Navegando por Palavras-chave "stress urinary incontinence"
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- ItemSomente MetadadadosChanges in the lower urinary tract in continent women and in women with stress urinary incontinence, according to menopausal status(Springer, 2001-06-01) Wakavaiachi, VMB; Girao, MJBC; Sartori, MGF; Baracat, E. C.; Lima, G. R. de; Novo, N. F.; Universidade Federal de São Paulo (UNIFESP)The aim of this study was to assess the impact of the postmenopausal period on clinical and urodynamic parameters and on the mobility of the bladder neck in continent women and in women with stress urinary incontinence. Fifty-seven postmenopausal women were studied: 30 were continent and 27 had stress urinary incontinence. They were subdivided according to postmenopausal stage into groups A (<5 years) and B (>5 years). Five years was a good marker to separate those women with mild and severe estrogen deficiency. Fifteen premenopausal incontinent women were selected for bladder neck ultrasound as controls. All underwent history, general physical and gynecologic examinations, LH and FSH determinations, type 1 urine and uroculture, circadian voiding diary, cotton-swab test, bladder neck ultrasound and urodynamic investigations. Analysis of the voiding diaries revealed a higher frequency of daytime micturition in both groups of incontinent patients than in the continent ones. Increased bladder neck mobility was also found, both in the cotton-swab test and an ultrasound, in group A and an ultrasound in the premenopausal incontinent women. Urodynamic investigation showed decreased bladder capacity at the first micturition urge, as well as decreased urinary volume in the group A patients compared to the continent ones. Decreased urethral closure maximum pressure was also found in group B patients in relation to the continent ones. We concluded that the effect of hypoestrogenism, manifested postmenopause, causes changes in the lower urinary tract of women, particularly those who are incontinent.
- ItemAcesso aberto (Open Access)Correlation between maximum voluntary contraction and endurance measured by digital palpation and manometry: An observational study(Assoc Medica Brasileira, 2016) Fitz, Fatima Fani [UNIFESP]; Stupp, Liliana [UNIFESP]; Costa, Thais Fonseca [UNIFESP]; Sartori, Marair Gracio Ferreira [UNIFESP]; Girão, Manoel João Batista Castello [UNIFESP]; Castro, Rodrigo Aquino [UNIFESP]Introduction: Digital palpation and manometry are methods that can provide information regarding maximum voluntary contraction (MVC) and endurance of the pelvic floor muscles (PFM), and a strong correlation between these variables can be expected. Objective: To investigate the correlation between MVC and endurance, measured by digital palpation and manometry. Method: Forty-two women, with mean age of 58.1 years (+/- 10.2), and predominant symptoms of stress urinary incontinence (SUI), were included. Examination was firstly conducted by digital palpation and subsequently using a Peritron manometer. MVC was measured using a 0-5 score, based on the Oxford Grading Scale. Endurance was assessed based on the PERFECT scheme. Results: We found a significant positive correlation between the MVC measured by digital palpation and the peak manometric pressure (r= 0.579, p< 0.001), and between the measurements of the endurance by Peritron manometer and the PERFECT assessment scheme (r= 0.559, p< 0.001). Conclusion: Our results revealed a positive and significant correlation between the capacity and maintenance of PFM contraction using digital and manometer evaluations in women with predominant symptoms of SUI.
- ItemSomente MetadadadosEffect of estrogen-progestogen hormonal replacement therapy on periurethral and bladder vessels(Springer, 2000-04-01) Endo, R. M.; Girao, MJBC; Sartori, MGF; Simoes, M. J.; Baracat, E. C.; Lima, G. R. de; Universidade Federal de São Paulo (UNIFESP)This study assessed the effect of hormone replacement therapy using estrogens and/or progestogens on the number of vessels in the proximal and distal urethra, vesicourethral junction and bladder of castrated adult female rats. Forty-five virgin adult rats (Rattus norvegicus albinus) castrated for at least 30 days were used. They were assigned to five groups; group I (control) received no medication; the others received via the subcutaneous route, respectively, 17-beta-estradiol (group II), medroxyprogesterone acetate (group III), a maize oil and benzyl acid solution - placebo (group IV) and 17-beta-estradiol combined with medroxyprogesterone acetate (group V), for a minimum of 28 days. Increased vascularization throughout the urinary tract, except in the distal urethra, was found following estrogen replacement alone. in the group that received combined estrogens and progestogens, no increase was found. It was concluded that estrogen replacement in castrated rats significantly increased the number of vessels in the lower urinary tract.
