Doxazossina/uso terapêutico , Imipramina/uso terapêutico , Ácidos Mandélicos/uso terapêutico , Antagonistas Muscarínicos/uso terapêutico , Bexiga Urinária Hiperativa/tratamento farmacológico , Adolescente , Adulto , Idoso , Criança , Sinergismo Farmacológico , Quimioterapia Combinada , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Estudos Prospectivos , Adulto JovemRESUMO
PURPOSE: We investigated whether viable spermatozoa could be obtained from the rat epididymis after vasectomy by up to 5 percutaneous epididymal sperm aspiration punctures. We analyzed the inflammatory and scar forming histological alterations to the epididymis due to these punctures. Epididymal smooth muscle fiber and collagen density were also analyzed. MATERIALS AND METHODS: A total of 50 rats that underwent bilateral vasectomy were divided into 5 groups of 10 each. Groups 1 to 5 underwent 1 to 5 right transscrotal percutaneous epididymal sperm aspiration punctures, respectively. Sperm quantification, and histological and stereological analyses were done on the punctured epididymides. RESULTS: A mean of 48.78 x 10(6), 37.55 x 10(6), 26.33 x 10(6), 33.90 x 10(6) and 41.34 x 10(6)/ml spermatozoa were recovered in groups 1 to 5, respectively. A cumulative effect of the punctures was only observed in the variables of lymphoplasmacytic infiltrate and fibrosis, thus, showing that groups 1 and 2 differed significantly from groups 3 to 5. Stereological analysis revealed that conjunctive tissue volumetric density was 21.56%, 27.60%, 35.67%, 37.56%, 38.60% and 22.30% on the punctured side in groups 1 to 5 and controls, respectively (p <0.05). CONCLUSIONS: Spermatozoa were obtained from all groups. All animals showed significant histological alterations in the epididymides from the second puncture and thereafter except with regard to necrosis. The cumulative effect of percutaneous epididymal sperm aspiration was only shown by lymphoplasmacytic infiltrate and fibrosis. Stereological analysis showed increased conjunctive tissue volumetric density from the second puncture and thereafter.
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Epididimo/patologia , Recuperação Espermática , Vasectomia , Animais , Masculino , Ratos , Ratos WistarRESUMO
Objectives. Using a urethral device at the fossa navicularis, bladder pressure during voiding can be estimated by a minimal invasive technique. This study purposes a new diagnostic index for patients with lower urinary tract symptoms (LUTSs). Methods. Fifty one patients presenting with LUTSs were submitted to a conventional urodynamic and a minimal invasive study. The results obtained through the urethral device and invasive classic urodynamics were compared. The existing bladder outlet obstruction index (BOOI) equation that classifies men with LUTSs was modified to allow minimal invasive measurement of isovolumetric bladder pressure in place of detrusor pressure at maximum urine flow. Accuracy of the new equation for classifying obstruction was then tested in this group of men. Results. The modified equation identified men with obstruction with a positive predictive value of 68% and a negative predictive value of 70%, with an overall accuracy of 70%. Conclusions. The proposed equation can accurately classify over 70% of men without resorting to invasive pressure flow studies. We must now evaluate the usefulness of this classification for the surgical treatment of men with LUTSs.
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PURPOSE: Bladder autoaugmentation was described in 1989, and the effectiveness of this surgical technique in the management of neurogenic bladder dysfunctions is still debated. Few experimental studies with different animals and diverse changes in technique have been described, making comparison of studies difficult. The aim of this study was to assess laparoscopic bladder autoaugmentation in dogs, allowing future studies to be developed using a uniform surgical technique and the results to be compared. MATERIALS AND METHODS: Seven male mongrel dogs weighing from 15 to 20 kg under general anesthesia underwent urodynamic evaluation. Laparoscopic bladder autoaugmentation was then attempted either with or without the use of the intravesical silicone balloon. RESULTS: The reproduction of the open technique caused complications. Changing the method of dissection was essential for completing the surgery. As different limitations appeared solutions were found as well. The use of the intravesical balloon requires the surgery to be different, although quite similar. CONCLUSIONS: Laparoscopic bladder autoaugmentation is feasible in the canine model with and without the intravesical silicone balloon. The best way to perform the surgery was identified for both methods. Future studies can be developed using a uniform surgical technique, and the functional results will be comparable.
