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Статті в журналах з теми "Incontinenza"
Nicolanti, G., F. Sacco, G. Rigon, D. Sacchini, L. Villani, A. Carbone, L. Pontani, S. Nallo, and R. Sacco. "Obesità E Incontinenza." Urologia Journal 57, no. 3 (June 1990): 253–57. http://dx.doi.org/10.1177/039156039005700301.
Повний текст джерелаPol Roux, S., and M. Mane. "Incontinenza urinaria del soggetto anziano." EMC - AKOS - Trattato di Medicina 9, no. 4 (January 2007): 1–6. http://dx.doi.org/10.1016/s1634-7358(07)70380-7.
Повний текст джерелаZaroli, A., S. Fontana, L. Giussani, and E. Ballarati. "Incontinenza Urinaria Da Sforzo Nella Donna." Urologia Journal 53, no. 4 (August 1986): 583–94. http://dx.doi.org/10.1177/039156038605300418.
Повний текст джерелаSacco, F., G. Rigon, G. Nicolanti, A. Carbone, D. Sacchini, P. A. Margariti, and C. Romanini. "Prevalenza E Incidenza Di Incontinenza Urinaria Femminile." Urologia Journal 56, no. 3 (June 1989): 303–9. http://dx.doi.org/10.1177/039156038905600306.
Повний текст джерелаRigon, G., F. Sacco, G. Nicolanti, D. Sacchini, G. Plotti, F. Castaldo, and R. Sacco. "Cause Di Recidiva Di Incontinenza Urinaria Dopo Uretroplastica." Urologia Journal 54, no. 4 (August 1987): 444–50. http://dx.doi.org/10.1177/039156038705400410.
Повний текст джерелаRigon, G., F. Sacco, G. Nicolanti, G. Plotti, F. Castaldo, D. Sacchini, and R. Sacco. "Incontinenza Nella Donna Adulta Con Pregressa Enuresi Infantile." Urologia Journal 54, no. 5 (October 1987): 533–42. http://dx.doi.org/10.1177/039156038705400502.
Повний текст джерелаPolito, M., E. Caraceni, and G. Gabrielloni. "Incontinenza Da Stress: Riabilitazione Perineale Mediante Biofeedback Pressorio." Urologia Journal 57, no. 2 (April 1990): 246–49. http://dx.doi.org/10.1177/039156039005700222.
Повний текст джерелаGianneo, E., P. Belvisi, S. Cappoli, G. Conti, M. G. Rizzuti, and G. C. Comeri. "Incontinenza Urinaria Ed Elettrostimolazione Funzionale Del Pavimento Pelvico." Urologia Journal 57, no. 4 (August 1990): 467–70. http://dx.doi.org/10.1177/039156039005700416.
Повний текст джерелаBERNASCONI, F., G. PISANI, S. ARIENTI, B. VERONESE, S. PITTALIS, M. CONTI, M. TASSI, S. GELOSA, A. BIELLA, and C. CERRI. "Uro-rehabilitation and effort urinary incontinence: medium-term results and analysis of the failure risk factors." Urogynaecologia 15, no. 3 (July 1, 2010): 7. http://dx.doi.org/10.4081/uij.2000.7.
Повний текст джерелаDell'Acqua, S., R. Bosia, and C. Zanoni. "Incontinenza Urinaria Post-Prostatectomia Radicale ad Inconsueta Insorgenza Tardiva." Urologia Journal 71, no. 1 (January 2004): 77–78. http://dx.doi.org/10.1177/039156030407100121.
Повний текст джерелаДисертації з теми "Incontinenza"
SPYROU, MARIA. "Chirurgia del prolasso rettale con o senza incontinenza anale associata." Doctoral thesis, Università degli Studi di Roma "Tor Vergata", 2010. http://hdl.handle.net/2108/1432.
