Incontinência urinária

Abstract

Urinary incontinence is not a disease, but rather a symptom resulting from impairment of the bladder or of the sphincteric mechanism. The International Continence Society (ICS) Standardization Committee defined urinary incontinence as "a condition in which involuntary loss of urine is a social or hygienic problem and is objectively demostrable." Women are more prone to urinary incontinence than men. Whereas prevalence rates for any type of urinary incontinence in general populations of adult women are estimated to be 10% to 58%, the prevalence rates in men have been estimated to be between 3% and 11%. A conservative estimate is that urinary incontinence disrupts the lives of approximately 20% of women. The most common outcome measures in clinical studies of urinary incontinence examine the quantity and frequency of urine loss, whether it be through voiding diaries, the pad test or urodynamic tests, such as detrusor or stress leak point pressure. These observations may reflect the degree of leakage but they do not reflect how it disrupts the quality of daily activity. Norton first hypothesized that after treatment there was no direct relationship of objective measures of urinary incontinence with the degree of improvement experienced by the patient. Consequently several others have found only weak relationships of the perceived impact of incontinence with measures of frequency and quantity of urine loss. In response to such situations Wood-Dauphinee and Troidl advocated the use of quality of life instruments as an outcome measure for surgical interventions. It is mainly in the last decade that researchers have developed and proposed the use of several self-administered questionnaires for urinary incontinence. They include measures of bother, symptom impact and quality of life. This review concentrates on quality of life measures in men and women with urinary incontinence and it is limited to questionnaires available in English. Although children are also affected by urinary incontinence, we did not find any article reporting quality of life of children with urinary incontinence. A report of enuresis and self-esteem in childhood was identified but considered to be outside of the scope of this review. © Copyright Moreira Jr. Editora. Todos os direitos reservados.