<p><strong>Background: </strong>Among young women vary the presence of urinary leakage between 28-80% depending on the study and the sport practiced. Poor support in the upper part of the urethra and urinary bladder base is considered the common cause of stress urinary incontinence. Supports are given by the pelvic floor muscles and the key muscles to prevent incontinence. Urinary leakage occurs more frequent in women who engaged in sports that provide a high abdominal pressure. Pelvic floor training is considered to be an effective and safe method to treat stress urinary incontinence and is recommended in the literature as the first treatment action. <strong>Aim:</strong> To examine young active women's experience of urinary incontinence affects their lives. <strong>Method:</strong> A qualitative design with tape-recorded interviews and semi-structured open questions were used as data collection method. A strategic selection was made. Six young active elite sportswomen interviewed. A qualitative content analysis was conducted. <strong>Results:</strong> Four categories were identified: manageable, social limitations, emotional and communication. Main findings shows that young women do not talk about urinary leakage as a problem, they have different ways to cope. Women experience a fear of urinary leakage shall be affected without prior notice and to lose control. The risk of urinary leakage gives concentration difficulties in training. The study shows a great lack of information. <strong>Weighted understanding:</strong> Among young women, there may be a risk that they are more affected by urinary leakage than middle-aged and older women, in terms of their experience of urinary leakage and leak impact on their lives. This in view of the ideals which today makes high demands and is difficult to live up to. Women get often their first information on the basin floor exercise to prevent urinary leakage at childbirth. This information should take place earlier.</p> / <p><strong>Bakgrund: </strong>Hos unga elitidrottare varierar förekomsten av urinläckage mellan 28-80 % beroende på studie och vilken sport som utövas. Dåligt stöd i övre delen av urinröret och urinblåsans botten anses vara den valigaste orsaken till ansträngningsinkontinens. Stödet ges av bäckenbottenmuskulaturen och dess viktiga muskler för att förhindra inkontinens. Urinläckage förekommer oftare hos kvinnor som utövar sporter som ger ett högt buktryck. Bäckenbottenträning anses vara en effektiv och säker metod för att behandla ansträngningsinkontinens och rekommenderas i litteraturen som första behandlingsåtgärd.<strong> </strong><strong>Syfte: </strong>Att undersöka yngre aktiva idrottande kvinnors upplevelse av om urininkontinens påverkar deras livssituation. <strong>Metod: </strong>En kvalitativ metod med bandade intervjuer och halvstrukturerade öppna frågor användes som datainsamlingsmetod. Ett strategiskt urval gjordes. Sex yngre kvinnliga aktiva elitidrottare intervjuades. En kvalitativ innehålls analys utfördes.<strong> Resultat: </strong>Fyra kategorier identifierades: Hanterbarhet, sociala begränsningar, Emotionellt och kommunikation. Huvudesultatet visar att yngre kvinnor inte pratar om urinläckage som ett problem, de hade olika sätt att hantera situationen. Kvinnorna upplevde en rädsla för att urinläckage skulle ske utan förvarning och för att tappa kontrollen. Risk för urinläckage gav koncentrationssvårigheter vid träning. Studien visar en stor informationsbrist.  <strong>Sammanvägd förståelse: </strong>Hos yngre kvinnor kan det finnas en risk för att de påverkas mer av urinläckage än medelålders och äldre kvinnor, när det gäller  upplevelsen av urinläckage och läckagets påverkan på  livssituationen. Detta med tanke på de ideal som idag ställer stora krav och är svåra att leva upp till. Kvinnor får oftast sin första information om bäcken botten träning för att förebygga urinläckage vid barnafödande. Denna information bör ske tidigare. <strong></strong></p>

