Correlação entre distopia urogenital e bexiga hiperativa em mulheres com incontinencia urinaria de esforço




Introduction: Urinary incontinence in women may be caused by two physiopathologic principal conditions which are not mutually excluding, represented both by vesical disfunctions and alterations in the urethral sphincteral mechanism, either the intrinsic or the ones occurring in the supporting elements of the pelvic floor. Vesical disfunctions include the detrusor overactivity and low compliance. The Integral Theory has been conceived aiming at fully explaining the physiopathologic mechanisms involved in urinary incontinence and its associated symptoms. It postulates, among other hypotheses, that the alterations on the tension of the vagina, resulting from urogenital prolapses also determines a premature activation of the mictional reflex, triggering detrusor involuntary contractions. Objective: The study herein has aimed at analysing the relation between urogenital dystopia and the presence of detrusor overactivity in women suffering from stress urinary incontinence. Methods and materials - Ninety-two women with clinical diagnosis of stress urinary incontinence who had been submitted to urodynamics, were prospectively assessed. They ages ranged from 29 to 75 years old, with a 48 + 10 years average. The relationship between the presence and level of urogentital dystopias (cystocele, urethrocele, rectocele) and the occurrence of detrusor overactivity have been analysed. Results ? According to the clinical examination and the urodynamic study, the following results were observed: cystocele in 65 (70,6%) women, urethrocele in 45 (48,9%), rectocele in 31 (33,6%). Detrusor overactivity were found in 13 (20%) of the cystocele cases, in 9 (20%) of the urethrocele cases and in 6 (19,3%) of the rectocele cases. We weren´t observed significant difference in neither of dystopias in relation to presence of detrusor overactivity: cystocele (p=0,1639), urethrocele (p=0,2044) and rectocele (p=0,1849). Conclusion ? Urogenital dystopias, in their different levels, have shown no relationship with the frequency of detrusor overactivity in women with stress urinary incontinence


uretra - patologia urina - incontinencia bexiga - patologia

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