Associated factors to urinary incontinence in women undergoing urodynamic testing

Silva, Juliana Cristina Pereira da; Soler, Zaida Aurora Sperli Geraldes; DominguesWysocki, Anneliese

doi:10.1590/S1980-220X2016140903209

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Sumário

ORIGINAL ARTICLE • Rev. esc. enferm. USP 51 • 2017 • https://doi.org/10.1590/S1980-220X2016140903209 copy

Associated factors to urinary incontinence in women undergoing urodynamic testing^* * Extracted from the dissertation “Incontinência Urinária pós-estudo urodinâmico: variáveis associadas”, Programa de Pós-Graduação, Faculdade de Medicina de São José do Rio Preto, 2016.

Factores asociados con la incontinencia urinaria en mujeres sometidas al estudio urodinámico

Authorship SCIMAGO INSTITUTIONS RANKINGS

Abstract

OBJECTIVE

Analyzing factors associated with urinary incontinence (UI) among women submitted to urodynamic testing.

METHOD

A cross-sectional study of 150 women attended at a urological center. Data were analyzed using univariate and multivariate statistics.

RESULTS

White women (79.3%), overweight (45.3%), menopausal (53.3%), who drink coffee (82.7%), sedentary (65.3%), who had vaginal birth (51.4%), with episiotomy (80%), and who underwent the Kristeller maneuver (69%). 60.7% had Urethral Hypermobility (UH). A statistical association was found between: weight change and UH (p = 0.024); menopause, Intrinsic Sphincter Deficiency (ISD) and Detrusor Instability (DI) (p = 0.001); gynecological surgery, ISD and DI (p = 0.014); hysterectomy and all types of UI (p = 0.040); physical activity and mixed UI (p = 0.014).

CONCLUSION

Interventions and guidance on preventing UI and strengthening pelvic muscles should be directed at women who present weight changes, who are sedentary menopausal women, and those who have undergone hysterectomy or other gynecological surgery. Studies on pelvic strengthening methods are needed in order to take into account the profile of the needs presented by women.

Descriptors
Urinary incontinence; Risk factors; Urodynamics; Urological Diagnostic Techniques; Women's Health

Variables		N	%
Race	Asian	2	1.3
	White	119	79.3
	Black	7	4.7
	Pardo (mixedraceBrazilian)	22	14.7

Weight change in the last 10 years	Haslostweight	21	14.0
	Hasgainedweight	91	60.7
	Remainedthesame	38	25.3
Arterial hypertension	No	104	69.3
Arterial hypertension	Yes	46	30.7

Use ofdiuretics	No	133	88.7
Use ofdiuretics	Yes	17	11.3

Diabetes	No	133	88.7
Diabetes	Yes	17	11.3

Menopause	No	70	46.7
Menopause	Yes	80	53.3

Obstetrichistory	No	10	6.7
Obstetrichistory	Yes	140	93.3

Coffeeintake	No	26	17.3
Coffeeintake	Yes	124	82.7

Smoker	No	101	67.3
	Not now, but in the past	39	26.0
	Yes	10	6.7
Frequentcough	No	110	73.3
Frequentcough	Yes	40	26.7
Constipation	No	72	48.0
	Not now, but in the past	19	12.7
	Yes	59	39.3
Hysterectomy	No	104	69.3
Hysterectomy	Yes	46	30.7

Perineoplasty	No	104	69.3
Perineoplasty	Yes	46	30.7

Sling (surgery)	No	143	95.3
Sling (surgery)	Yes	7	4.7

Physicalactivity	No	98	65.3
Physicalactivity	Yes	52	34.7
Typeof UI	ISD	17	11.3
	UH	91	60.7
	DI	34	22.7
	Mixed	8	5.3

Variables		Typeof UI				p value
Variables		ISD	UH	DI	Mixed	p value

Weightchange	Weight loss	3 (17.6%)	8 (8.8%)	6 (17.6%)	4 (50.0%)	0.024
	Weight gain	8 (47.1%)	62 (68.1%)	17 (50.00%)	4 (50.0%)
	Same	6 (35.3%)	21 (23.1%)	11 (32.4%)	0 (0.0%)

Menopause	Yes	12 (70.6%)	37 (40.7%)	25 (73.5%)	6 (75.0%)	0.001
Menopause	No	5 (29.4%)	54 (59.3%)	9 (26.5%)	2 (25.0%)	0.001
Gynecologicalsurgery	Yes	12 (70.6%)	34 (37.4%)	21 (61.8%)	3 (37.5%)	0.014
Gynecologicalsurgery	No	5 (29.4%)	57 (62.6%)	13 (38.2%)	5 (62.5%)	0.014

Hysterectomy	Yes	9 (52.9%)	71 (78.0%)	19 (55.9%)	5 (62.5%)	0.040
Hysterectomy	No	8 (47.1%)	20 (22.0%)	15 (44.1%)	3 (37.5%)	0.040

Physicalactivity	Yes	7 (41.2%)	33 (36.3%)	6 (17.6%)	6 (75.0%)	0.014
Physicalactivity	No	10 (58.8%)	58 (63.7%)	28 (82.4%)	2 (25.0%)	0.014