- ItemSomente MetadadadosHormonal influence on periurethral vessels in postmenopausal incontinent women using Doppler velocimetry analysis(Elsevier B.V., 2007-03-20) Jarmy-Di Bella, Z. I. K.; Girao, M. J. B. C.; Di Bella, V.; Sartori, M. G. F.; Szejnfeld, J.; Baracat, E. C. [UNIFESP]; Lima, G. R.; Universidade Federal de São Paulo (UNIFESP)The lack of estrogen affects the urinary tract mainly by diminishing vascular, muscular and epithelial trophism, resulting in negative effects on continence in postmenopausal women.Objective: Study the effect of hormone therapy (estrogen and progesterone) in periurethral vessels detected by Doppler velocimetric analysis using, as parameters, the number of vessels, resistance and pulsatility indexes, as well as the minimum diastolic value.Methods: Thirty-eight postmenopausal women with stress urinary incontinence were randomized into two groups. the first consisted of women receiving 3 months of estrogen therapy previous to 3 months of continuous estrogen and progesterone combined therapy. the second comprised of women receiving 3 months of continuous estrogen and progesterone therapy. Periurethral Doppler velocimetric analysis was done before hormone administration and during treatment in both groups.Results: We observed a statistically significant increased number of periurethral vessels during treatment in both groups. There was an increase in value of the mean minimum diastolic value during estrogen and progesterone therapy in Group 2. the resistance indexes diminished in both groups. However, they were not statistically significant.Conclusion: Hormonal therapy of short duration (3-6 months) had a positive effect on the urethral continence mechanism increasing the number of periurethral vessels either with estrogen alone or combined therapy (estrogen and progesterone). (c) 2006 Elsevier Ireland Ltd. All rights reserved.
- ItemAcesso aberto (Open Access)Impacto do treinamento dos músculos do assoalho pélvico na qualidade de vida em mulheres com incontinência urinária(Associação Médica Brasileira, 2012-04-01) Fitz, Fátima Faní [UNIFESP]; Costa, Thaís Fonseca [UNIFESP]; Yamamoto, Deborah Mari [UNIFESP]; Resende, Ana Paula Magalhães [UNIFESP]; Stüpp, Liliana [UNIFESP]; Sartori, Marair Gracio Ferreira [UNIFESP]; Girão, Manoel João Batista Castello [UNIFESP]; Castro, Rodrigo de Aquino [UNIFESP]; Universidade Federal de São Paulo (UNIFESP)OBJECTIVE: To evaluate the impact of pelvic floor muscle (PFM) training on the quality of life (QOL) in women with stress urinary incontinence (SUI). METHODS: Prospective clinical trial with 36 women with a diagnosis of SUI confirmed by urodynamic study. Women with neuromuscular diseases, using hormone replacement therapy, and with prolapse stage III and IV were not included. The exercise protocol for the PFM consisted of slow contractions (tonic fibers), followed by rapid contractions (phasic fibers) practiced in the supine, sitting, and standing positions, three times a week for a period of three months. We evaluated the impact of PFM on QOL using the King's Health Questionnaire (KHQ), a voiding diary, and digital palpation to assess the function of the PFMs during the initial evaluation and after three months of treatment. The result was described as means and standard deviations. We used the Wilcoxon test for comparison of the KHQ scores for paired samples, and the significance level was set at 0.05. RESULTS: There was a significant decrease in the mean scores of the domains assessed by the KHQ regarding the perception of health, impact of the incontinence, limitations of daily activities, physical limitations, social limitations, personal relationships, emotions, sleep/disposition, and measures of severity. In agreement with these results, significant decrease in nocturnal urinary frequency and urinary incontinence, as well as significant increase in muscle strength and endurance were observed. CONCLUSION: PFM training resulted in significant improvement in the QOL of women with SUI.
- ItemSomente MetadadadosMorphological and functional response to injury to the external urethral sphincter - similarities and differences between male and female rats(Wiley-Blackwell, 2016) Nascimento, Scheila F. C. [UNIFESP]; Bispo, Ana Paula S. [UNIFESP]; Leite, Katia Ramos; Plapler, Helio; Fuellhase, Claudius; Simonetti, Rogerio [UNIFESP]; Soler, Roberto [UNIFESP]AimsThe objective of this study was to evaluate the similarities and differences of the urethral morphological and functional changes following external urethral sphincter EUS injury in male and female rats. Methods30 female and 30 male age-matched Wistar rats were used in the experiments. Half of them underwent electrocauterization of the surrounding tissues lateral to the urethra at the level of the (EUS) and the others, a sham operation. At 2, 6, and 16 weeks after surgeries they underwent anesthetized cystometry, measurement of leak point pressure (LPP) and their urethras were harvested for morphological analyses. ResultsThere were no differences in cystometric parameters between sex-time-matched animals, ensuring normal bladder function in the manipulated animals. The mean LPP in male and female rats was lower compared with sham animals. Age-time-matched sham operated male rats exhibited a higher LPP compared with female rats. The reduction in LPP comparing electrocauterized and sham time-matched animals was more pronounced in male rats than in female rats. Electrocauterization produced urethral collagen deposition and nerve damage in both male and female animals. Muscle atrophy and disruption also occurred, being more evident in female rats. ConclusionsThe urethras of male and female rats exhibited a similar morphological and functional response to electrocauterization. The time-course evaluation revealed that the male animal model is as reliable, reproducible and long-lasting as the female model. Intact males had a higher LPP than female rats and the nerve injury led to a more drastic impairment of this mechanism. Neurourol. Urodynam. 35:371-376, 2016. (c) 2014 Wiley Periodicals, Inc.
