Hallazgos urodinámicos en mayores de 65 años: experiencia en el departamento 19 de la Agencia Valenciana de Salud (AVS)

Santamaría, C. Giner; Baena, Juan Franciso Galiano; Romeu, Juan Pablo Caballero; Tamayo, A. Leivar; Esclapes, Vicente Belvis; Encinas, J.J. Lobato

doi:10.4321/s0004-06142007000600006

Cited by 2 publications

(1 citation statement)

References 1 publication

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“…Giner-Santamaría has observed that UDS confirms SUI in 60% of cases, it is not reproducible in 20%, and MUI is seen in 10%. On the other hand, in patients with UUI, UDS confirmed the diagnosis in 64% (bladder hyperactivity, urgency, or UUI); it was not reproducible in 12% and showed uncoordinated urination in 8% [37]. This diagnostic assessment was similar to that observed in our study, to diagnose UUI (64.7%), but not to confirm SUI (35.1%).…”

Section: Discussionsupporting

confidence: 86%

Stress and Urgency Urinary Incontinence: Clinical-Urodynamic Correlation and Rehabilitation Management in Daily Clinical Practice

Fernández-Cuadros

Albaladejo-Florín

Álava-Rabasa

et al. 2022

SN Compr. Clin. Med.

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Abstract(a) To correlate the clinical with the urodynamic diagnosis in a series of patients with UUI (urgency urinary incontinence) and SUI (stress urinary incontinence); (b) establish age, clinical and urodynamic differences; and (c) demonstrate the effectiveness of individualized rehabilitation treatment based on the clinical-urodynamic diagnosis in patients with SUI and UUI in the daily clinical practice of a third-level rehabilitation service. Retrospective study of 60 patients with SUI and UUI. Urodynamic study: (a) free flowmetry; (b) filling cystomanometry; (c) pressure-flow study. Outcome variables: daytime (DUF) and nighttime (NUF) urinary frequency, strength of the pelvic floor muscles (PFM) measured by manometry (maximum and mean pressure), and use of absorbents/day. Rehabilitation treatment: (a) pelvic floor muscle training (PFMT); (b) biofeedback (BFB), transcutaneous neuromodulation of the posterior tibial nerve (TTNM). Age, clinical, and urodynamic differences have been observed between patients with UUI versus SUI. UUI is more frequent in older patients (UUI 67.3 ± 10.19 years vs SUI 58.6 ± 8.54 years), p = 0.0028. Patients with UUI, when compared with patients with SUI, present more episodes of DUF (7.7 ± 5.1 vs 5.5 ± 3.99) and NUF (2.51 ± 1.67 vs 1.46 ± 1.42). Patients with SUI use more absorbents/day than patients with UUI (2.7 ± 1.53 vs 1.37 ± 1.5), p = 0.0243. The urodynamic study (UDS) confirmed the clinical diagnosis in UUI in 64.7%, while in SUI, it was only confirmed in 35.1%. In the urodynamic analysis (free flowmetry), patients with UUI have smaller bladders than patients with SUI (voiding volume in UUI 275.8 ± 178.95 vs 411.03 ± 203.62 in SUI), p = 0.083. The maximum flow (Qmax) is higher in patients with SUI compared to UUI (19.6 ± 7.07 vs 16.06 ± 8.54), p = 0.0836. In filling cystomanometry, the bladders of patients with UUI are smaller than those with SUI (bladder capacity UUI 266.3 ± 52.76 vs 308.6 ± 49.72 ml in SUI), p = 0.023. In SUI, the BFB/PFMT significantly improved DUF, NUF, PFM pressure, and absorbent use. In UUI, the BFB plus TTNM improved DUF, NUF, and the maximum and mean PFM pressure with statistical difference, while the use of absorbents decreased with a tendency to significance. There are age, clinical, manometric, and urodynamic differences in patients with UUI when compared with patients with SUI. UUI occurs in older patients; they present a greater number of daytime and nocturnal urinary frequency episodes and use fewer absorbents than patients with SUI. Patients with UUI evacuate a smaller urine volume have a lower peak flow (in flowmetry) and a lower bladder capacity (in cystomanometry) than patients with SUI. The rehabilitation treatment proposed in daily clinical practice (PFMT/BFB with or without TTNM improves SUI and UUI). In this study, the UDS has shown a greater clinical-urodynamic correlation in UUI than in SUI.

