Incontinencia urinaria em mulheres climatericas : estudo epidemiologico, clinico e urodinamico

Orientadores: Aarão Mendes Pinto-Neto, Anibal Faundes, Viviane HerrmannTese (doutorado) - Universidade Estadual de Campinas. Faculdade de Ciencias MedicasDoutorad

Urinary Incontinence Among Climateric Brazilian Women: Household Survey

Objective. To investigate the prevalence of stress urinary incontinence and its associated factors in perimenopause women using a population-based household survey. Methods. A descriptive, exploratory cross-sectional population-based study with secondary analysis of a population-based household survey on perimenopause and menopause was conducted among women living in the city of Campinas, Brazil. Through a sampling process, 456 women between 45 and 60 years old were selected. Complaints of urinary incontinence and related risk factors, such as age, socioeconomic status, education level, race, parity, smoking habits, body mass index, previous gynecological surgeries, menopausal status, and hormonal replacement therapy were explored. Data were collected through home interviews using an adapted version of the structured pre-tested questionnaire elaborated by the International Health Foundation, International Menopause Society and the American Menopause Society. Statistical analysis were performed using prevalence rates (CI 95%). Results. Thirty-five percent of the interviewees referred stress urinary incontinence. None of the sociodemographic factors studied was associated to the risk of urinary incontinence. In addition, parity did not significantly change the risk of urinary incontinence. Other factors, such as previous gynecological surgeries, body mass index, and smoking habits, were not associated with the prevalence of stress urinary incontinence. Also, menopausal status and hormonal replacement therapy did not change the risk of stress urinary incontinence. Conclusion. Though there was a high prevalence of stress urinary incontinence among perimenopause women, there was not found any associations with sociodemographic and reproductive factors.355428435Bortolotti, A., Bernardini, B., Colli, E., Di Benedetto, P., Giocoli Nacci, G., Landoni, M., Prevalence and risk factors for urinary incontinence in Italy (2000) Eur Urol, 37, pp. 30-35Brown, J.S., Grady, D., Ouslander, J.G., Herzog, A.R., Varner, R.E., Posner, S.F., Prevalence of urinary incontinence and associated risk factors in postmenopausal women (1999) Obstet Gynecol, 94, pp. 66-70. , Hert & Estrogen/Progestin Replacement Study (HERS) Research GroupBurgio, K.L., Mathews, K.A., Engel, B.T., Prevalence, incidence and correlates of urinary incontinence in healthy, middle-aged women (1991) J Urol, 146, pp. 1255-1259Comportamento sexual da população brasileira e percepção sobre o HIV/AIDS: Relatório final de pesquisa (1999), pp. 34-37. , Centro Brasileiro de Análise e Planejamento (CEBRAP), Ministério da Saúde-SPS-CNDST/HIV/AIDS. São PauloChiarelli, P., Brown, W., Mc Elduf, F.P., Leaking urine: Prevalence and associated factors in Australian women (1999) Neurourol Urodyn, 18, pp. 567-577Elving, L.B., Foldspang, A., Lam, G.W., Mommsen, S., Descriptive epidemiology of urinary incontinence in 3100 women age 30-59 (1989) Scand J Urol Nephrol, 125 (SUPPL.), pp. 37-43Fantl, J.A., Cardozo, L., Mc Clish, D.K., Estrogen therapy in the management of urinary incontinence in postmenopausal women: A meta-analisys (1994) Obstet Gynecol, 83, pp. 12-18. , First report of the Hormones and Urogenital Therapy CommiteeFantl, J.A., Bump, R.C., Robinson, D., Efficacy of estrogen supplementation in the treatment of urinary incontinece (1996) Obstet Gynecol, 88, pp. 745-749Guarisi, T., Pinto-Neto, A.M., Costa-Paiva, L.H.S., Pedro, A.O., Faúndes, A., Sintomas urinários e genitais em mulheres climatéricas (1998) J Bras Ginecol, 108, pp. 125-130Jaszmann, L., Epidemiology of climateric and postclimateric complaints (1973), pp. 22-24. , Van Keep PA, Lauritzen C, editors. Ageing and estrogens: front hormone research. Basel: KargerLaurenti, R., Mello-Jorge, M.L.P., Lebrão, M.L., Gotlieb, S.L.D., População: Recenseamento e estimativas (1987) Estatística de saúde., pp. 9-38. , editors. 2a ed. São Paulo: EPUMendonça, M., Reis, R.V., Macedo, C.B.M.S., Barbosa, K.S.R., Prevalência da queixa de incontinência urinária de esforço em pacientes atendidas no serviço de ginecologia do Hospital Júlia Kubitschek (1997) J Bras Ginecol, 107, pp. 153-155Moller, L.A., Lose, G., Jorgensen, T., The prevalence and bothersomeness of lower urinary tract symptons in women 40-60 years of age (2000) Acta Obstet Gynecol Scand, 79, pp. 298-305Thom, D.H., Brown, J.S., Reproductive and hormonal risk factors for urinary incontinence in later life: A review of the clinical and epidemiologic literature (1998) J Am Geriatr Soc, 46, pp. 1411-1417Van Geelen, J.M., Van de Weijer, P.H., Arnolds, H.T., Urogenital symptons and resulting discomfort in noninstitutionalized Dutch women aged 50-75 years (2000) Int Urogynecol J Pelvic Floor Dysfunct, 11, pp. 9-14Von Mühlen, D.G., Kritz-Silverstein, D., Barret-Connor, E., A community based study of menopause symptoms and estrogen replacement in older women (1995) Maturitas, 22, pp. 71-78Wilbur, J., Miller, A.M., Montgomery, A., Chandler, P., Sociodemographic characteristics, biological factors, an symptom reporting in midlife women (1998) Menopause, 5, pp. 43-5

