Incontinência urinária em mulheres submetidas à cirurgia bariátrica

• Ano de defesa: 2018
• Autor(a) principal: Nygaard, Christiana Campani
• Orientador(a): Padoin, Alexandre Vontobel
• Tipo de documento: Tese
• Tipo de acesso: Acesso aberto
• Idioma: por
• Instituição de defesa: Pontifícia Universidade Católica do Rio Grande do Sul
• Programa de Pós-Graduação: Programa de Pós-Graduação em Medicina e Ciências da Saúde
• Departamento: Escola de Medicina
• País: Brasil
• Palavras-chave em Português: Obesidade; Incontinência Urinária
• Palavras-chave em Inglês: Obesity; Urinary incontinence; Bariatric surgery
• Área do conhecimento CNPq: CIENCIAS DA SAUDE::MEDICINA
• Link de acesso: http://tede2.pucrs.br/tede2/handle/tede/8385

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.