Повний текст джерелаBackground. Anal Incontinence (AI) is the ability to defer the call to stool to a socially acceptable time and place. Loss of control of solid feces is complete anal incontinence, whereas loss of control over flatus or liquid is partial anal incontinence, incomplete and more associated with diarrheal syndromes and fecal impaction. The most frequently used score are the CCF (0-20) score (Jorge and Wexner), which takes in account also the quality of life, and the Pescatori score (0-6), which is simple an easily understandable by the patients, AMS, Vaizey (St.Mark’s Hospital), Williams. Severe incontinence is likely to require surgery, whereas mild and moderate AI are better managed conservatively. The association between rectal prolapse and AI represent a clinical entity difficult to manage. Methods History, the most important factor is determination of the etiology, by physical examination, inspection of perineus for soiling, scars, mucosal ectropion , size of the rectal prolapse muscular deficit, fistulae, prolapsing hemorrhoids. digital exploration will allow to assess anal sphincter’s function: such as resting tone and squeeze contraction endoscopic evaluation to esclude the existence of inflammatory bowel disease, tumors, solitary rectal ulcer syndrome, mucosal prolapse. Special Investigations: anal manometry, cine defecography, electromyography of the pelvic floor, rectal compliance, anal, vaginal and dynamic parineal endosonography. Surgical treatment: Park’s post anal repair, overlapping sphincteroplasty, total pelvic floor repair, encirclement procedures, injection of bulking agents. At the coloproctology units of the Italian society of Colorectal surgery, from 1983 to 2000, 738 patients were observed . Fortyseven (30 women) pts (6.4%), presented AI associated with rectal prolapse, twentyfive of those patients (53%), underwent surgical treatment. Rectal prolapse ( RP) may be full thickness, i.e. procidentia of the rectum through the sphincters, causes a variety of symptoms including pain, bleeding, mucous discharge, and urge to defecate. Associated AI, is experienced by 50% to 70% of the patients, and 25% to 50% of them have significant constipation according to CCF scoring system (0-30) for constipation. The specific causation has yet to be fully elucidated. The patients generally undergo baseline functional tests, following a detailed history and physical examination, as well as an evaluation of a comorbid history of genitourinary dysfunction and bowel habits. In addition anoscopy and full colonoscopy should be performed to exclude other sources of rectal bleeding or the presence of masses that may initiate an intussusception. Cinedefecography, pudendal nerve terminal motor latency assessment and colonic transit studies are generally performed to better evaluate the concomitant presence of enterocele, paradoxical puborectalis contraction, pudendal nerve injury and denervation of the pelvic floor muscles and sphincter. Anorectal manometry is usually abnormal in the incontinent rectal prolapse patients. Surgical therapy of rectal prolapse is often non standard, but rather, tailored after careful consideration of the patient’s operative risk, life expectancy, associated functional disorders, and previous operative history.The goals of the surgical treatment are to eradicate the external prolapse of the rectum and to reduce the risk of recurrence, without causing an adverse impact on bowel function and continence. Perineal approaches, including Delorme’s procedure and perineal rectosigmoidectomy according to Altemeier, with or without levatorplasty (in case of incontinence) are usually carried out and may be tailored according to the presence and the degree of AI. Results Sixteen patients (10 women), at St. Eugenio Hospital (Rome) from 1987 to 2003, underwent Delorme’s procedure. Recurrence rate was 9% at 5 years (range of follow-up 6-60 months). Postoperative overall satisfaction was 73%, 46-75% of the patients experienced an improvement in continence. Twelve patients (8 women) underwent Altemeier procedure, recurrence rate was 1% with excellent results in terms of functional outcome regarding constipation and incontinence rates. Twenty five patients (9 women), underwent abdominal rectopexy according Orr-Loygue, recurrence rate at 5 years, was 2.5%, (range of follow-up 8-80 months).Continence was improved in 58% and constipation was improved in 61% of the patients. Satisfaction rate was 72%. Thirty six patients (16 women),underwent rectopexy according to Wells technique, 12 patients developed recurrence (range of follow-up 8-80 months). Continence was improved in 35%, constipation was worsened in 20% of the cases. Transabdominal open repair, has gained acceptance by most clinicians as the standard surgical procedure for patients with acceptable surgical risks, and is considered to have lower recurrence rates and better functional results than perineal approaches. In addition low recurrence rates, better functional outcome can be safely achieved using laparoscopic surgical techniques to repair full thickness rectal prolapse. Conclusion Selecting an operative approach based on clinical criteria provides satisfactory functional outcomes with regard to symptoms of constipation and incontinence. Anal incontinence is a complex dysfunction with multiple causes, and in rectal prolapse, it may be difficult to understand if it is due anatomical defect (full rectal eversion, internal and external anal sphincter and anal canal integrity in their anatomy and nerve supply) or to a functional lesion (abnormal anal and rectal sensitivity, loss of rectal reservoir function and rectal compliance). This may explain why in some cases treating just the prolapse may not be sufficient to cure all symptoms. A combination of both rectal excision or rectopexy and sphincteroplasty may be required to cure some patients with rectal prolapse and severe anal incontinence due to sphincters weakness, taking in account that rectopexy and other rectal prolapse procedure may improve anal continence. Keywords Anal incontinence, constipation, rectal prolapse, recurrence, rectopexy, laparoscopy, treatment outcomes.
