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A Síndrome da bexiga urinária hiperativa neurogênica, de alta prevalência, é causada principalmente pela hiperatividade do músculo detrusor da bexiga. A patofisiologia ainda é pouco elucidada e existem algumas opções de tratamento cirúrgico e clínico. Muitas vezes são necessários tratamentos conjuntos para melhores resultados. As pesquisas sobre intervenções conservadoras têm crescido nos últimos anos, apontando para novas estratégias de manejo dos sintomas. A eletrostimulação transcutânea do nervo tibial posterior é uma delas, que tem mostrado resultados promissores, de fácil aplicação, boa adesão, baixo custo e com eficiência.

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Objective. To evaluate if there is a relation between quality of life and quality of sleep in pregnant women. Method. This was a crosssectional study which participants were selected at Ipiranga Hospital and applied an evaluation form, Pittsburgh Sleep Quality Index (PSQI), questionnaire of quality of life (SF-36), and was given a booklet of guidelines of sleep hygiene. Inclusion criteria was pregnancy; exclusion criteria was hearing loss, sleep disturbance, prior night occupation, neurological damage and that was not doing prenatal care. Results. 51 volunteers participated in the work, of which 32 were in the third trimester and 10 in the second trimester, the average age was 25,3 (±6,3) years, and 70% of the entire sample had poor sleep quality. It was also observed that multiparous pregnant women had worsening in sleep and quality of life. Conclusion. There was no correlation between quality of sleep and quality of life in pregnant women. But it was worst in the second trimester of pregnancy.

Background: Approximately 30 to 50% of women are unable to correctly perform pelvic floor muscle (PFM) contractions. For women to benefit from a pelvic floor muscle training (PFMT) programme for stress urinary incontinence (SUI), the awareness phase of PFMT cannot be omitted. The purpose of this study is to evaluate whether vaginal palpation together with verbal instructions about PFMs and body awareness techniques helps women with SUI learn how to correctly contract the PFMs and improve their functions. Methods: This single-centre, double-blind randomized controlled trial with two intervention groups was designed following the standard protocol items for randomized interventional trials (SPIRIT). The results will be reported in a manner consistent with the Consolidated Standards of Reporting Trials (CONSORT) guidelines. Patients with SUI (n = 172) will be recruited. The experimental group will receive verbal instructions about PFM function and body awareness techniques together with vaginal palpation; the control group will receive similar protocol without vaginal palpation. The primary outcome includes the number of fast-twitch muscle fibres assessed by vaginal palpation and visual observation. Secondary outcomes include power and muscular endurance that will be assessed by visual observation and vaginal palpation (Oxford scale), the use of accessory muscles during the voluntary contraction of PFMs, and the self-efficacy and the expectations for the results using the self-efficacy scale of pelvic floor exercises. Discussion: This study will determine whether vaginal palpation can help women with SUI to correctly perform PFM contractions and improve their functions. Trial registration: ClinicalTrials.gov NCT 03325543. Registered on 30 November 2017. Study protocol version 1; 30 November 2020. Prospectively registered.

Background Stress urinary incontinence (SUI) is a subtype of urinary incontinence that occurs more commonly amongst women. The pelvic floor muscle training (PFMT) is considered the gold standard for treating SUI. Another technique called the Knack postulated that pre-contraction of the pelvic floor muscles (PFM) during activities of increasing intra-abdominal pressure prevents urinary loss. Currently, there are no studies supporting the Knack for the treatment of SUI. Thus, the aim of this study is to test the hypothesis that voluntary pre-contraction of PFM can treat SUI. For this purpose, the following parameters will be analysed and compared amongst (1) the Knack, (2) PFMT and (3) the Knack + PFMT groups: urine leakage as assessed by the pad test, urinary symptoms, muscle function, quality of life, subjective cure, adherence to exercises in the outpatient setting and at home and perceived self-efficacy of PFM exercises. Methods A single-centre, double-blind (investigator and outcome assessor) randomised controlled trial with a 3-month follow-up of supervised treatment and an additional 3 months of follow-up (unsupervised) for a total of 6 months of follow-up. Two hundred ten women with mild to moderate SUI will be included, aged between 18 and 70 years. To compare the primary and secondary outcome measures within and between the groups studied (before and after intervention), the ANOVA statistical test will be used. Primary and secondary outcome measures will be presented as mean, standard deviation, 95% confidence interval and median and minimum and maximum values. Discussion/significance This study closes a gap, as voluntary PFM pre-contraction (the Knack) has not yet been included in the physiotherapeutic treatment of SUI, and if shown successful could be implemented in clinical practice. Trial registration ClinicalTrials.gov NCT03722719. Registered on October 29, 2018. Study protocol version 1. Was this trial prospectively registered? Yes Funded by: The present study did not receive funding. Anticipated completion date: The anticipated trial commencement and completion dates are October 2018 and October 2021, respectively. Provenance: Not invited. Peer reviewed. Human research ethics approval committee: Research Ethical Board of the Universidade Federal de São Paulo (UNIFESP), Brazil. Human research ethics approval number: 2.517.312.