Impacto sobre a quantidade de urina perdida de uma intervenção fisioterapêutica em idosas com incontinência urinária

Incontinência urinária (IU) é um problema de saúde comum entre mulheres idosas, podendo afetar estruturas e função do corpo, atividades e participação social. Tratamentos conservadores têm sido indicados comoalternativa para melhorar os sintomas de IU. O objetivo deste estudo foi verificar o impacto nos sintomas de perda urinária de um protocolo de exercícios terapêuticos para o assoalho pélvico, associado a eletroestimulação vaginal. Participaram deste estudo quase-experimental 30 mulheres idosas (70,10±8,628 anos) com diagnóstico de hiperatividade detrusora e incontinência mista, confirmado por estudo urodinâmico. Nas avaliações foram utilizados pad test de 24 horas e diário miccional. A intervenção consistiu em 12 sessões de exercícios para o assoalho pélvico associadas a eletroestimulação vaginal. Os resultados mostram diferença significativa na quantidade de urina perdida medida pelo pad test após a intervenção (p=0,001), nos episódios de perda(p=0,004) e na freqüência miccional (p=0,000). O protocolo de exercíciosterapêuticos para assoalho pélvico associado a eletroestimulação vaginal teve pois impacto positivo sobre a perda urinária, os episódios de perda e a freqüência miccional, levando à melhora clínica das pacientes.Urinary incontinence (UI) is a common health problem among elderly women that may affect body structure, functions, activities and social participation. Conservative treatments are advocated as an alternativeto improve UI symptoms. This pre-post-one-group experimental study assessed the impact onto urine loss of a protocol of pelvic floor exercises and vaginal electrical stimulation. Thirty elderly women (70.10±8.628 years old) with diagnosis of overactive bladder and mixed UI (confirmed by urodynamic exam) were submitted first to the 24-hour pad test and bladder diary, and subsequently to 12 therapeutic exercise sessions for pelvic floor muscles, associated to electrical stimulation. There were statistically significant differences between the quantity of urine loss as measured by the 24-hour pad test (p=0.001), as well as in loss episodes (p=0.004) and in mictional frequency (p=0.000). The protocol of therapeutic exercises and pelvic floor muscle electric stimulation had thus a positive impact over symptoms of urine loss, number of loss episodes, and mictional frequency, assuring patients‘ clinical improvement

Pregnant women autonomy when choosing their way of delivery: scoping review protocol

Objective: to identify in current literature the concepts related to the autonomy of pregnant women in choosing their route of delivery during the birth of their children. Review question: The strategy for selecting the research question was based on the PCC mnemonic (Population, Concept, Context), according to the Joanna Briggs Institute (JBI) manual. Review method: scoping review protocol according to the JBI method. Studies focused on pregnant women's autonomy in choosing the birth route published in scientific journals, government websites and/or entities representing women's and children's health with free access, as well as in gray literature, will be considered. Thus, a detailed and individual search strategy will be applied to the following databases: PubMed, Web of Science, Scopus, Scielo and LILACS. Thus, a detailed and individual search strategy will be applied to the following databases: PubMed, Web of Science, Scopus, Scielo and LILACS. Two reviewers will screen the titles and abstracts, read the full texts and extract data from the included material. Disagreements between the two reviewers will be resolved through dialogue or by calling on a third reviewer. The results included in this scoping review will be classified into conceptual analysis categories based on content analysis

Vacuum-assisted excision: a safe minimally invasive option for benign phyllodes tumor diagnosis and treatment-a systematic review and meta-analysis

This is a systematic review and meta-analysis comparing surgical excision with percutaneous ultrasound-guided vacuum-assisted excision (US-VAE) for the treatment of benign phyllodes tumor (PT) using local recurrence (LR) as the endpoint. To determine the frequency of local recurrence (LR) of benign phyllodes tumor (PT) after ultrasound-guided vacuum-assisted excision (US-VAE) compared to the frequency of LR after surgical excision. A systematic review and meta-analysis [following the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) standard] was conducted by comparing LR in women older than 18 years treated for benign PT by US-VAE compared with local surgical excision with at least 12 months of follow-up. Studies were retrieved from PubMed, Scopus, Web of Science, and Embase. The pooled effect measure used was the odds ratio (OR) of recurrence. Five comparative prospective or retrospective observational studies published between January 1, 1992, and January 10, 2022, comparing surgical excision with percutaneous US-VAE for LR of benign PT met the selection criteria. Four were retrospective observational cohorts, and one was a prospective observational cohort. A total of 778 women were followed up. Of them, 439 (56.4%) underwent local surgical excision, and 339 (43.6%) patients had US-VAE. The median age of patients in the five studies ranged from 33.7 to 39 years; the median size ranged from 1.5 cm to 3.0 cm, and the median follow-up ranged from 12 months to 46.6 months. The needle gauge ranged from 7G to 11G. LR rates were not statically significant between US-VAE and surgical excision (41 of 339 34 of 439; OR 1.3; p = 0.29). This meta-analysis suggests that using US-VAE for the removal of benign PT does not increase local regional recurrence and is a safe minimally invasive therapeutic option. https://www.crd.york.ac.uk/prospero/, identifier CRD42022309782