RANAVOLO, RAFFAELE. "Effetti della stimolazione percutanea del nervo tibiale (PTNS) su pazienti affetti da urge incontinence: risultati di uno studio doppio cieco controllato con placebo." Doctoral thesis, Università degli Studi di Roma "Tor Vergata", 2010. http://hdl.handle.net/2108/1323.
Повний текст джерелаPURPOSE. This is a prospective double blind, placebo controlled study, based on an original placebo technique, aimed to evaluate the efficacy of percutaneous tibial nerve stimulation (PTNS) in female patients with detrusor overactivity incontinence. PATIENTS AND METHODS. 35 female patients presenting with detrusor overactivity incontinence non responding to antimuscarinic therapy, were randomly assigned either to PTNS or to control group. PTNS group (18 patients) was treated with 12 PTNS sessions. Control group (17 patients) underwent an original placebo treatment, using a 34 G needle placed in the medial part of the gastrocnemius muscle. The sessions lasted for 30 minutes and were performed 3-times per week as PTNS sessions. All patients were evaluated with bladder diaries and quality of life scores (I-QoL) before and after treatment. Patients showing a reduction >50% of urge incontinence episodes were considered responders. RESULTS. 3 patients (1 in PTNS group and 2 in placebo group) did not complete the study for reasons not related to the technique. 12/17 patients (71%) in PTNS group and 0/15 in placebo group (p<0.001) were considered �responders� according to the previously reported definition. Improvement in number of incontinence episodes, number of voids, voided volume and I-QoL score were statistically significant in PTNS group but not in placebo group. CONCLUSIONS. PTNS can be considered an effective treatment of detrusor overactivity incontinence with 71% of patients considered responders, whilst none of the patients treated with placebo was considered responders. The relevance of a placebo effect seems to be negligible in this patient population.
Pirastu, Francesca. "Ideazione e design di uno sfintere extrauretrale impiantabile a comando magnetico." Master's thesis, Alma Mater Studiorum - Università di Bologna, 2019.
Знайти повний текст джерелаMagnani, Virginia. "Studio della prevalenza dell'incontinenza urinaria nelle pazienti con fibrosi cistica afferenti al Centro Regionale di Cesena come premessa alla presa in carico riabilitativa." Bachelor's thesis, Alma Mater Studiorum - Università di Bologna, 2019.
Знайти повний текст джерелаAGOSTINI, MASSIMILIANO. "La Neuromodulazione sacrale nelle disfunzioni del pavimento pelvico." Doctoral thesis, Università degli Studi di Roma "Tor Vergata", 2008. http://hdl.handle.net/2108/673.