Obstetricvariables		Typeof UI
		ISD	UH	DI	Mixed	TOTAL
		n (%)	n (%)	n (%)	n (%)

Typeofdelivery	Cesarean Vaginal	8 (53.3%) 7 (46.7%)	43 (48.9%) 45 (51.1%)	11 (37.9%) 18 (62.1%)	6 (75.0%) 2 (25.0%)	68 72

Placeofbirth	Homebirth	1 (6.7%)	5 (5.7%)	5 (17.2%)	0 (0%)	11
Placeofbirth	Hospital	14 (93.3%)	83 (94.3%)	24 (82.8%)	8 (100 %)	129

Miscarriages	Yes	4 (26.7%)	30 (34.1%)	8 (27.6%)	5 (62.5%)	47
Miscarriages	No	11 (73.3%)	58 (65.9%)	21 (72.4%)	3 (37.5%)	93

Typeofanesthesia	None	1 (6.7%)	7 (8%)	6 (20.7%)	0 (0%)	14
	Epidural	9 (60%)	47 (53.4%)	13 (44.8%)	6 (75%)	75
	Local	5 (33.3%)	34 (38.6%)	10 (34.5%)	2 (25%)	51

Loss of urine during pregnancy	Yes	3 (20%)	19 (21.6%)	7 (25%)	0 (0%)	29
Loss of urine during pregnancy	No	12 (80%)	69 (78.4%)	21 (75%)	9 (100%)	111

Kg gainedduringpregnancy	Up to10 kg	2 (13.3%)	21 (23.9%)	6 (20.7%)	4 (50%)	33
Kg gainedduringpregnancy	Over 10 kg	13 (86.7%)	67 (76.1%)	23 (79.3%)	4 (50%)	107

Newbornweightatbirth	Upto 3,000 g	4 (26.7%)	18 (20.5%)	11 (37.9%)	2 (25%)	35
Newbornweightatbirth	Over 3,000 g	11 (73.3%)	70 (79.5%)	18 (62.1%)	6 (75%)	105

Laceration^* * Only the 72 women who had vaginal delivery were considered for these variables.	Yes	3 (42.9%)	16 (35.6%)	8 (44.4%)	1 (50%)	28
	No	4 (57.1%)	29 (64.4%)	10 (55.6%)	1 (50%)	44

Episiotomy^* * Only the 72 women who had vaginal delivery were considered for these variables.	Yes	5 (71.4%)	40 (88.9%)	11 (61.1%)	2 (100%)	58
	No	2 (28.6%)	5 (11.1%)	7 (38.9%)	0 (0%)	14

Use offorceps^* * Only the 72 women who had vaginal delivery were considered for these variables.	Yes	2 (28.6%)	4 (8.9%)	4 (22.2%)	1 (50%)	11
	No	5 (71.4%)	41 (91.1%)	14 (77.8%)	1 (50%)	61

Kristeller'smaneuver^* * Only the 72 women who had vaginal delivery were considered for these variables.	Yes	4 (57.1%)	31 (68.9%)	13 (72.2%)	2 (100%)	50
	No	3 (42.9%)	14 (31.1%)	5 (27.8%)	0 (0%)	22
Use ofOxytocin^* * Only the 72 women who had vaginal delivery were considered for these variables.	Yes	1 (14.3%)	10 (22.2%)	3 (16.7%)	1 (50%)	15
	No	6 (85.7%)	35 (77.8%)	15 (83.3%)	1 (50%)	57

Universidade de São Paulo, Escola de Enfermagem Av. Dr. Enéas de Carvalho Aguiar, 419 , 05403-000 São Paulo - SP/ Brasil, Tel./Fax: (55 11) 3061-7553, - São Paulo - SP - Brazil
E-mail: reeusp@usp.br

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[1] Corresponding author
Juliana Cristina Pereira da Silva. Rua da Fé, 265, Apto 402/04 - Jardim Urano. CEP 15084-230 - São José do Rio Preto, SP, Brazil. julianapereira.enf@gmail.com

Typeof UI	Mean±SD	Median	(Min;Max)	P value^ * P value for the Analysis of Variance test (ANOVA).*
ISD (n=17)	57.76±12.35	58.00	(36.0;78.0)	0.001
UH (n=91)	50.35±11.43	48.00	(31.0;79.0)
DI (n=34)	59.21±16.26	60.00	(28.0;86.0)
Mixed (n=8)	59.88±9.73	62.50	(47.0;71.0)

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Associated factors to urinary incontinence in women undergoing urodynamic testing* * Extracted from the dissertation “Incontinência Urinária pós-estudo urodinâmico: variáveis associadas”, Programa de Pós-Graduação, Faculdade de Medicina de São José do Rio Preto, 2016.

Factores asociados con la incontinencia urinaria en mujeres sometidas al estudio urodinámico

Abstract

OBJECTIVE

METHOD

RESULTS

CONCLUSION

Associated factors to urinary incontinence in women undergoing urodynamic testing^* * Extracted from the dissertation “Incontinência Urinária pós-estudo urodinâmico: variáveis associadas”, Programa de Pós-Graduação, Faculdade de Medicina de São José do Rio Preto, 2016.