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Laparoscopia/métodos , Bexiga Urinária/cirurgia , Animais , Cateterismo , Dissecação , Cães , Masculino , RotaçãoRESUMO
INTRODUCTION: Renal cell carcinoma with thrombus in the inferior vena cava and no apparent metastasis requires immediate surgical treatment. Over the last few years, extracorporeal circulation with deep hypothermia and total circulatory arrest have played an increasingly important role in the treatment of diseases not associated with primary cardiovascular disorders, such as cavoatrial tumor thrombus in uterine tumors, adrenal tumors, Wilms' tumor, as well as renal cell carcinoma. CASE REPORT: A 78-year-old patient with renal cell carcinoma and tumoral thrombus in the inferior vena cava and above the supra-hepatic veins underwent right radical nephrectomy and removal of the thrombus from the vena cava with extracorporeal circulation and deep hypothermia with total circulatory arrest without opening the chest. The patient presented good post-operative evolution.
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Carcinoma de Células Renais/complicações , Neoplasias Renais/complicações , Trombose/etiologia , Veia Cava Inferior/patologia , Idoso , Carcinoma de Células Renais/cirurgia , Circulação Extracorpórea , Humanos , Hipotermia Induzida , Neoplasias Renais/cirurgia , Imageamento por Ressonância Magnética , Masculino , Nefrectomia/métodos , Radiografia , Trombose/diagnóstico por imagem , Trombose/cirurgia , Resultado do Tratamento , Veia Cava Inferior/diagnóstico por imagem , Veia Cava Inferior/cirurgiaRESUMO
OBJECTIVE: To evaluate the reliability and responsiveness (internal and external) of the Portuguese version of the ICIQ-SF. We assessed the responsiveness of the ICIQ-SF after surgical procedures for the treatment of stress urinary incontinence. MATERIALS AND METHODS: Prospective open label study in 2 tertiary referral centers. Sixty-one patients of both genders (54 female and 7 male) were enrolled. Patients were treated using surgical procedures, mostly with synthetic sling (82%). Patients were assessed before surgery and at least 1 month postoperatively using the ICIQ-SF in its translated and validated Portuguese version. Patients also underwent pre-operative urodynamic tests, Stamey incontinence grading and pad usage assessments. After surgery, patients underwent stress tests, Stamey incontinence grading and pad usage assessments. RESULTS: The mean age was 57.2 (+/- 11.6) years and the mean duration of follow-up was 7.2 months (+/- 4.5). Objective parameters such as urodynamic tests (by means of VLPP) and pad usage had significant correlation with changes in post-treatment scores on the ICIQ-SF (p = 0.0062 and p < 0.0001 respectively). The responsiveness expressed in terms of standardized effect sizes (SES) and standardized response means (SRM) was large for both questionnaires (p < 0.0001). CONCLUSION: The results showed high responsiveness (large effect sizes I and II) for the Portuguese version of the ICIQ-SF, indicating that this instrument is suitable for measuring outcomes in clinical trials for Brazilian patients with stress urinary incontinence.
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Inquéritos e Questionários/normas , Tradução , Incontinência Urinária por Estresse/cirurgia , Adulto , Idoso , Brasil , Feminino , Seguimentos , Humanos , Masculino , Pessoa de Meia-Idade , Período Pós-Operatório , Estudos Prospectivos , Reprodutibilidade dos TestesRESUMO
OBJECTIVE: To evaluate the concurrent validity, internal consistency and responsiveness of King's Health Questionnaire (KHQ) in patients who underwent sling procedures for the treatment of stress urinary incontinence. MATERIALS AND METHODS: We performed a prospective open label multicenter study in 4 tertiary referral centers. Sixty-eight female patients were enrolled with urodynamically diagnosed urinary stress incontinence. Patients were treated using surgical procedures, mostly (73%) with the synthetic sling procedure, which has been considered one of the gold standard methods for the treatment of urinary incontinence. The patients were assessed before and after one month of postoperative follow up, using the KHQ in its validated Portuguese version. Patients also underwent preoperative urodynamic test, Stamey incontinence grading, pad usage and the assessment of number of pads used per day. After surgery, patients underwent stress test, Stamey incontinence grading pad usage and the assessment of number of pads used per day. RESULTS: The concurrent validity showed good correlations in some domains of KHQ to clinical parameters. The internal consistency was higher after treatment compared to preoperative values. Objective parameters, such as pad usage and the assessment of number of pads used per day, had significant correlation with changes in post-treatment scores on KHQ. The responsiveness expressed in terms of standardized effect size (SES) and standardized response mean (SRM) was large. CONCLUSION: The results showed moderate concurrent validity, strong internal consistency and high responsiveness for KHQ, indicating that it is suitable for measuring outcomes in clinical trials among female patients with stress urinary incontinence.
