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.