Purpose: To determine adherence rate and variables associate with patients' adherence to Clean Intermittent Self Catheterization (CISC). Materials and Methods: Patients refereed to CISC training program between July 2006 and May 2008, were prospectively evaluated with urodynamic, 3 days bladder diary (BD) and WHOQoL-bref questionnaire. After training to perform CISC, patients were evaluated at 2 weeks, monthly for 6 months and at 12 months with clinical visits and BD. Patients were considered adherent if they were performing at least 80% of the initial recommendation. Results: Sixty patients (50.4 ± 19.9 years old) were trained to perform CISC (21 female and 39 male). Out of them, 30 (50%) had neurogenic and 30 (50%) had a non-neurogenic voiding dysfunction. The adherence rate at 6 and 12 months was 61.7%, 58%, respectively. Patients < 40 years old had adherence rate of 86%. Women and neurogenic patients had higher adherence rate than their counterparts (p = 0.024 and p = 0.016, respectively). In the WHOQoL-bref, patients that adhere to the program had a significant higher score on psychological and social relationships domains. There was not difference in pre and post training WHOQoL-bref scores. Educational background, marriage status, detrusor leak point pressure, Bladder Capacity, number of leakage episodes did not play a role on the adherence rate. Conclusion: Patients in CISC program present a reasonable adherence after one year. Women, neurogenic voiding dysfunction and patients under 40 years old were significantly more adherents. The psychological and social relationship status seems to positively interfere on adherence. CISC did not affect patient's QoL evaluated by WHOQoL-bref.

The aim of this study is to validate the International Consultation on Incontinence Questionnaire-Vaginal Symptoms (ICIQ-VS) in Portuguese. Two hundred four women (108 symptomatic, 94 asymptomatic, and two with no data) with mean age of 55.4 years received a Portuguese version of the ICIQ-VS. Clinical data and pelvic organ prolapse quantification index (POP-Q) were obtained. Retest was performed 3 weeks later. Responsiveness was assessed after 20 weeks of postsurgical follow-up. Overall, most patients presented POP-Q > 2. ICIQ-VS demonstrated good psychometric properties (validity, reliability and responsiveness). The test-retest reliability was moderate to excellent for all questions. The construct validation distinguished differences in ICIQ-VS scores between symptomatic (ICIQ-VS5a > 0) and asymptomatic (ICIQ-VS5a = 0) women. ICIQ-VS was highly responsive to surgical treatment and discriminated between levels of change in the vaginal symptoms score, sexual matters score, quality-of-life score, and POP-Q. The Portuguese version of ICIQ-VS was successfully validated.

Complex vesicovaginal fistulas are a big challenge for the urologist, and there is no gold standard surgical approach. The majority of complex vaginal fistula can be successfully managed by vaginal repair. As the vaginal approach is a minimally invasive procedure with low costs, easy learning curve, and high cure rates, new approaches must be carefully evaluated before being suggested as an alternative.

IntroductionUrinary incontinence (UI) has been associated with negative effects on women's sexuality. Women's sexuality and sexual function are a complex issue, and the role of UI is not completely clear.AimTo assess the impact of UI on female sexual function by comparing this population with a control group of continent women.MethodsWe performed a case-control study from August 2012 to September 2013. We evaluated continent and incontinent women (age range = 30–70 years) for their sexuality.Main Outcome MeasuresAll patients were evaluated by anamnesis, physical examination, and self-report quality-of-life questionnaires. In addition, incontinent women underwent a 1-hour pad test. Patients without sexual activity were evaluated for the role of UI in their sexual abstinence. Sexual abstinence was defined as the absence of sexual activity for more than 6 months. All sexually active women completed the self-report Sexuality Quotient–Female Version (SQ-F) questionnaire.ResultsA total of 356 women were included in the study (incontinent, n = 243; continent, n = 113). Sexual abstinence was found in 162 women (45%). Incontinent women presented a higher prevalence (P < .001) of sexual abstinence than their counterparts (129 [53%] and 33 [29.2%], respectively). Age, marital status, and UI were found to be isolated predictive factors for more sexual abstinence in incontinent women. Sexually active women (incontinent, n = 114; continent, n = 80) presented similar demographic data. Despite a similar frequency of sexual activity, incontinent women had less sexual desire, foreplay, harmony with a partner, sexual comfort, and sexual satisfaction than their counterparts. Women with greater urinary leakage during the 1-hour pad test (weight > 11 g) had the worst sexual function (SQ-F) score.ConclusionWomen with UI were more likely to be sexual abstinent than continent women. Furthermore, women with UI showed less sexual desire, sexual comfort, and sexual satisfaction than their counterparts despite having a similar frequency of sexual activity.