Background: Among young women vary the presence of urinary leakage between 28-80% depending on the study and the sport practiced. Poor support in the upper part of the urethra and urinary bladder base is considered the common cause of stress urinary incontinence. Supports are given by the pelvic floor muscles and the key muscles to prevent incontinence. Urinary leakage occurs more frequent in women who engaged in sports that provide a high abdominal pressure. Pelvic floor training is considered to be an effective and safe method to treat stress urinary incontinence and is recommended in the literature as the first treatment action. Aim: To examine young active women's experience of urinary incontinence affects their lives. Method: A qualitative design with tape-recorded interviews and semi-structured open questions were used as data collection method. A strategic selection was made. Six young active elite sportswomen interviewed. A qualitative content analysis was conducted. Results: Four categories were identified: manageable, social limitations, emotional and communication. Main findings shows that young women do not talk about urinary leakage as a problem, they have different ways to cope. Women experience a fear of urinary leakage shall be affected without prior notice and to lose control. The risk of urinary leakage gives concentration difficulties in training. The study shows a great lack of information. Weighted understanding: Among young women, there may be a risk that they are more affected by urinary leakage than middle-aged and older women, in terms of their experience of urinary leakage and leak impact on their lives. This in view of the ideals which today makes high demands and is difficult to live up to. Women get often their first information on the basin floor exercise to prevent urinary leakage at childbirth. This information should take place earlier. / Bakgrund: Hos unga elitidrottare varierar förekomsten av urinläckage mellan 28-80 % beroende på studie och vilken sport som utövas. Dåligt stöd i övre delen av urinröret och urinblåsans botten anses vara den valigaste orsaken till ansträngningsinkontinens. Stödet ges av bäckenbottenmuskulaturen och dess viktiga muskler för att förhindra inkontinens. Urinläckage förekommer oftare hos kvinnor som utövar sporter som ger ett högt buktryck. Bäckenbottenträning anses vara en effektiv och säker metod för att behandla ansträngningsinkontinens och rekommenderas i litteraturen som första behandlingsåtgärd. Syfte: Att undersöka yngre aktiva idrottande kvinnors upplevelse av om urininkontinens påverkar deras livssituation. Metod: En kvalitativ metod med bandade intervjuer och halvstrukturerade öppna frågor användes som datainsamlingsmetod. Ett strategiskt urval gjordes. Sex yngre kvinnliga aktiva elitidrottare intervjuades. En kvalitativ innehålls analys utfördes. Resultat: Fyra kategorier identifierades: Hanterbarhet, sociala begränsningar, Emotionellt och kommunikation. Huvudesultatet visar att yngre kvinnor inte pratar om urinläckage som ett problem, de hade olika sätt att hantera situationen. Kvinnorna upplevde en rädsla för att urinläckage skulle ske utan förvarning och för att tappa kontrollen. Risk för urinläckage gav koncentrationssvårigheter vid träning. Studien visar en stor informationsbrist.  Sammanvägd förståelse: Hos yngre kvinnor kan det finnas en risk för att de påverkas mer av urinläckage än medelålders och äldre kvinnor, när det gäller  upplevelsen av urinläckage och läckagets påverkan på  livssituationen. Detta med tanke på de ideal som idag ställer stora krav och är svåra att leva upp till. Kvinnor får oftast sin första information om bäcken botten träning för att förebygga urinläckage vid barnafödande. Denna information bör ske tidigare.

Purpose: Current literature reports that between 7 and 14% of young, healthy women have stress urinary incontinence (SUI). No gold standard exists for quantifying urine leakage, although pad tests have been used in older, parous populations. The aim of this study was to determine the reliability and accuracy of a new pad test for young, healthy women with SUI. Methods: The pad test consisted of measuring quantity of leakage after the following activities: stair running, standing up from sitting, curl-ups, running on the spot, jumping jacks, jumping on a mini-trampoline and coughing vigorously. Bladder volume was standardised by having the volunteers drink one litre of water one hour prior to the testing. The volunteers performed the pad test on two consecutive days. Results: Sixteen nulliparous women between the ages of 18 and 30 years (7 controls and 9 with SUI) participated in this study. The mean increase in pad weight was 0.64 g (± 0.50) in the continent group and 11.89 g (± 20.32) in the group with SUI. There was no significant difference in pad weight between the testing sessions (p=0.228), however the test was not able to elicit measureable urine loss in 3 participants with SUI. Pad weights between the two groups of women were significantly different (p=0.023). The test re-test ICC for the continent group was 0.845 (95% CI: 0.139–0.973) and 0.782 (95% CI: -0.040–0.952) for the group with SUI. Significance: The results of this study support the use of this pad test in healthy young women with SUI; it appears to be reliable and challenging enough to cause measureable urine loss in the majority, and it may be useful for diagnosing and quantifying SUI without urodynamic studies.