[urinary Incontinence Among Climateric Brazilian Women: Household Survey].

To investigate the prevalence of stress urinary incontinence and its associated factors in perimenopause women using a population-based household survey. A descriptive, exploratory cross-sectional population-based study with secondary analysis of a population-based household survey on perimenopause and menopause was conducted among women living in the city of Campinas, Brazil. Through a sampling process, 456 women between 45 and 60 years old were selected. Complaints of urinary incontinence and related risk factors, such as age, socioeconomic status, education level, race, parity, smoking habits, body mass index, previous gynecological surgeries, menopausal status, and hormonal replacement therapy were explored. Data were collected through home interviews using an adapted version of the structured pre-tested questionnaire elaborated by the International Health Foundation, International Menopause Society and the American Menopause Society. Statistical analysis were performed using prevalence rates (CI 95%). Thirty-five percent of the interviewees referred stress urinary incontinence. None of the sociodemographic factors studied was associated to the risk of urinary incontinence. In addition, parity did not significantly change the risk of urinary incontinence. Other factors, such as previous gynecological surgeries, body mass index, and smoking habits, were not associated with the prevalence of stress urinary incontinence. Also, menopausal status and hormonal replacement therapy did not change the risk of stress urinary incontinence. Though there was a high prevalence of stress urinary incontinence among perimenopause women, there was not found any associations with sociodemographic and reproductive factors.35428-3

Association between lipid profile and bone mineral density in post-menopausal women

A total of 72 postmenopausal patients presenting no risk factors for cardiovascular disease nor osteoporosis, were studied. The study evaluated total serum cholesterol and fractions and bone mass by densitometry of the lumbar spine and femur using a Lunar-DPX. There was no association between lipid profile variables and bone mineral density, except for high density lipoprotein (HDL), which showed an inverse correlation (p = 0.001). Multiple regression showed that total cholesterol levels higher than 240 mg% had a positive association with BMD (p = 0.026). In addition, the ratio between LDL and HDL (Castelli 2 index) showed a negative association with BMD (p = 0.002). The diagnostic validation test showed that all lipid profile variables had low sensitivity and specificity as indicators for osteoporosis. The conclusions were that lipid profile variables did not show a significant association with bone mass and could not be used as indicators for bone mineral density.O objetivo deste estudo foi avaliar a possível associação entre algumas variáveis do perfil lipídico e a densidade mineral óssea e se estas variáveis poderiam ser usadas como indicadoras de massa óssea em mulheres menopausadas, atendidas no ambulatório de menopausa do CAISM-Unicamp, no ano de 1995. Estudaram-se 72 pacientes pós-menopausadas, sem fatores de risco para doenças cardiovasculares e para osteoporose, por meio da dosagem de colesterol total e frações e da avaliação da densidade mineral óssea por densitometria óssea em aparelho Lunar DPX (Dexa). Dentre as variáveis do perfil lipídico, a densidade mineral óssea associou-se inversamente à lipoproteína HDL de alta densidade (p = 0,001). A análise de regressão múltipla observou que níveis de colesterol total acima de 240mg% associaram-se a menor densidade mineral óssea (p = 0,026). A razão entre a lipoproteína de baixa densidade e a lipoproteína de alta densidade (índice de Castelli 2) correlacionou-se positivamente com a densidade mineral óssea (p = 0,002). O teste de validação diagnóstica mostrou que todas as variáveis do perfil lipídico apresentaram baixa sensibilidade e especificidade como indicadoras de diminuição de massa óssea. Conclui-se que, apesar de algumas variáveis do perfil lipídico apresentarem associação estatisticamente significativa com a massa óssea, elas foram contraditórias e não têm boa capacidade diagnóstica.77978