RESUMEN
BACKGROUND: Urinary incontinence (UI) is a serious condition for which often times insufficient non-surgical treatment options are provided or sought. Mobile health (mHealth) applications (apps) offer potential to assist with the self-management of UI. OBJECTIVE: To perform a systematic review of available mHealth apps for UI in Brazil. METHODS: A search for UI mHealth apps from the Google Play Store and AppStore in Brazil was performed by two independent reviewers on June 4 2020, and the quality of eligible mHealth apps was assessed using the Mobile App Rating Scale (MARS). RESULTS: Of the 1111 mHealth apps found, 12 were eligible for inclusion. Four offered exclusively exercise programs, six offered exercise and educational content, and two offered tools to track patient-reported symptoms. The included apps scored poorly on the MARS quality scale, with a mean⯱â¯standard deviation score of 2.7⯱â¯0.6 on a 0-5 scale. Most apps scored poorly based on credibility, user interface and experience, and engagement. CONCLUSION: Although there is growing interest in the development of mHealth technologies to support patients with UI, currently available tools in Brazil are of poor quality and limited functionality. Effective collaboration between industry and research is needed to develop new user-centered mHealth apps that can empower patients with UI.
Asunto(s)
Telemedicina , Incontinencia Urinaria , Brasil , Atención a la Salud , Ejercicio Físico , Humanos , Aplicaciones MóvilesRESUMEN
AIMS: To estimate the prevalence of LUTS and overactive bladder (OAB) in the Colombian population. METHODS: A cross-sectional, population-based study was conducted in men and women ≥18 years using directed interviews and self-administered questionnaires in five main cities in Colombia. A sample size of 1054 subjects was estimated (prevalence of LUTS/OAB 15%, CI 95%, statistical power 80%, precision 3%). We used a multi-stage probabilistic sampling technique to randomly select individuals in the community, stratified by socioeconomic status, gender, and age. We used the 2002 ICS and 2010 IUGA/ICS definitions as well as validated questionnaires in Spanish. Descriptive statistics were employed. RESULTS: A total of 1060 participants were included. Mean age was 42 (range 18-89) years. The prevalence of at least one LUTS was 84%, while overactive bladder was reported by 31.8% participants. Among individuals with at least one LUTS, 13.2% would feel "mostly unsatisfied," "unhappy," or "terrible" to spend the rest of their lives with their current urinary condition. Nocturia was the most prevalent LUTS (55.3%), followed by urgency (46.4%) and frequency (45.8%). Urge, stress, and mixed urinary incontinence were reported by 15.3%, 8.6%, and 7% of participants, respectively. CONCLUSIONS: LUTS are highly prevalent in the Colombian population and severely affect quality of life. This is the first study conducted in Colombia and Latin America focused on evaluating LUTS in men and women of all age groups of interest using a multi-stage probabilistic sampling technique. These results may have a significant influence on health decision-making and assessment of future therapies.
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Vejiga Urinaria Hiperactiva/epidemiología , Incontinencia Urinaria/epidemiología , Adolescente , Adulto , Anciano , Anciano de 80 o más Años , Colombia/epidemiología , Estudios Transversales , Femenino , Encuestas Epidemiológicas , Humanos , Síntomas del Sistema Urinario Inferior/epidemiología , Masculino , Persona de Mediana Edad , Prevalencia , Calidad de Vida , Encuestas y Cuestionarios , Adulto JovenRESUMEN
El leiomioma parauretral es una patología poco frecuente, se trata de un tumor mesenquimatoso no dependiente de uretra y que ocasiona sintomatología uroginecológica en la paciente. Su manejo es principalmente quirúrgico. No se reportan casos de malignización, recidiva, ni metástasis y su diagnóstico diferencial se debe realizar con todas las patologías de masas uretrales y para-uretrales. El presente caso describe la presencia de este tumor en una mujer post-menopaúsica de 60 años, que además de presentar incontinencia urinaria mixta, refería signos obstructivos urinarios, fue diagnosticada y manejada de manera quirúrgica: Resección de tumor y posterior ubicación de cinta suburetral.
