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Previous issue date: 2018-10-19 / Coordena??o de Aperfei?oamento de Pessoal de N?vel Superior - CAPES / Introduction: Urinary incontinence(UI) symptoms have a high prevalence in women
with obesity. The excess of weight is the most well-established and potentially
modifiable risk factor for developing UI. Weight loss is known to improve symptoms.
This thesis was divided into two papers
Objectives: The aim of the first paper is to evaluate the prevalence, risk factors and
impact on the quality of life of UI symptoms in patients with obesity. The second
study aims to evaluate the modification of symptoms after bariatric surgery and
identify factors associated with remission of symptoms.
Methods: A cross-sectional study was performed with female patients in the
preoperative period of bariatric surgery, followed by a prospective cohort with
patients who presented UI symptoms. The evaluation was carried out with the
application of a form and with quality of life questionnaires specific to UI, validated for
the Portuguese language.
Results: In the cross-sectional study, of the 221 patients evaluated, 118 (53.4%)
reported episodes of UI. The prevalence of UI was 47% higher in patients who had
a vaginal delivery and 34% higher in postmenopausal women. The severity of the
symptoms was considered moderate in 63 (53.3%) patients. In the cohort study,
eighty-eight (74.6%) of the patients were followed up and re-evaluated after 6-12
months after the Roux-en-Y gastric bypass. Of these, 50 (56.8%) had remission of
symptoms. Patients who only had a cesarean delivery type had a greater probability
of remission of symptoms. Patients with an additional point in the "International
Consultation on Incontinence Questionnaire-Short Form" (ICIQ-SF) result prior to
surgery had a 4% lower probability of remission of symptoms.
Conclusion: UI has a high prevalence in patients with obesity and has a negative
impact on quality of life. In the cross-sectional study, vaginal delivery and menopause
were independent risk factors associated with UI. In the cohort study, cesarean
section was associated with greater remission of symptoms, while patients with
higher ICIQ-SF scores had lower remission of symptoms. / Introdu??o: Os sintomas de incontin?ncia urin?ria (IU) s?o altamente prevalentes
em mulheres com obesidade. O excesso de peso ? o fator de risco mais bem
estabelecido e potencialmente modific?vel no desenvolvimento da IU. A perda de
peso est? associada a melhora dos sintomas. Esta tese foi dividida em dois
trabalhos.
Objetivos- O primeiro trabalho tem como objetivo avaliar a preval?ncia, os fatores de
risco e o impacto na qualidade de vida dos sintomas de IU em pacientes com
obesidade. O segundo trabalho visa avaliar a modifica??o dos sintomas ap?s a
cirurgia bari?trica e identificar fatores associados a remiss?o dos sintomas.
M?todos: Foi realizado um estudo transversal com pacientes femininas no pr?operat?rio
da cirurgia bari?trica, seguido de uma coorte prospectiva com as
pacientes que apresentaram sintomas de IU. A avalia??o foi realizada com a
aplica??o de um formul?rio e com question?rios de qualidade de vida espec?ficos
para IU, validados para a l?ngua portuguesa.
Resultados: No estudo transversal, das 221 pacientes avaliadas, 118 (53,4%)
relataram epis?dios de IU. A preval?ncia de IU foi 47% maior em pacientes que
tiveram parto vaginal e 34% maior em mulheres na menopausa. A gravidade dos
sintomas foi considerada moderada em 63 (53.3%) pacientes. No estudo de coorte,
oitenta e oito (74,6%) pacientes foram seguidas e reavaliadas 6-12 meses ap?s o
bypass g?strico em Y-de-Roux. Destas, 50 (56,8%) obtiveram remiss?o dos
sintomas. Pacientes com apenas ces?rea como tipo de parto tiveram uma
probabilidade maior de remiss?o dos sintomas. Pacientes com um ponto adicional
no resultado do ?International Consultation on Incontinence Questionnaire-Short
Form? (ICIQ-SF) antes da cirurgia tiveram uma probabilidade 4% menor de remiss?o
dos sintomas.
Conclus?o: A IU ? altamente prevalente em pacientes com obesidade e tem um
impacto negativo na qualidade de vida. No estudo transversal, parto vaginal e
menopausa foram fatores de risco independentes associados a IU. No estudo decoorte, a ces?rea foi associada a maior remiss?o dos sintomas ap?s a cirurgia,
enquanto pacientes com escores mais elevados no ICIQ-SF tiveram menor
remiss?o de sintomas.
| Identifer | oai:union.ndltd.org:IBICT/oai:tede2.pucrs.br:tede/8385 |
| Date | 19 October 2018 |
| Creators | Nygaard, Christiana Campani |
| Contributors | Padoin, Alexandre Vontobel |
| Publisher | Pontif?cia Universidade Cat?lica do Rio Grande do Sul, Programa de P?s-Gradua??o em Medicina e Ci?ncias da Sa?de, PUCRS, Brasil, Escola de Medicina |
| Source Sets | IBICT Brazilian ETDs |
| Language | Portuguese |
| Detected Language | English |
| Type | info:eu-repo/semantics/publishedVersion, info:eu-repo/semantics/doctoralThesis |
| Format | application/pdf |
| Source | reponame:Biblioteca Digital de Teses e Dissertações da PUC_RS, instname:Pontifícia Universidade Católica do Rio Grande do Sul, instacron:PUC_RS |
| Rights | info:eu-repo/semantics/openAccess |
| Relation | -721401722658532398, 500, 500, 500, 600, -224747486637135387, -969369452308786627, 3590462550136975366 |
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