Повний текст джерелаVesico-urethral dysfunction is a major problem in daily medical practice due to its psychological disturbances, its social costs and its high impact on quality of life. Recently, sacral neuromodulation, namely the electrical stimulation of the sacral nerves, appears to have become an alternative for radical bladder surgery particularly in cases of idiopathic bladder over¬activity. The mechanism of action is only partially understood but it seems to involve a modulation in the spinal cord due to stimulation of inhibitory interneurons. Temporary sacral nerve stimulation is the first step. It comprises the temporary application of neuromodulation as a diagnostic test to deter¬mine the best location for the implant and to control the integrity of the sacral root. If test stimulation is successful, a permanent device is implanted. This procedure is safe in experienced hands. So-called idiopathic bladder overactivity still the major indication for this technique. Patients not likely to benefit from the procedure were those with complete or almost complete spinal lesions, but incomplete spinal lesions seemed to be a potential indication. This technique is now also indicated in the case of idiopathic chronic retention and chronic pelvic pain syndrome. When selection is performed, more than three-quarters of the patients showed a clinically significant response with 50% or more reduction in the frequency of incontinent episodes, but the results vary according to the author’s mode of evaluation. From the economic point of view, the initial investment in the device is amortized in the mid-term by savings related to lower urinary tract dysfunction. Finally, this technique requires an attentive follow-up and adjustments to the electric parameters so as to optimize the equilibrium between the neurological systems
Giammaria, Valeria. "Efficacia dell’esercizio terapeutico della muscolatura del pavimento pelvico nella prevenzione dell’incontinenza urinaria femminile durante la gravidanza e dopo il parto: revisione basata sull'evidenze." Bachelor's thesis, Alma Mater Studiorum - Università di Bologna, 2019.
Знайти повний текст джерелаThiel, Marcelo. "Analise quantitativa da fibrose e semiquantitativa da reação inflamatoria de quatro diferentes slings sinteticos." [s.n.], 2006. http://repositorio.unicamp.br/jspui/handle/REPOSIP/308661.
Повний текст джерелаTese (doutorado) - Universidade Estadual de Campinas, Faculdade de Ciencias Medicas
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Resumo: OBJETIVOS: Analisar quantitativamente, com método estereológico, a densidade de fibras colágenas formadas após implante de quatro diferentes tipos de sling;verificar por análise histopatológica a reação inflamatória. MATERIAS E MÉTODOS: Realizou-se o estudo em 70 ratas da raça Wistar, divididas em 3 grupos (A,B,C): No grupo A (30 ratas) implantou-se uma faixa de silicone e outra de submucosa intestinal suína, de 8x 4 mm, no tecido subcutâneo da parede abdominal. No grupo B (30 ratas), implantou-se, da mesma maneira, uma faixa de copolímeros de poligalactina com ácido poliglicólico e outra de polipropileno monofilamentar, de 8x 4 mm. Sutura com fio de nylon 5/0, fixou as faixas e, no grupo C (10 ratas), denominado controle, realizou-se dissecção do subcutâneo e aplicação do mesmo fio, sem implante de material. A coloração de Picro-Sirius, empregada apenas no 90° dia de pós-operatório, permitiu análise das fibras colágenas e a de Hematoxilia-eosina, o estudo histopatológico da reação inflamatória. Nos dias 7, 30 e 90 de pós-operatório, sacrificaram-se 10 ratas de cada grupo. RESULTADOS: No 7° dia, todos os materiais induziram moderada reação inflamatória, sem diferença com o controle. No 30° dia, os copolímeros de poligalactina com ácido poliglicólico apresentaram a menor reação inflamatória, sem diferença com o controle. Neste período, polipropileno monofilamentar e silicone produziram inflamação moderada, enquanto que na submucosa intestinal suína, a intensidade foi severa. No 90° dia, a reação inflamatória, nos copolímeros de poligalactina com ácido poliglicólico, foi maior que antes, porém menor do que a do polipropileno monofilamentar e silicone, que permaneceram semelhantes entre si. Novamente, o grau de inflamação na submucosa intestinal suína continuou o maior de todos. Na análise estereológica, a densidade. de fibras colágenas dos copolímeros de poligalactina com ácido poliglicólico e polipropileno monofilamentar foi significativamente menor (61 % e 65% respectivamente) do que o silicone (85%) e submucosa intestinal suína (86%). CONCLUSÕES: Polipropileno monofilamentar foi o melhor material inabsorvível, pois induziu menos reação inflamatória que os outros materiais testados. Como a submucosa intestinal suína foi completamente removida, a intensa reação fibrótica que produz, toma-se útil, e responsável pelo suporte suburetral após a cirurgia
