Ambulatório de urologia geriátrica: caracterização e desafios de uma experiência interdisciplinar
Data
2011
Autores
Sica Filho, Dante 
Orientadores
Dambros, Miriam
Tipo
Tese de doutorado
Título da Revista
ISSN da Revista
Título de Volume
Resumo
Objetivo: O presente estudo tem por objetivo descrever a experiencia interdisciplinar pioneira do ambulatorio de urologia geriatrica da disciplina de urologia da Universidade Federal de São Paulo u Escola Paulista de Medicina (UNIFESP/EPM), atraves da caracterizacao do perfil dos pacientes atendidos e da metodologia de trabalho utilizada em seu cotidiano. Metodo: Estudo observacional, transversal. A amostra de participantes deste estudo compreendeu todos os individuos do sexo masculino que foram atendidos em primeira consulta no ambulatorio de Urologia Geriatrica da UNIFESP, sob a responsabilidade da disciplina de Urologia, de janeiro a maio de 2010. Os criterios de inclusao adotados foram: sexo masculino; primeira consulta no ambulatorio; interesse voluntario em participar do estudo; compreensao e assinatura do termo de consentimento informado. Resultados: Foram incluidos 66 pacientes, cujas idades variaram entre 48 e 86 anos, pois nao houve restricao a admissao de pessoas de faixa etaria inferior a 65 anos. A media de idade foi 68,24 anos, sendo 8,271 o desvio padrao. Sintomas do trato urinario inferior, episodio previo de retencao urinaria aguda e aumento de prostata corresponderam a 72,5% dos motivos de encaminhamento ao ambulatorio de urologia geriatrica. Diagnosticos previos de hipertensao arterial sistemica e diabetes melitus foram relatados por, respectivamente, 51,5% e 19,3% dos pacientes. Antecedentes de doenca arterial coronariana e cerebrovascular foram relatados por 3% dos pacientes. Cancer de prostata foi relatado por 3% dos pacientes, e 10,6% referiam ter sido submetidos a resseccao transuretral de prostata. O uso de alfa-bloqueadores e inibidores da 5-alfa-redutase foi referido por 19,7% e 18,2% dos pacientes. Dos 66 questionarios IPSS aplicados, 55 foram considerados validos (completos) e 11 anulados. A mediana da pontuacao foi 11, com uma variacao de zero a 33. O percentil 25 foi 5, e o percentil 75 foi 20. Conclusao: Os homens encaminhados para primeira consulta no ambulatorio de urologia geriatrica da UNIFESP sao predominantemente oidosos jovenso (<80 anos), com prevalencia das principais doencas cronicas (hipertensao e diabetes) semelhantes as encontradas na populacao brasileira idosa, e em sua maioria foram encaminhados devido a queixas relacionadas a hiperplasia benigna da prostata, de intensidade leve a moderada, com pequena repercussao em sua qualidade de vida, e sem historico previo de nenhum tipo de tratamento clinico ou cirurgico. A interdisciplinaridade do ambulatorio promoveu um atendimento global aos pacientes, permitindo que a avaliacao clinica do geriatra complementasse a consulta urologica.
Purpose: this research's purpose is to describe the geriatric urological ambulatory interdisciplinary pioneer experience of the urology class of the Federal University of Sao Paulo - Medicine Paulista School (UNIFESP/EPM), through the characterization of the patient’s outline and the ambulatory daily routine. Method: observation study, transversal. The sample of patients analyzed included all male individuals whose first appointment was in the Geriatric Urological ambulatory of UNIFESP, under responsibility of the urology class, from January to May 2010. The criteria to include data were: male; first appointment in the ambulatory; patient's volunteer to participate of the study; comprehension and signature of the consent form. Results: 66 patients were included, whose ages varied from 48 to 86, considering that there were no restrictions to the inclusion of patients under the age of 65. The average age was 68,24, with standard deviation of 8,271. Lower urinary tract symptoms, previous acute urinary retention and prostate enlargement corresponded to 72,5% of the reasons to seek the geriatric urological ambulatory. Previous diagnosis of systemic high blood pressure and mellitus diabetes were respectively referred by 51,5% and 19,3% of the patients. Prior coronary artery and brain vascular sickness were referred by 3% of the patients and 10,6% referred to have been submitted to a transurethral resection of the prostate. The use of alpha-blockers and of 5 alpha-reductase inhibitors was referred by 19,7% and 18,2% of the patients. Out of the total of 66 IPSS forms completed, 55 were considered valid (complete) and 11 were void. The average of the points was 11, with a variation from zero to 33. The percentile 25 was 5 and the percentile 75 was 20. Conclusion: the male patients whose first appointment was in the Geriatric Urological ambulatory of UNIFESP are predominantly "young elders" (<80 years old), prevailing the main chronic diseases (hypertension and diabetes) similar to the ones detected in the Brazilian elderly population, and, in its majority, were sent to treatment due to complaints related to the prostate benign hyperplasia, of low to moderate intensity, with little reflect on life quality, and with no previous history of clinical or chirurgical treatment. The interdisciplinary attention on the ambulatory promoted a complete evaluation of the patients, including a geriatric and urological appointment.
Purpose: this research's purpose is to describe the geriatric urological ambulatory interdisciplinary pioneer experience of the urology class of the Federal University of Sao Paulo - Medicine Paulista School (UNIFESP/EPM), through the characterization of the patient’s outline and the ambulatory daily routine. Method: observation study, transversal. The sample of patients analyzed included all male individuals whose first appointment was in the Geriatric Urological ambulatory of UNIFESP, under responsibility of the urology class, from January to May 2010. The criteria to include data were: male; first appointment in the ambulatory; patient's volunteer to participate of the study; comprehension and signature of the consent form. Results: 66 patients were included, whose ages varied from 48 to 86, considering that there were no restrictions to the inclusion of patients under the age of 65. The average age was 68,24, with standard deviation of 8,271. Lower urinary tract symptoms, previous acute urinary retention and prostate enlargement corresponded to 72,5% of the reasons to seek the geriatric urological ambulatory. Previous diagnosis of systemic high blood pressure and mellitus diabetes were respectively referred by 51,5% and 19,3% of the patients. Prior coronary artery and brain vascular sickness were referred by 3% of the patients and 10,6% referred to have been submitted to a transurethral resection of the prostate. The use of alpha-blockers and of 5 alpha-reductase inhibitors was referred by 19,7% and 18,2% of the patients. Out of the total of 66 IPSS forms completed, 55 were considered valid (complete) and 11 were void. The average of the points was 11, with a variation from zero to 33. The percentile 25 was 5 and the percentile 75 was 20. Conclusion: the male patients whose first appointment was in the Geriatric Urological ambulatory of UNIFESP are predominantly "young elders" (<80 years old), prevailing the main chronic diseases (hypertension and diabetes) similar to the ones detected in the Brazilian elderly population, and, in its majority, were sent to treatment due to complaints related to the prostate benign hyperplasia, of low to moderate intensity, with little reflect on life quality, and with no previous history of clinical or chirurgical treatment. The interdisciplinary attention on the ambulatory promoted a complete evaluation of the patients, including a geriatric and urological appointment.
Descrição
Citação
SICA FILHO, Dante. Ambulatório de urologia geriátrica: caracterização e desafios de uma experiência interdisciplinar. 2011. 61 f. Tese (Doutorado em Urologia) - Escola Paulista de Medicina, Universidade Federal de São Paulo (UNIFESP). São Paulo, 2011.