The Epidemilogical Characteristics of Women consulting for Urinary Incontinence in a Public Hospital in Buenos Aires

Cobreros C1, Sangalli D1, Del Villar M1, Garcia Penela E1, Bechara A1, Rey H1

Research Type

Clinical

Abstract Category

Health Services Delivery

Abstract 692
Non Discussion Abstracts
Scientific Non Discussion Abstract Session 36
Incontinence Quality of Life (QoL) Gerontology Pelvic Floor
1. Hospital Carlos G Durand
Links

Abstract

Hypothesis / aims of study
Urinary incontinence is a health problem that affects a large proportion of the female population with a significant negative effect on their quality of life. The objective of this work is to determine the prevalence and risk factors surrounding this epidemic illness in a public hospital where females that attend has no health insurance
Study design, materials and methods
This is a cross-sectional study that has been carried out since September 2015 to September 2017. The statistical analysis included descriptive analysis and comparison tests. To avoid misleading data a clinic history chart was first fulfill by the patient and then review by a nurse and the urologist in charge. The chart was review and authorized by the committee of Ethics of the site, and include  personal data, medical background, obstetric-gynecological, biometric data, general and specialized physical examination (POP Q, Qtip) and validated questionnaires ICIQ-SF, IIQ-7 and The Female Sexual Function Index. The statistical analysis included descriptive analysis and comparison tests.
Results
145 women consult for urinary incontinence for the first time in our unit were included, the mean age of this base population was 64.82 years (between 20-95 years with a standard deviation (D.S.) of 13,897 years). Most of the patients  (65,4%) had previously consulted for urinary incontinence before but they have not continued with the treatment or haven't got adequate response for the health system care; 34,48% of the population didnt even correspond to the public local health system. The time of onset of the symptom was 7.9 years (5 and 61 years old with DS of 13.9 years). The time of delay from the beginning of the symptom until his first contact with health system this population was average of 3.68 years (range 2-24 years). In relation to the physical examination and associated comorbidities, the Body Mass Index (BMI) was 27.87 kg / m2 (range 17.3-48.04 kg / m, DS 5.46 kg / m2), previous pregnancies averaged 1.99 (range of 2 -8), caesareans average of 0.27 (range of 0-3), average episiotomies of 1 (range of 1-6). Of the 145 patients assessed it was possible to determine using two simple questions with an affirmative vs negative response: ¨Your leakage is preceded by urgency?¨ and ¨Your leakage is preceded by a stress effort?¨ that 52.41% (76 patients) referred Mixed Urine Incontinence, 24.14% (35 patients) presented Stress Urinary Incontinence  while 15.86% (23 patients) referred Urge Urinary Incontinence alone, and  7.59% (11 patients) referred  not having urinary leakage at all. There were no statistically significant differences between the population with stress urinary incontinence, those with urinary incontinence of urgency or mixed in relation to age, number of previous pregnancies, concomitant diseases, or current medication.  The previous medication with anticholinergic drugs in patients with SUI, UUI and MUI was 5.7, 9.2 and 13% respectively. The physical exam shows a POPQ 9.1% of patients with stage IV, while 41,2% had a predominant stage I prolapse, of the anterior compartment .The impact on the quality of life in relation to the validated  questionnaires has shown that in relation to the ICIQ-SF, the IIQ-7 and the ISFF  a negative impact in all areas which is consistent with the global literature collected.
Interpretation of results
In this prospective study, a cross-sectional study of the patients was carried out in the first visit to our healthcare center for urinary incontinence. The analysis of the obtained data points out that even though urinary incontinence is a prevalent pathology, the patient delays several years from the appearance of the symptom, which is more evident in older patients, and that the psychosocial impact of the Urinary incontinence is very high in relation to other benign and treatable pathologies.
Concluding message
We perform the first cross sectional study in the population that attend for the very first time in our center consulting for urinary incontinence, our study shows the an underlying problem that is the access of the people without any social security and whose health is supported by the Social Estate Network, the challenging problem of urinary incontinence is surrounding but others medical issues that are described and discuss in this study.
Disclosures
Funding None Clinical Trial No Subjects Human Ethics Committee Hospital carlos G Durand Helsinki Yes Informed Consent No