Abstract: OBJECTIVES: To analyse quantitatively, using stereological methods, the density of the collagen fibres induced by four types of sling materials, and verify by a histopathological analysis the corresponding inflammatory reaction, as fibrosis secondary to sling implantation is considered responsible for restoring urethral support and re-establishing continence in women with stress urinary incontinence, and new synthetic materials that promote adequate fibrosis with the least intensity and duration have been proposed to substitute the aponeurotic sling. MATERIALS AND METHODS: The study comprised 70 isogenic white Wistar rats divided into three groups: group A (30 rats) had 8 x 4 mm strips of silicone and porcine small intestine submucosa (SIS) implanted in the abdominal subcutaneous tissues; group B (30 rats) had 8 x 4 mm strips of polycaprolactone and polylactic acid copolymers and monofilament polypropylene (PLP) implanted the abdominal subcutaneous layer; while a control group of 10 rats had dissection and suturing with 5/0 Nylon in the abdominal subcutaneous layer, as used to fix the strips in the other rats. Picro-Sirius staining was used to assess collagen fibres, and haematoxylin-eosin for the histopathological study. At 7, 30 and 90 days after surgery, 10 rats from each group were killed and assessed. RESULTS: Afier 7 days all the materials induced a moderate inflammatory reaction that did not differ from that in the control group. At 30 days there was no difference between the control and polycaprolactone and polylactic acid copolymers, having the least inflammatory reaction. PLP and silicone produced a moderate inflammatory reaction, while the porcine SIS induced a more intense reaction. At 90 days there was a more intense inflammatory reaction in polycaprolactone and polylactic acid copolymers than before but it was less than with PLP and silicone, which again were no different. During this period the inflammatory reaction induced by SIS was greater. The stereological analysis indicated that collagen fibres induced by polycaprolactone and polylactic acid copolymers and PLP were less dense (61% and 65%, respectively), and significant1y less than with silicone (85%) and SIS (86%). CONCLUSION: PLP was the best nonabsorbable material as it induced a less intense inflammatory reaction than the other tested materials. As porcine SIS was completely absorbed the intense fibrosis induced is useful, as it is exclusively responsible for the urethral support later after surgery
Doutorado
Cirurgia
Mestre em Cirurgia
Foster, Patricia Margaret. "Living with incontinence : a qualitative study of elderly women with urinary incontinence." Thesis, University of British Columbia, 1987. http://hdl.handle.net/2429/26131.
Повний текст джерелаApplied Science, Faculty of
Nursing, School of
Graduate
Fozzatti, Maria Celina Martins. "Efeito da reeducação postural global (RPG) na incontinencia urinaria de esforço feminina." [s.n.], 2006. http://repositorio.unicamp.br/jspui/handle/REPOSIP/311597.
Повний текст джерелаDissertação (mestrado) - Universidade Estadual de Campinas, Faculdade de Ciências Médicas
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Resumo: A Incontinência urinária de esforço (IUE) feminina, condição com alta prevalência, é definida como um sinal e sintoma ligado a distúrbios funcionais da uretra (esfíncteres) e/ou bexiga e não caracteriza uma doença. Trata-se então de uma disfunção mecânica em que alterações na biomecânica da bacia pélvica podem estar associadas à modificação deste mecanismo. Atualmente tem-se valorizado e vem-se aplicando o tratamento fisioterapêutico nesta afecção, como o treinamento dos músculos do assoalho pélvico, obtendo-se bons resultados a curto e médio prazos. Além disso, técnicas baseadas na abordagem global da paciente, que consideram aspectos da estrutura postural, estão ainda em fase de investigação. O trabalho aqui descrito constou da aplicação do tratamento da Reeducação Postural Global (RPG), trabalhando-se a reestruturação postural por meio do reequilíbrio do