Dynamic transperineal ultrasound (TPUS) video allows for kinematic analysis of urogenital morphology and mobility, however, measures are often limited to peak displacements of anatomical landmarks and are vulnerable to error incurred by probe rotation during imaging. This thesis aimed to (1) develop an algorithm to calculate kinematic curves of urogenital landmark motion from TPUS video and to (2) investigate the error incurred in these kinematic measures due to in-plane ultrasound probe rotation. UROKIN, a semi-automated software, was developed and, as a proof of concept, was used to identify differences in urogenital kinematics during pelvic floor muscle maximum voluntary contractions between women with and without stress urinary incontinence. A mathematical model revealed that the error incurred by TPUS probe rotation in the x- (anterior-posterior) and y- (cranial-caudal) directions, was a factor of: r, the radius of rotation; Ɵ, the in-plane angular probe rotation; and α, the angular deviation between the anatomical planes and the coordinate system in which error was calculated. As an absolute measure, the error incurred by in-plane probe rotation is reduced to a factor of only r and Ɵ. Moving forward, UROKIN must be adapted to include findings from (1), and must be tested for validity and reliability.

Title: An examination of pelvic floor activity following the application of special exercises Objectives: The aim of this thesis is to validate the usefulness of carrying out local pelvic floor muscle examinations as an indication and education for therapy. A second objective is for the women involved in the research to subjectively evaluate the examination methods and therapy. Furthermore, the thesis aims to establish an example of a comprehensive and detailed local examination of the pelvic floor muscles. Methods: We measured the pelvic floor activity per vaginam using an EMG biofeedback device on clients with a pelvic floor dysfunction and grade I stress incontinence symptoms. Based on the results of the examination, therapy using the vaginal device was recommended and in six weeks a follow-up examination was carried out. The changes in pelvic floor activity were evaluated by comparing the initial and follow-up examinations. Thus the usefulness of carrying out an examination of the local pelvic floor muscles before indicating a therapy was validated. At the end of the examination an interview with participating clients was conducted in order to subjectively evaluate the method. Results: All of the women participating in the research had previously undergone a different method of pelvic floor...

Introduction: The primary purpose of this research was to determine whether women with stress urinary incontinence (SUI) demonstrate pelvic floor muscle (PFM) strength or endurance deficits and/or changes in the motor control patterns used during maximum voluntary PFM contractions (PFM MVCs) and coughing. A secondary purpose was to determine the effect of age on these parameters. Methods: After first validating the use of vaginal pressure to study the functional output of the PFMs, three studies were carried out to address these objectives. In two studies vaginal pressure and PFM and abdominal muscle electromyography (EMG) data were recorded simultaneously during PFM MVCs and maximum effort coughs in continent women, women with mild SUI and women with moderate to severe SUI in both supine and standing. In the final study, the effect of continence status and age on PFM strength and endurance was measured with vaginal pressure. Results: Changes in vaginal pressure induced by PFM MVCs and coughing were found to reflect changes in urethral pressure. The women with SUI and the continent women were found to be equally able to produce peak PFM EMG and vaginal pressure amplitudes during PFM MVCs and coughs. Compared to the continent women, the women with SUI delayed activating their abdominal muscles during the PFM MVCs. During coughing, vaginal pressure and PFM EMG peaked simultaneously in the continent women, while in the women with SUI vaginal pressure peaked after PFM EMG. During both the PFM MVCs and the coughs, the EMG activity in all of the muscles tested was higher at the onset of vaginal pressure generation in the women with SUI compared to the continent women. No difference was found in PFM endurance between the women with and without SUI. The ability to generate peak vaginal pressure during coughing decreased with age. Conclusions: PFM weakness does not appear to play a significant role in SUI. Rather, the results of this research suggest that a combination of motor control deficits and delays in pressure transmission are associated with SUI in women. / Thesis (Ph.D, Rehabilitation Science) -- Queen's University, 2009-09-21 09:37:12.923