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Indicadores Básicos de Saúde , Inquéritos e Questionários , Incontinência Urinária por Estresse/cirurgia , Feminino , Humanos , Período Pós-Operatório , Estudos Prospectivos , Próteses e Implantes , Qualidade de Vida , Reprodutibilidade dos TestesRESUMO
INTRODUCTION: Renal cell carcinoma with thrombus in the inferior vena cava and no apparent metastasis requires immediate surgical treatment. Over the last few years, extracorporeal circulation with deep hypothermia and total circulatory arrest have played an increasingly important role in the treatment of diseases not associated with primary cardiovascular disorders, such as cavoatrial tumor thrombus in uterine tumors, adrenal tumors, Wilms' tumor, as well as renal cell carcinoma. CASE REPORT: A 78-year-old patient with renal cell carcinoma and tumoral thrombus in the inferior vena cava and above the supra-hepatic veins underwent right radical nephrectomy and removal of the thrombus from the vena cava with extracorporeal circulation and deep hypothermia with total circulatory arrest without opening the chest. The patient presented good post-operative evolution.
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Idoso , Humanos , Masculino , Carcinoma de Células Renais/complicações , Neoplasias Renais/complicações , Trombose/etiologia , Veia Cava Inferior/patologia , Carcinoma de Células Renais/cirurgia , Circulação Extracorpórea , Hipotermia Induzida , Neoplasias Renais/cirurgia , Imageamento por Ressonância Magnética , Nefrectomia/métodos , Resultado do Tratamento , Trombose , Trombose/cirurgia , Veia Cava Inferior , Veia Cava Inferior/cirurgiaRESUMO
OBJECTIVE: To evaluate the reliability and responsiveness (internal and external) of the Portuguese version of the ICIQ-SF. We assessed the responsiveness of the ICIQ-SF after surgical procedures for the treatment of stress urinary incontinence. MATERIALS AND METHODS: Prospective open label study in 2 tertiary referral centers. Sixty-one patients of both genders (54 female and 7 male) were enrolled. Patients were treated using surgical procedures, mostly with synthetic sling (82 percent). Patients were assessed before surgery and at least 1 month postoperatively using the ICIQ-SF in its translated and validated Portuguese version. Patients also underwent pre-operative urodynamic tests, Stamey incontinence grading and pad usage assessments. After surgery, patients underwent stress tests, Stamey incontinence grading and pad usage assessments. RESULTS: The mean age was 57.2 (± 11.6) years and the mean duration of follow-up was 7.2 months (± 4.5). Objective parameters such as urodynamic tests (by means of VLPP) and pad usage had significant correlation with changes in post-treatment scores on the ICIQ-SF (p = 0.0062 and p < 0.0001 respectively). The responsiveness expressed in terms of standardized effect sizes (SES) and standardized response means (SRM) was large for both questionnaires (p < 0.0001). CONCLUSION: The results showed high responsiveness (large effect sizes I and II) for the Portuguese version of the ICIQ-SF, indicating that this instrument is suitable for measuring outcomes in clinical trials for Brazilian patients with stress urinary incontinence.