Sistema músculo esquelético (SME), alongamento das cadeias musculares e reequilíbrio dos eixos ósseos, num enfoque global. Objetivo: Avaliar os efeitos da RPG nas queixas de IUE e qualidade de vida em um grupo de mulheres incontinentes. Casuística e Método: Para o estudo, foram selecionadas 26 mulheres portadoras de queixa clínica de IUE, que foram submetidas ao tratamento da RPG. O tratamento constou de sessões semanais de 50 minutos num período de três meses e posteriormente de sessões quinzenais por mais três meses. O grupo foi acompanhado por seis meses após final do tratamento, sendo reavaliado no término do tratamento, no terceiro e sexto meses. A avaliação foi feita usando Questionário de Qualidade de Vida, diário miccional de três dias, Pad Use e Avaliação funcional do assoalho pélvico (AFA). No término do tratamento e no seguimento de seis meses, as pacientes também foram avaliadas por meio de escala analógica de satisfação. Resultados: Das 26 pacientes que iniciaram o programa, 25 concluíram o tratamento. No final deste quatro pacientes (16%) estavam curadas, 18 (72%) apresentaram melhora significativa e três (12%) não apresentaram melhora. No seguimento de seis meses, seis (24%) pacientes estavam curadas, 16 (64%) apresentaram melhora e três (12%) não apresentaram melhora. Diferenças significativas foram notadas no número de perdas (p<0.001), Pad Use (p<0.001) e AFA (p<0.001). Além disso, foi percebida melhora em todos os domínios do Questionário de Qualidade de Vida, especialmente em Percepção geral da saúde (p<0.005) e Impacto da incontinência (p<0.001) em todos os seguimentos da avaliação. Conclusão: A RPG induziu à melhora significativa dos sintomas de IUE e qualidade de vida no grupo de mulheres incontinentes estudado
Abstract: Stress Urinary Incontinence (SUI), is defined as a signal and/or a symptom connected to functional disorders of the urethra (sphincter) and/or blader and do not characterize a disease. It is, indeed a dysfunction where alterations in the pelvis biomechanics can be associated to a modification of this mechanism. Lately, physiotherapeutic treatments, as the training of the pelvic floor muscles, have been used and good results have been obtained in short and medium terms. Besides, techniques based on a global approach of the patient, which consider also aspects of the postural structure, are still under investigation. The work hereby described consisted of the application of the Global Postural Reeducation (GPR) treatment, in which the postural restructuring is worked through the reestablishment of the balance of the skeletal muscle system, stretching of the muscle chains and rebalance of the bone axis, in a global approach. Objective: Evaluate the effects of the GPR on Stress Urinary Incontinence and Life Quality in a group of incontinent women. Material and Methods: For this study, 26 women with SUI were selected, who underwent a GPR treatment. All patients were treated for six months using GPR, 50 minutes weekly sessions during three months and three more months of sessions every other week. The patients were evaluated before and after the treatment, and also at three and six months follow-up. Outcome measures were made using King's Health Questionnaire, three days voiding diary, Pad Use and Functional Evaluation of Pelvic Floor (FEPF). In the end of the treatment and after six months, the patient satisfaction was evaluated trough a standardized analogical visual scale. Results: Twenty-five patients were available for follow-up. At the end of the treatment there were four (16%) patients completely dry, 18 (72%) pesented significant improvement and three (12%) did not presented improvement. At six months follow-up there were six (24%) patients completely dry, 16 (64%) improved and three (12%) failures. Significant differences were noted in the number of leak episodes (p<0.001), Pad Use (p<0.001) and FEPF (p<0.001). Regarding the King's Health Questionnaire, improvement in all domains were observed, especially in General Perception of Health (p<0.005), leakage impact (p<0.001) in all the moments of evaluation. Conclusion: GPR significantly improved the symptoms and Quality of Life in women with SUI
Mestrado
Pesquisa Experimental
Mestre em Cirurgia
Silveira, Arlon Breno Figueiredo da. "Uso de sling sintetico pre-publico para tratamento da incontinencia urinaria de esforço : eficacia, segurança e qualidade de vida." [s.n.], 2008. http://repositorio.unicamp.br/jspui/handle/REPOSIP/308657.