The aims of this study were to evaluate the impact of radical retropubic prostatectomy on patient's quality of life. Patients undergoing radical retropubic prostatectomy were followed for six months after surgery. We used quality of life questionnaires to study specific urinary symptoms and general health. WHOQOL-Bref (World Health Organization for Quality of Life) questionnaire was used to evaluate general health aspects, ICIQ-SF (International Consultation on Incontinence Questionnaire-Short Form), OABq (Overactive Bladder) and IPSS (International Prostatic Symptom Score) to evaluate incontinence and overactive bladder symptoms and Male Sexual Quotient to assess postoperative sexual dysfunctions. The questionnaires were scheduled before surgery, one, three and six months after surgery. Regarding the OAB-q scores, I-PSS and WHOQOL-Bref (physical, psychological, environmental, general, Question 1 and Question 2), symptoms worsened after one month if compared to preoperative symptoms. After six months, the WHOQOL's social domain, the ICIQ-SF and QS-M scores remained worse if compared to preoperative evaluation. The incidence of sexual dysfunctions after six months was 0.83. In conclusion, urinary incontinence affects patient's quality of life with gradual recovery after six months postoperatively. The social domain was the most common aspect affected by urinary incontinence. Our sexual dysfunction incidence was higher than other studies and this fact could be explained by many surgeries having been done by residents.

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Introduction and Objective Male detrusor underactivity (DUA) definition remains controversial and no effective treatment is consolidated. Transurethral resection of the prostate (TURP) is one of the cornerstones surgical treatments recommended in bladder outlet obstruction (BOO). However, the role of prostatic surgery in male DUA is not clear. The primary endpoint was the clinical and voiding improvement based on IPSS and the maximum flow rate in uroflowmetry (Qmax) within 12 months. Materials and Methods We analyzed an ongoing prospective database that embraces benign prostata hyperplasia (BPH) male patients with lower urinary tract symptoms who have undergone to TURP. All patients were evaluated pre and postoperatively based on IPSS questionnaires, prostate volume measured by ultrasound, postvoid residual urine volume (PVR), Prostate Specific Antigen measurement and urodynamic study (UDS) before the procedure. After surgery, all patients were evaluated at 1‐, 3‐, 6‐ and 12‐months. Patients were categorized in 3 groups: Group 1—Detrusor Underactive (Bladder Contractility Index (BCI) [BCI] < 100 and BOO index [BOOI] < 40); Group 2—Detrusor Underactive and BOO (BCI < 100 and BOOI ≥ 40); Group 3—BOO (BCI ≥ 100 and BOOI ≥ 0). Results It was included 158 patients underwent monopolar or bipolar TURP since November 2015 to March 2021. According to UDS, patients were categorized in: group 1 (n = 39 patients); group 2 (n = 41 patients); group 3 (n = 77 patients). Preoperative IPSS was similar between groups (group 1—24.9 ± 6.33; group 2—24.8 ± 7.33; group 3—24.5 ± 6.23). Qmax was statistically lower in the group 2 (group 1—5.43 ± 3.69; group 2—3.91 ± 2.08; group 3—6.3 ± 3.18) as well as greater PVR. The 3 groups presented similar outcomes regard to IPSS score during the follow‐up. There was a significant increase in Qmax in the 3 groups. However, group 1 presented the lowest Qmax improvement. Conclusion There were different objective outcomes depending on the degree of DUA at 12 months follow‐up. Patients with DUA had similar IPSS improvement. However, DUA patients had worst Qmax improvement than men with normal bladder contraction.

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