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Adulto , Idoso , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Inquéritos e Questionários/normas , Tradução , Incontinência Urinária por Estresse/cirurgia , Brasil , Seguimentos , Período Pós-Operatório , Estudos Prospectivos , Reprodutibilidade dos TestesRESUMO
OBJECTIVE: To evaluate the concurrent validity, internal consistency and responsiveness of King's Health Questionnaire (KHQ) in patients who underwent sling procedures for the treatment of stress urinary incontinence. MATERIALS AND METHODS: We performed a prospective open label multicenter study in 4 tertiary referral centers. Sixty-eight female patients were enrolled with urodynamically diagnosed urinary stress incontinence. Patients were treated using surgical procedures, mostly (73 percent) with the synthetic sling procedure, which has been considered one of the gold standard methods for the treatment of urinary incontinence. The patients were assessed before and after one month of postoperative follow up, using the KHQ in its validated Portuguese version. Patients also underwent preoperative urodynamic test, Stamey incontinence grading, pad usage and the assessment of number of pads used per day. After surgery, patients underwent stress test, Stamey incontinence grading pad usage and the assessment of number of pads used per day. RESULTS: The concurrent validity showed good correlations in some domains of KHQ to clinical parameters. The internal consistency was higher after treatment compared to preoperative values. Objective parameters, such as pad usage and the assessment of number of pads used per day, had significant correlation with changes in post-treatment scores on KHQ. The responsiveness expressed in terms of standardized effect size (SES) and standardized response mean (SRM) was large. CONCLUSION: The results showed moderate concurrent validity, strong internal consistency and high responsiveness for KHQ, indicating that it is suitable for measuring outcomes in clinical trials among female patients with stress urinary incontinence.
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Feminino , Humanos , Indicadores Básicos de Saúde , Inquéritos e Questionários , Incontinência Urinária por Estresse/cirurgia , Período Pós-Operatório , Estudos Prospectivos , Próteses e Implantes , Qualidade de Vida , Reprodutibilidade dos TestesRESUMO
Proteinas associadas ao tecido tumoral (PATT) foram extraidas e utilizadas tanto para a preparaçao de uma vacina como para a comparaçao, quanto ao seu perfil imunoquimico com proteinas associadas ao tecido renal normal (PATN). A analise eletroforetica em gel de poliacrilamida na presença de SDS demonstrou a existencia de um componente na fraçao PATT praticamente ausente em PATN. A cromatografia de filtraçao em Sephadex G-100 da fraçao PATT evidenciou seis fraçoes (F1 a F6). A analise eletroforetica das fraçoes obtidas em gel de poliacrimida na presença de SDS, evidenciou que a fraçao F2 encontrada em PATT estava em PATN, sugerindo que a imunogenicidade da vacina em estudo poderia ser atribuida ao antigeno F2. A reaçao linfoproliferativa de celulas do paciente imunizado com a vacina bruta frente a F2 foi cinco vezes maior do que em celulas de individuos normais. A determinaçao de TNF (Fator de Necrose Tumoral) foi realizada no paciente, antes e depois do inicio da imunoterapia, e mostrou a queda desta citocina em torno de 47//apos seis meses de tratamento com a vacina.
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Humanos , Eletroforese em Gel de Poliacrilamida , Imunoterapia Ativa , Neoplasias RenaisRESUMO
No período de janeiro a setembro de 1993 foram estudadas 15 pacientes com idade variando entre 29 a 54 anos (mediana de 43 anos), com história de incontinência urinária recidivada após tentativa de correçåo cirúrgica por diferentes métodos com o objetivo de avaliar a contribuiçåo da ultra-sonografia transvaginal associada à avaliaçåo urodinâmica no diagnóstico etiólogico. Durante a fase de enchimento vesical foram avaliados com a ultra-sonografia transvaginal a abertura do colo vesical em relaçåo às variaçöes da pressåo intravesical e quando da ocorrência de perdas urinárias. Abertura do colo vesical durante a micçåo também foi estudada. Foram diagnosticados cinco casos com instabilidade do detrusor, oito pacientes com abertura do colo vesical e perda urinária apenas quando submetidas à manobra de Valsalva e duas pacientes com o colo vesical aberto em repouso, com perda urinária contínua já na fase de enchimento vesical, correspondendo à insuficiência esfincteriana. A avaliaçåo urodinâmica associada à ultra-sonografia transvaginal constitui um método diagnóstico promissor em virtude da facilidade de aprendizado e aplicaçåo podendo vir auxiliar no diagnóstico etiólogico da incontinência urinária na mulher