Повний текст джерелаDissertação (mestrado) - Universidade Estadual de Campinas, Faculdade de Ciencias
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Resumo: Objetivos: Com o objetivo de avaliar os resultados cirúrgicos e de modificação na qualidade de vida de mulheres submetidas ao tratamento de incontinência urinária de esforço com sling sintético de polipropileno com abordagem pré-púbica. Métodos: Foi desenvolvido estudo prospectivo, de intervenção, com seguimento por seis meses, envolvendo 20 pacientes, com idade mínima de 21 anos e com diagnóstico de incontinência urinária de esforço realizado no Serviço de Uroginecologia do Hospital das Clínicas da Universidade Estadual de Campinas, Campinas, São Paulo, com base em dados clínicos, urodinâmicos e de Pad-test compatíveis, as quais expressaram a vontade de se submeter à implantação de sling para correção cirúrgica; não gestantes; sem doença ou qualquer condição que pudesse comprometer o resultado da cirurgia, tal como: distúrbio de coagulação sanguínea, obstrução do trato urinário superior, insuficiência renal, comprometimento do sistema imune, infecção urinária ou vaginal; não submetidas a procedimento de sling sintético prévio; que concordaram em participar do estudo, por meio da assinatura do Termo de Consentimento Livre Esclarecido e em responder os questionários King's Health Questionnaire (KHQ) e International Consultation on Incontinence Questionnaire Short Form (ICIQ-SF) antes da cirurgia e decorridos seis meses do procedimento. Para o tratamento de incontinência urinária de esforço, empregou-se tela manufaturada em fibras de polipropileno, classe I, monofilamentar com 42 µm de diâmetro e macroporos maiores que 75 mm, por abordagem pré-púbica. As variáveis estudadas incluíram: idade, avaliação urodinâmica, Pad-test e resultados dos questionários King's Health Questionnaire (KHQ) e International Consultation on Incontinence Questionnaire Short Form (ICIQ-SF) . Os dados foram organizados por meio do programa Epi-INfo versão 6.04d e analisados com o programa Statistical Package for Social Sciences (SPSS), versão 13.0. As variáveis nominais e ordinais foram expressas em distribuição de freqüências absolutas e relativas e as quantitativas, pelos parâmetros da Estatística Descritiva. Para comparação dos parâmetros objetivos uroginecológicos e de qualidade de vida aferida pelos questionários International Consultation on Incontinence Questionnaire Short Form (ICIQ-SF) e King's Health Questionnaire (KHQ), do período pré-operatório e decorridos seis meses do procedimento cirúrgico, empregou-se teste de diferença de médias, em nível de significância de 0,05, determinando-se o intervalo de confiança em nível de confiança de 95%. Resultados: Comparando a avaliação pré-operatória àquela decorridos seis meses do procedimento cirúrgico, verificou-se redução significante da perda de urina mensurada através do Pad-test (p<0,001). A pressão de perda sob esforço foi negativa em 90% das pacientes decorridos seis meses da cirurgia. Os demais parâmetros urodinâmicos da cistometria não foram alterados significativamente comparando antes e depois da cirurgia. O fluxo máximo miccional despida de significância estatística (p = 0,034). Houve melhora de todos os parâmetros subjetivos avaliados pelo International Consultation on Incontinence Questionnaire Short Form (ICIQ-SF), com significância estatística da freqüência de perda de urina (0,009) e menor interferência na vida da pacientes (p= 0,001), assim como de todos os domínios do King's Health Questionnaire (KHQ). Houve 6 (30%) casos de complicações, que consistiram em extrusão vaginal do sling, instituindo-se tratamento cirúrgico por retirada do segmento da tela exposta e síntese da mucosa vaginal. Conclusão: Embora tenha havido a necessidade de interromper este estudo devido ao alto índice de complicações, confirmou-se o fato de ser a incontinência urinária um evento que compromete a qualidade de vida das pacientes exercendo tal impacto que, mesmo diante do insucesso do procedimento terapêutico, a avaliação subjetiva foi favorável, decorridos seis meses da cirurgia
