RESUMOOBJETIVO. Avaliar a ocorrência de incontinência urinária (IU) em atletas corredoras de longa distância e associá-la a presença ou não de distúrbios alimentares. MÉTODOS. Um total de 37 corredoras de longa distância completaram os questionários ¨International Consultation on Incontinence Questionnaire-Short Form¨ (ICIQ-SF) e o ¨Eating Attitudes Test¨ . O teste do absorvente de uma hora foi realizado para quantificar a perda de urina. A análise estatística das variáveis contínuas foi feita pelo teste t pareado, ou teste de Mann-Whitney. RESULTADOS. 23 atletas (62,2%) tinham queixa de perda de urina. A média dos escores do ICIQ-SF neste grupo foi de 4,03 ± 5,06. Houve diferença estatisticamente significante entre o valor do teste do absorvente (p=0,02) e o resultado do questionário 03) INTRODUÇÃOAs corridas de longa distância, praticadas em vias públicas, incluem: provas de 10 km, meia maratona (21,095km) e maratona (42,195km) 1 . Também chamada de "pedestrianismo", esta modalidade esportiva vem crescendo e atraindo adeptos em todo o mundo. Os corredores, profissionais ou amadores, treinam diariamente, sob a supervisão de um técnico, e participam de competições em busca de superação, recordes ou melhora da qualidade de vida.As distâncias percorridas, assim como as diferenças de superfície e as características da prova, exigem do atleta técnica e estratégias específicas. A biomecânica da corrida de longa distância difere da mecânica das demais provas de corrida 2 . Também é importante ressaltar o aumento da participação feminina neste tipo de modalidade esportiva, e que a mulher atleta não pode ser avaliada e treinada da mesma forma que o homem 3 . Além das alterações hormonais fisiológicas envolvidas no ciclo menstrual, os técnicos e preparadores físicos devem estar cientes de eventuais distúrbios clínicos que podem ocorrer, como a incontinência urinária e os distúrbios alimentares 3 . A incontinência urinária (IU) é definida pela Sociedade Internacional de Continência (ICS) como qualquer perda involuntária de urina 4,5,6 . Estudos mostram que a prevalência da IU durante a prática esportiva nas atletas de elite varia de 0% (golfe) até 80% (trampolinistas) 7,8 . As maiores prevalências ocorrem em esportes que envolvem atividades de alto impacto como: ginástica, atletismo e alguns jogos com bola 7,9 . Uma grande proporção destas atletas relata que a perda de urina é muito embaraçosa e que afeta a concentração e a performance 6,10 . Algumas teorias tentam explicar a ocorrência de IU nas atletas. Uma delas afirma que, embora as atletas tenham os músculos do assoalho pélvico fortes, a atividade física árdua levaria ao aumento da pressão abdominal, predispondo a IU 9 . Outros autores acreditam que estas atletas têm sobrecarga, estiramento e enfraquecimento do assoalho pélvico 6, 11 . Reforça esta teoria o fato de que a força vertical de reação máxima do solo durante diferentes atividades esportivas é três a quatro vezes o peso do corpo quando corremos, cinco a 12 vezes pulando, e nove vezes na queda após u...

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Objective To propose the inclusion of a gynecological investigation during the evaluation of athletes before competitions, using a specific instrument called the Pre-participation Gynecological Examination (PPGE).Methods The study assessed 148 athletes, mean age of 15.4±2.0 years, who engaged in eight different sports modalities, and who responded to a questionnaire named Pre-Participation Gynecological Examination (PPGE), to the International Consultation on Incontinence Questionnaire - Short Form (for urinary loss), and to the Eating Attitudes Test (for eating disorders).Results Fifty percent of the participants reported irregular menstrual intervals, 23.0% did not know about sexually transmitted diseases, and 72.4% denied having, at least, an annual gynecological appointment. The study identified 18.2% who had urinary loss, and 15% presented with an increased risk of eating disorders. Moreover, 89.9% were not familiar with the occurrence of urinary incontinence in athletes and did not know that they were susceptible to the female athlete triad. A total of 87.1% of them stated that would not mention these issues to their coaches even if this would improve their health or performance.Conclusion The Pre-Participation Gynecological Examination can be considered an easy-to-apply instrument that allowed the diagnosis of alterations often underestimated by the athletes themselves. After its application, the alterations were identified, and determined the athletes’ referral to appropriate evaluation and treatment.