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Section: Discussionsupporting

confidence: 86%

Stress and Urgency Urinary Incontinence: Clinical-Urodynamic Correlation and Rehabilitation Management in Daily Clinical Practice

Fernández-Cuadros

Albaladejo-Florín

Álava-Rabasa

et al. 2022

SN Compr. Clin. Med.

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Comparative Analysis Between Urinary Complaints and the Results of the Urodinamic Study of Women Seen at a Urogynecology Ambulatory in Macapa-Aresume

Rego¹,

Nascimento²,

Gomes³

2022

J Biomed Res Environ Sci

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Introduction: Urinary Incontinence (UI) is investigated through clinical history, physical exam, urinalysis, voiding diary, Pad-test, urodynamic study and imaging exams. Objective: To assess the efectiveness of the urodynamic test in proving UI. Methodology: Retrospective-cross-sectional-observational descriptive quantitative study. We analyzed the medical records of 594 women treated at the Women Hospital and Maternity “Mãe Luzia” – WHML in Macapá – AP aged 18 years or older, with complaints of urinary incontinence and who underwent urodynamic examination without any Other associated conditions. Statistical analysis was performed using the Chi-squared test, Mann-Whitney U test or Kruskal-Wallis test. Values of p < 0.05 were considered statistically significant. The research received authorization from the Ethics and Research Committee of the Federal University of Amapá (FR 347446/011). Results: 49.49% presented clinical complaints. Of those, 13.9% were compatible with Overactive Bladder (OAB), 11.2% with Stress Urinary Incontinence (SUI) and 74.8% with Mixed Urinary Incontinence (MUI). 50.5% were diagnosed by urodynamics, being 0.7% normal, 15.7% OAB, 14% SUI and 69.7% MUI. 45.2% of SUI and 46.4% of MUI were concentrated in pressure loss of up to 60cmH2O. As for age, 27.7% of those with OAB were between 31-40 years old, while 38.8% with MUI 41-50 years and 28.6% with SUI 51-60. The percentagem of women who had a clinical complaint and a corresponding urodynamic finding was Only 1.7% for SUI, 52.3% for MUI and 5.7% for OAB among those evaluated. Thus, urodynmics for SUI had a sensitivity of 89.1%, specificity of 11.9%, PPV of 86.1%, NPV of 15.2%, and accuracy of 78.3%, for BH it had a senstivity of 90.5%, specificity of 36.2%, PPV of 88.4%, NPV of 41.5%, and accuracy of 82% and for IUM it has a sensitivity of 30.8% and a specificity of 75.1%, leading to a PPV of 35.0% and a NPV of 71.4%, and therefore with an accuracy of 61.7%. Conclusion: Correspondence between clinical complaint and urodynamic study was low. Further studies are still needed in this regard for a final conclusion on the effectiveness of the urodynamic test for the diagnosis of UI.

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Hallazgos urodinámicos en mayores de 65 años: experiencia en el departamento 19 de la Agencia Valenciana de Salud (AVS)

Cited by 2 publications

References 1 publication

Stress and Urgency Urinary Incontinence: Clinical-Urodynamic Correlation and Rehabilitation Management in Daily Clinical Practice

Stress and Urgency Urinary Incontinence: Clinical-Urodynamic Correlation and Rehabilitation Management in Daily Clinical Practice

Comparative Analysis Between Urinary Complaints and the Results of the Urodinamic Study of Women Seen at a Urogynecology Ambulatory in Macapa-Aresume

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