Abstract: Objectives: A prospective study of intervention was developed aiming to evaluate the surgical results and impact in the quality of life of women submitted to stress urinary incontinence treatment with polypropylene synthetic sling with prepubic approach. Methods: Twenty patients were included in this study. Diagnosis of stress urinary incontinence were based on clinical data, urodynamics and Pad-test. Inclusion criteria included: minimum age of 21 years; non pregnant; without illness or any condition that could compromise surgery's result (sanguineous coagulation disorders, superior urinary tract obstruction, renal insufficiency, immune system disorder, urinary or vaginal infection); abcense of previous synthetic sling procedure; agreement to participate of the study, by means of Free Consent Term signature and to answer to the questionnaires King's Health Questionnaire (KHQ) e International Consultation on Incontinence Questionnaire Short Form (ICIQ-SF) before the surgery and after six months of the procedure. Its was used a sling made of staple fibres of polypropylene, type I, monofilamentar (42 µm diameter) and macropores. All the procedures were performed under spinal anesthesia. The sling was placed and adjusted in midurethral area with minimal periurethral dissection. The proper tension and fixation was achieved by passing the sling arms through the prepubic subcutaneous fat tissue. The variables studied included: age; urodynamic evaluation; Pad-test; King's Health Questionnaire; and International Consultation on Incontinence Questionnaire. Data were recorded using Epi-INfo version 6.04d software and analyzed with Statistical Package for Social Sciences (SPSS), version 13.0. The nominal and ordinal variables were express in absolute and relative frequency distribution and the quantitative ones by parameters of descriptive statistics. Difference of means test was used (significance level of 0,05, 95% confidence interval) for comparison of the urogynecologic objective parameters and quality of life surveyed by ICIQ and KHQ questionnaires, of pre-operative and six months post-operative evaluation. Results: Comparing pre-surgical evaluations with those after six months of the surgical procedure, there were significant reduction of urine loss assessed by the pad-test (p<0,001). Comparing urodynamics evaluations before and after surgical procedure 90% patients no there were of urine loss. Other urodynamics parameters no there were significant alterations. The max flow there was significant reduction (p=0,034). There was an improvement of all subjective parameters evaluated by ICIQ-SF, with significance for frequency of urine loss (0,009) and minor interference in life (p= 0.001), as well as of all KHQ domains. Six patients (20%) presented complications which consisted of vaginal exposition of the sling. All of them were corrected surgically by excision of the mesh and suture of the vaginal wall. The study was interrupted after six months of follow up due to the high frequency of adverse effects. Conclusion: Although the decision of interrupting the study due to the high index of complication, it allowed to confirm that stress urinary incontinence compromises the quality of life of the patients significantly, and the treatmet could promote an improvement in the quality of life, even when objective results were unfavourable
Mestrado
Cirurgia
Mestre em Cirurgia
Книги з теми "Incontinenza"
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Знайти повний текст джерелаDocimo, Ludovico, and Luigi Brusciano, eds. Anal Incontinence. Cham: Springer International Publishing, 2023. http://dx.doi.org/10.1007/978-3-031-08392-1.
Повний текст джерелаRatto, Carlo, Giovanni B. Doglietto, Ann C. Lowry, Lars Påhlman, and Giovanni Romano, eds. Fecal Incontinence. Milano: Springer Milan, 2007. http://dx.doi.org/10.1007/978-88-470-0638-6.
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Повний текст джерелаЧастини книг з теми "Incontinenza"
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Повний текст джерелаMatson, Johnny L., and Abigail Issarraras. "Incontinence." In Handbook of Intellectual Disabilities, 1093–103. Cham: Springer International Publishing, 2019. http://dx.doi.org/10.1007/978-3-030-20843-1_57.
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Повний текст джерелаAl-Mousa, Riyad Taher, and Hashim Hashim. "Incontinence." In Neuro-Urology, 193–206. Cham: Springer International Publishing, 2018. http://dx.doi.org/10.1007/978-3-319-90997-4_14.
Повний текст джерелаТези доповідей конференцій з теми "Incontinenza"
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Повний текст джерелаЗвіти організацій з теми "Incontinenza"
Hsieh, David T., and Bhagwan Moorjani. Incontinentia Pigmenti. Fort Belvoir, VA: Defense Technical Information Center, January 2008. http://dx.doi.org/10.21236/ada478042.
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