Diss. (sammanfattning) Stockholm : Karol. inst., 2004. / Härtill 5 uppsatser.

Orientadores: Paulo Cesar Rodrigues Palma, Miriam Dambros / Dissertação (mestrado) - Universidade Estadual de Campinas, Faculdade de Ciências Médicas / Made available in DSpace on 2018-08-10T05:38:31Z (GMT). No. of bitstreams: 1 Fozzatti_MariaCelinaMartins_M.pdf: 2306333 bytes, checksum: 040314ce3a3460ed7af49497e661b9aa (MD5) Previous issue date: 2006 / 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

Orientadores: Viviane Herrmann, Paulo César Rodrigues Palma / Tese (doutorado) - Universidade Estadual de Campinas, Faculdade de Ciências Médicas / Made available in DSpace on 2018-08-17T02:53:51Z (GMT). No. of bitstreams: 1 Fozzatti_MariaCelinaMartins_D.pdf: 4656341 bytes, checksum: eb6677485cb09dbe79185403e87167c4 (MD5) Previous issue date: 2010 / Resumo: A incontinência urinária de esforço é uma das queixas clínicas mais comuns de mulheres em consultório médico e o desequilíbrio postural tem sido considerado como possível causa deste sintoma. Estudos demonstram que disfunções posturais como a hiperlordose, a anteversão da bacia pélvica, dores lombares e fraqueza dos músculos abdominais estão associados às disfunções dos músculos do assoalho pélvico. Objetivo: Comparar o efeito da Reeducação Postural Global com o treinamento dos músculos do assoalho pélvico no tratamento da incontinência urinária de esforço feminina a curto e a longo prazo. Metodologia: Cinquenta e duas mulheres com queixa clínica de incontinência urinária de esforço foram divididas em dois grupos: o Grupo 1 (G1) recebeu tratamento pela Reeducação Postural Global em 1 sessão semanal de 50 minutos por três meses e o Grupo 2 (G2) recebeu treinamento dos músculos do assoalho pélvico quatro vezes por semana, uma vez supervisionada em sessão individual de 50 minutos e três não supervisionadas, por três meses. Ao final do tratamento, após 6 meses, e em dois anos, foi realizada avaliação subjetiva (cura, melhora, inalterada e piora), diário miccional, avaliação funcional do assoalho pélvico (AFA) e questionário de qualidade de vida. Resultados: Concluíram o tratamento 25 pacientes do G1 e 17 do G2. A avaliação subjetiva do G1 ao final do tratamento apresentou 16% cura e após seis meses, 24%. No G2, no final do tratamento, nenhuma paciente considerava-se curada, 69% referiram melhora e 31% encontravam-se inalteradas. Após seis meses, 19% referiram cura, 37,5% melhoram, 31% inalteradas e 12,5% que haviam referido melhora ao final do tratamento, apresentaram piora dos sintomas. O número de episódios de perda e o número de troca de absorventes diminuiram significativamente nos dois grupos (p<0,001), sendo significativamente menor no G1. A Avaliação Funcional do Assoalho Pélvico (AFA) melhorou significativamente nos dois grupos (p<0,001), sem diferença entre eles. A avaliação da Qualidade de Vida demonstrou melhora significativa nos dois grupos, em todos os domínios. Após dois anos foram reavaliadas 21 pacientes no G1 e 12 no G2. O G1 apresentou 47,6% de cura e o G2, 16,7%, sendo que neste grupo, 33,3% das pacientes referiram piora com relação ao final do tratamento. O número de perdas e o número de absorventes diminuíram significativamente nos dois grupos (p=0,0001), sem diferença significativa entre eles (p=0,0787 e p=0,0579, respectivamente). A AFA melhorou significativamente no G1, porém no G2, apresentou melhora significativa ao final do tratamento e mante-se inalterada no seguimento de dois anos (p=0,045). Conclusão: A RPG mostrou-se uma alternativa eficaz no tratamento da Incontinência Urinária de