- ItemAcesso aberto (Open Access)Structural and thermal properties of polypropylene mesh used in treatment of stress urinary incontinence(Wroclaw Univ Technology, 2009-01-01) Afonso, José Sebastião [UNIFESP]; Jorge, Renato Natal; Martins, Pedro Alexandre Lopes de Sousa; Soldi, Marly da Silveira; Alves, Oswaldo Luiz; Patricio, Belmiro; Mascarenhas, Teresa; Sartori, Marair Gracio Ferreira [UNIFESP]; Girão, Manoel João Batista Castello [UNIFESP]; Universidade Federal de São Paulo (UNIFESP); Univ Porto; Universidade Federal de Santa Catarina (UFSC); Universidade Estadual de Campinas (UNICAMP)Besides material biocompatibility, it is possible to infer that both vaginal and urethral erosion rates associated with sub-urethral synthetic slings may be related to the mechanical properties of the meshes and also to their other properties. With the aim of understanding what distinguishes the different polypropylene meshes, used for the treatment of the stress urinary incontinence (SUI), their structural and thermal properties were investigated. Five different mesh types were tested (Aris (TM), Auto Suture (TM), Avaulta (TM), TVTO (TM) and Uretex (TM)). Differential scanning calorimetry (DSC) and infrared spectroscopy (FTIR) tests were performed. Furthermore, geometry (electron microscope), linear density and relative density (pyknometer) of the meshes were investigated. The meshes are made of the isotactic polypropylene homopolymer. Aris (TM) mesh presented the smallest fibre diameter, linear density and the level of crystallinity among all the meshes used for the treatment of the SUI. This study shows that there is a direct relationship between the fibre diameter, linear density, level of crystallinity and flexural stiffness of the polypropylene meshes used for the treatment of the SUI.
- ItemSomente MetadadadosSulfated glycosaminoglycans of the periurethral tissue in women with and without stress urinary incontinence, according to genital prolapse stage(Elsevier B.V., 2006-06-01) Feldner, P. C.; Kati, L. M.; Sartori, MGF; Baracat, E. C.; Lima, G. R. de; Nader, H. B.; Dietrich, C. P.; Girao, MJBC; Universidade Federal de São Paulo (UNIFESP)Objective: the objective was to determine sulfated glycosaminoglycans (GAG) of the extracellular matrix (ECM) in women with and without stress urinary incontinence according to genital prolapse stage.Study design: Periurethral tissue was obtained from 30 women who underwent surgery for urinary incontinence, for pelvic organ prolapse, or for other benign gynecologic conditions. Biopsy specimens were assessed by biochemical methods to characterize and quantify sulfated glycosaminoglycans. Measurements were made of total glycosaminoglycans, chondroitin sulfate, dermatan sulfate, and of heparan sulfate. Data were compared using the t-test.Results: in two groups, dermatan sulfate was the most predominant glycosaminoglycan. Women with stress urinary incontinence had significantly more total sulfated glycosaminoglycans (p < 0.05) and dermatan sulfate (p < 0.05) than women without stress urinary incontinence. We did not observe any differences in chondroitin sulfate and heparan sulfate.Conclusions: Women with stress urinary incontinence showed quantitative and qualitative differences in the biochemical characteristics of the extracellular matrix in periurethral tissue by analysis of sulfated glycosaminoglycans, according to genital prolapse stage. (C) 2005 Elsevier Ireland Ltd. All rights reserved.
- ItemSomente MetadadadosUrodynamic changes induced by the intravaginal electrode during pelvic floor electrical stimulation(Wiley-Blackwell, 2003-01-01) Resplande, J.; Gholami, S.; Bruschini, H.; Srougi, M.; Universidade Federal de São Paulo (UNIFESP); Univ Calif San FranciscoAims: the goal of this study was to evaluate whether the intravaginal electrode used to perform vaginal electrical stimulation could induce acute changes on the cystometrograms and urethral pressure profiles (UPP) recordings. Methods: Three consecutive urodynamic examinations were performed on 30 women with stress urinary incontinence (SUI) symptoms. the first exam was performed without the electrode, the second with the electrode inserted into the vagina, but with the stimulator switched off and the third with the stimulator turned on. We used the INNOVA (Empi) stimulator with electrical parameters set at 50 Hz and 60 mA and on an intermittent cycle during the cystometries and a continuous stimulation during the UPP. the data of functional profile length (FPL), maximum urethral closure pressure (MUCP), and area of the resting UPP as well as the filling sensations and its respective bladder volumes during the cystometries, were compared. With regard to the cystometries. Results: No effect of the electrode was observed on cystometry. However, the simple presence of the electrode improved the FPL, MUCP, and areas of the UPP similar to those when the stimulation was applied. Conclusions: We conclude that, the presence of the intravaginal electrode induces changes in the UPP not related to the stimulation itself. the physiotherapeutic effect of the electrode itself is still to be evaluated. (C) 2003 Wiley-Liss, Inc.