To analyze the clinical profile of patients referred to the Pelvic Floor Dysfunctions nursing clinic at a University Hospital

Cross-sectional study.
The Pelvic Floor Dysfunctions nursing outpatient clinic receives patients referred by the Gynecology, Urology, and Coloproctology specialties, with symptoms of Pelvic Floor Dysfunctions, for conservative treatment.
In 2019, more than 800 patients were on the waiting list at this clinic. The service capacity contemplated 40 new patients per month, resulting in an approximate wait of 20 months. As a strategy for prioritizing severe cases and general and collective guidance regarding the main behavioral measures that could lead to the reduction or resolution of symptoms, the team carried out joint efforts when the first 50 patients in the queue were called and gathered in the service auditorium to receive the guidelines and fill out a self-administered symptom form, which could provide prioritization of severe cases.
The data presented consist of descriptive statistics based on the tabulation and analysis of the symptom forms filled in by the first patients on the waiting list on the day of the orientation task force.

One hundred ten patients participated in the two days of the joint effort. They were 12 men and 98 women. The age of the patients varied between 32 and 80 years, with a predominance between 50 and 70 years (61%). As for the clinical profile related to Pelvic Floor Disorders, 52 (47%), they reported symptoms of Stress Urinary Incontinence and Urge Urinary Incontinence, configuring the diagnosis of Mixed Urinary Incontinence being the most prevalent. Forty-two patients (38%) had isolated Stress Urinary Incontinence, and only 04 (3.6%) had isolated Urinary Incontinence. Of the patients, 68 (61%) indicated more than one symptom related to an overactive bladder. Fifty-three patients reported at least one voiding symptom (48%), of which 64% reported having more than three symptomatic urinary tract infections in one year. Forty-two women (43%) reported feeling, seeing, or touching a ball protruding through the vagina, indicating the presence of Pelvic Organ Prolapse grade 02 or higher, and 29 women with prolapse (60%) had urinary tract infections. Fifty-four people (49%) ticked at least two ROMA criteria, indicating Functional Constipation. Forty-five (40%) patients reported episodes of involuntary loss of stool, indicating fecal incontinence and twenty-two patients had an association between fecal incontinence and constipation.

The results demonstrate a significant occurrence rate for all demands met at the clinic: Stress Urinary Incontinence, Urge Urinary Incontinence, Mixed Urinary Incontinence, Symptoms of Incomplete Vesical Emptying, Pelvic Organ Prolapses, Constipation, and Fecal Incontinence. Almost the entire sample had at least one of the most common types of Urinary Incontinence, the most common condition being Mixed Urinary Incontinence, evidencing the nurse's need for knowledge not only about Pelvic Rehabilitation Programs (1) but the identification of risk factors for overactive bladder that will guide the bold choice of behavioral modifications (2). Most patients with Urinary Incontinence also had Constipation or Fecal Incontinence and, in some cases, both conditions. This scenario demonstrates the need for nurses to develop clinical reasoning, who will need not only to apply behavioral modification programs or pelvic rehabilitation in these cases but also to make correlations between symptoms to prioritize measures of more comprehensive results. The high occurrence of Pelvic Organ Prolapses, perceived by the patients, points to the need for nurses' training regarding Vaginal Pessaries, considering that grades 3 and 4 prolapses and those that do not show improvement with pelvic rehabilitation should be treated with surgery or insertion of pessaries. It is worth mentioning that the waiting list for surgery at the study site was approximately 24 months during the study period. Therefore, even patients with a desire or indication for surgery would benefit from temporarily using a pessary (3). The data draw attention to emptying symptoms, which could cause recurrent urinary tract infections, as the patients who presented it were predominantly in this group. It is worth mentioning that the data point to the evident need to expand the offer of conservative treatment due to its high-resolution rate to save the patient from exposure to medication or surgical procedures before trying the first line of treatment due to the economy for the health service. Health and because it is often the only indicated procedure, as is the case of incomplete bladder emptying with recurrent urinary tract infection, when the chosen procedure would be the implementation of Clean Intermittent Catheterization and the lack of it could lead to impaired renal function.

Patients referred to the Pelvic Floor Dysfunctions Nursing outpatient clinic were predominantly women aged between 50 and 70, with Mixed Urinary Incontinence associated with other Dysfunctions such as Constipation, Anal Incontinence, and Prolapses. This profile highlights the need to expand the supply of consultations with first-line treatment and training of nurses focused on clinical reasoning in order to meet this patient demand.

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