The paraurethral leiomyoma is a rare pathology, it is a mesenchymal tumor not dependent of the urethra which causes urogynecological symptoms in the patient. Its management is mainly surgical. No cases of malignancy, recurrence or metastasis are reported and its differential diagnosis must be performed with all pathologies of urethral and para-urethral masses. The present case describes the presence of this tumor in a 60-year-old post-menopausal woman who, in addition to presenting mixed urinary incontinence, referred obstructive urinary signs, was diagnosed and managed surgically: tumor resection and subsequent placement of suburethral tape.
Asunto(s)
Humanos , Técnicas de Diagnóstico Obstétrico y Ginecológico , Leiomioma/diagnóstico por imagen , Incontinencia Urinaria/tratamiento farmacológico , Espectroscopía de Resonancia MagnéticaRESUMEN
Resumen OBJETIVO Evaluar el éxito subjetivo y analizar las complicaciones de la aplicación de la cinta transobturadora en el tratamiento de pacientes con incontinencia urinaria de esfuerzo. MATERIALES Y MÉTODOS Estudio de cohorte simple, retrospectivo, al que se incluyeron pacientes a quienes entre los años 2008-2016 se les colocó una cinta transobturadora. Se consideró éxito subjetivo cuando la paciente negó la pérdida de orina por interrogatorio; se registraron las complicaciones intra y posoperatorias. Se realizó estadística descriptiva (SPSS 24.0.), χ2 para variables cualitativas y t de Student para cuantitativas; para determinar los factores de riesgo se obtuvieron la razón de momios y el IC95%. RESULTADOS Se incluyeron 292 pacientes con edad promedio de 51 ± 10 años, 48.6% (n = 141) con diagnóstico de incontinencia urinaria de esfuerzo, 47.2% (n = 139) con incontinencia urinaria mixta, 3.4% (n = 10) con alto riesgo de incontinencia urinaria de novo posterior a la cirugía de prolapso pélvico, 0.68% (n = 2) con incontinencia urinaria oculta. A 214 (73.2%) pacientes se les realizó cirugía concomitante por prolapso de órganos pélvicos. La tasa de curación subjetiva de incontinencia urinaria de esfuerzo fue de 95%; las complicaciones transquirúrgicas fueron: lesión vesical (n = 3) y lesión uretral (n = 1) e inmediatas: retención urinaria 11.3% (n = 33). Las pacientes con falla quirúrgica eran de mayor edad y paridad que las que tuvieron éxito subjetivo (4 ± 2.4 vs 2.72 ± 1.9, p = 0.045 y 56.44 ± 11.6 vs 51.29 ± 9.8, p = 0.007, respectivamente). CONCLUSIONES En el tratamiento de la incontinencia urinaria de esfuerzo la colocación de una cinta transobturadora tiene altas tasas de curación subjetiva y bajos índices de complicaciones. La edad y la paridad son factores asociados con la falla del tratamiento quirúrgico.
Abstract OBJECTIVE To evaluate the subjective success and analyze the complications of transobturator tape application in the treatment of stress urinary incontinence. MATERIAL AND METHODS Retrospective single cohort study. Patients who were placed to transobturator tape application from 2008-2016 were included. Subjective success of Stress Urinary Incontinence was defined when the patient denied urine loss by questioning, intra and postoperative complications were recorded. With the SPSS 24.0 program was done descriptive statistics, χ2 for qualitative variables and t student for quantitative. Odds Ratio and Confidence Intervals of 95% (95% CI) to determine the risk factors. RESULTS 292 patients, average age of 51 ± 10 years, 48.6% (n = 141) with a diagnosis of SUI, 47.2% (n = 139) mixed urinary incontinence, 3.4% (n = 10) with high risk of de novo urinary incontinence after pelvic prolapse surgery, 0.68% (n = 2) with occult urinary incontinence. To 214 (73.2%) concomitant surgery for pelvic organ prolapse was performed. The subjective cure rate of stress urinary incontinence was 95%, the trans-surgical complications: bladder injury (n = 3) and urethral injury (n = 1) and immediate complications: urinary retention in 11.3% (n = 33). Patients with surgical failure was increased age and parity than patients with subjective success (4 ± 2.4 vs 2.72 ± 1.9, p = 0.045 and 56.44 ± 11.6 vs 51.29 ± 9.8, p = 0.007, respectively). CONCLUSIONS Transobturator tape application placement has high subjective cure rates for the treatment of stress urinary incontinence and low complication rates.