The presence of bacteria in urine is called bacteriuria, which may be symptomatic or asymptomatic. The manipulation of the urinary tract during urodynamic study (UDS), which is an invasive procedure, can result in urinary tract infection (UTI). Studies on the use of prophylactic antibiotics for UDSs are contradictory. Some investigators concluded that they were valuable and others did not. The objective of this study is to evaluate the efficacy of antibiotic prophylaxis before UDS. This is a placebo-control randomized double-blind study. Two-hundred and seventeen women affected by urinary incontinence were eligible for this study. All patients had presented negative urine culture previous to the UDS. They were randomized in four groups: group A received placebo, group B received 500 mg of levofloxacin, group C received 80 mg trimethoprim and 400 mg sulfamethoxazole and group D received 100 mg of nitrofurantoin. A urine culture was performed 14 days after the UDS. We observed asymptomatic bacteriuria after the UDS in five patients in group A, one in group B, one in group C and one in group D. Only one patient on group A had symptomatic bacteriuria. We didn't observe statistical difference between the groups. When we recategorized the patients in two groups, the incidence of bacteriuria was significantly higher in the placebo group compared with the antibiotic group. The conclusion is that antibiotic prophylaxis before the UDS did not reduce the incidence of UTI in women within the target population.

Objective Using three-dimensional ultrasound (3D-US), we aimed to compare the tape position and the angle formed by the sling arms in different techniques of mid-urethral sling insertion for the surgical treatment of stress urinary incontinence, three years after surgery. In addition, we examined the correlations between the US findings and the clinical late postoperative results. Methods A prospective cross-sectional cohort study of 170 patients who underwent a sling procedure between May 2009 and December 2011 was performed. The final sample, with US images of sufficient quality, included 26 retropubic slings (tension-free vaginal tape, TVT), 42 transobturator slings (tension-free vaginal tape-obturator, TVT-O), and 37 single-incision slings (tension-free vaginal tape-Secur, TVT-S). The images (at rest, during the Valsalva maneuver, and during pelvic floor contraction) were analyzed offline by 2 different observers blinded against the surgical and urinary continence status. Group comparisons were performed using the Student t-test, the chi-squared and the Kruskal-Wallis tests, and analyses of variance with Tukey multiple comparisons. Results Differences among the groups were found in the mean angle of the tape arms (TVT = 119.94°, TVT-O = 141.93°, TVT-S = 121.06°; p < 0.001) and in the distance between the bladder neck and the tape at rest (TVT = 1.65 cm, TVT-O = 1.93 cm, TVT-S = 1.95 cm; p = 0.010). The global objective cure rate was of 87.8% (TVT = 88.5%, TVT-O = 90.5%, TVT-S = 83.8%; p = 0.701). The overall subjective cure rate was of 83.8% (TVT = 88.5%, TVT-O = 88.5% and TVT-S = 78.4%; p = 0.514). The slings were located in the mid-urethra in 85.7% of the patients (TVT = 100%, TVT-O = 73.8%, TVT-S = 89.2%; p = 0.001), with a more distal location associated with obesity (distal: 66.7% obese; mid-urethra: 34% obese; p = 0.003). Urgency-related symptoms were observed in 23.8% of the patients (TVT = 30.8%, TVT-O = 21.4%, TVT-S = 21.6%; p = 0.630). Conclusions The angle formed by the arms of the sling tape was more obtuse for the transobturator slings compared with the angles for the retropubic or single-incision slings. Retropubic slings were more frequently located in the mid-urethra compared with the other slings, regardless of obesity. However, the analyzed sonographic measures did not correlate with the urinary symptoms three years after the surgery.

There is a change in sulfated glycosaminoglycans in female rat urethra during pregnancy and simulated birth trauma.

The present study implies a potential relationship between VEGF and urinary tract physiology. The results suggest that there are quantitative differences in VEGF expression in these tissues depending on steroid hormone status.

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