Esforço Feminina, com resultados comparáveis ao treinamento dos músculos do assoalho pélvico, a curto e a longo prazo / Abstract: Stress urinary incontinence (SUI) is one of the most common complains of women and postural unbalances have been considered as a possible cause. Studies have shown that postural disequilibrium such as hiperlordose, pelvis anteversion, lumbar pain and weakness of the abdominal muscles are associated to pelvic floor muscles dysfunctions. Objective: To compare the effect of Global Postural Re-education (GPR) and Pelvic Floor Muscle Training (PFMP) for the treatment of female stress urinary incontinence at short and long term. Methodology: Fifty-two women with SUI complain were distributed into two groups: Group 1 (G1) was submitted to 50 minutes weekly sessions of GPR for three months and Group 2 (G2) performed PFMT four times a week for three months, being one time in individual session under professional supervision and the other three times at home, for three months. Patients were evaluated at the end of the treatment and after six months and two years on subjective evaluation (cure, improvement, no change and recurrence), voiding diary, functional evaluation of pelvic floor (FEPF) and through a questionnaire of quality of life. Results: The number of patients completing the treatments was 25 in G1 and 17 in G2. The subjective evaluation of G1 showed cure in 16% women at the end of the treatment and 24% after six months. In G2 no women reported cure at the end of the treatment, 69% indicated improvement and 31% reported no change. After six months, the reports of cure, improvement and no change in G2 were, respectively, 19%, 37.5% and 31%. Additionally, 12.5% of the women in this group, who had referred to improvement at the end of the treatment, reported symptom recurrence after six months. The urine leakage episodes reduced significantly in both groups (p<0.001), being significantly lower in G1. PAD use reduced significantly in both groups (p<0.001) and was significantly lower in G1. FEPF improved significantly in both groups (p<0.001), with no difference between them. The evaluation of Quality of Life had shown significantly improvement in both groups, in all domains. Two years after the end of the treatment, 21 patients of G1and 12 of G2 were reevaluated. The amount of women reporting cure in G1 and G2 were, respectively, 47.6% and 16.7%. In G2, 33.3% of the patients referred to symptoms recurrence in comparison with the end of the treatment. Episodes of urine leakage and PAD use reduced significantly in both groups (p=0.0001), without significant difference between groups (p=0.0787 and p=0.0579, respectively). FEPF had shown improvement in G1 in the evaluation at six months and two years; however, in G2 it had shown improvement at the end of the treatment but it did not change in the evaluation at two years. This shows that the behavior of the groups was different throughout the time (p=0.045). Conclusion: GPR has proven to be an efficient alternative to treat SUI in women when compared to PFMT, either on short term or long term follow-up / Doutorado / Fisiopatologia Cirúrgica / Doutor em Ciências

Orientadores: Cassio Luis Zanettini Riccetto, Paulo Cesar Rodrigues Palma / Dissertação (mestrado) - Universidade Estadual de Campinas, Faculdade de Ciencias / Made available in DSpace on 2018-08-12T17:44:11Z (GMT). No. of bitstreams: 1 Silveira_ArlonBrenoFigueiredoda_M.pdf: 2621259 bytes, checksum: 4ce31188b66f0429c0dd69afbac24d21 (MD5) Previous issue date: 2008 / 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