Cinara Sacomori

Predictors of Improvement in Sexual Function of Women with Urinary Incontinence After Treatment with Pelvic Floor Exercises: A Secondary Analysis

INTRODUCTION Women with urinary incontinence (UI) frequently present with complaints of sexual problems. AIM To evaluate the predictors of sexual function improvement after participating in three physical therapy sessions and performing home-based pelvic floor muscle exercises (PFME) for the treatment of female UI. METHODS This is a secondary analysis of a randomized trial with a 3-month follow-up in which the sexual function of 54 women with UI was evaluated. These women joined three supervised physiotherapy sessions that included PFME and health education during 1 month, with a 15-day interval between each session, and kept practicing home-based PFME for a further 2 months. MAIN OUTCOME MEASURE Sexual function was assessed using the Female Sexual Quotient, the pelvic floor muscle strength was measured using the modified Oxford scale, and UI was assessed using the International Consultation on Incontinence Questionnaire. RESULTS The mean of sexual quotient score improved after treatment (P = 0.001). With respect to specific domains of sexual function, improvement was observed only in the questions about sexual desire, arousal/excitement, and orgasm. Before treatment, 18 women (33.3%) were classified as having sexual dysfunction, and after treatment, eight remained with sexual dysfunction and two other joined this category (total of 18.5%). Those women who had sexual dysfunction at baseline experienced a higher level of improvement of the sexual quotient compared with those without sexual dysfunction (P = 0.001, 95% CI = 9.1-31.9). A multivariate linear regression with backward elimination revealed the following predictors of improvement of the sexual quotient: higher parity, higher adherence to PFME, improvement in the strength of PFM, and a decrease in the frequency of urine leakage (R(2)  = 0.497). CONCLUSION PFME was more beneficial with regard to sexual function in those women who presented with sexual dysfunction at baseline.

Pelvic floor muscle strength and body self-perception among Brazilian pregnant women

OBJECTIVES To examine the relationship between pelvic floor muscle strength and body self-perception variables in pregnant women; and, more specifically, to determine the influence of the number of pregnancies (primigravidas vs multigravidas) on the strength of contraction of the pelvic floor muscles and on the body self-perception of pregnant women. DESIGN Comparative cross-sectional research. SETTING Public health centres from Florianópolis, Brazil. PARTICIPANTS Thirty-five pregnant women (18 primigravidas, 17 multigravidas) with a mean age of 25.5 (standard deviation 5.7) years. MAIN OUTCOME MEASURES Pelvic floor strength measured through manual palpation, and body self-perception using the Questionnaire of Corporeality and Human Sexuality. RESULTS Pelvic floor muscle strength was positively correlated with schooling [rho (ρ)=0.496] and body self-perception variables: finding the body beautiful (ρ=0.476), finding the body sexy (ρ=0.520), feeling that others find them sexy (ρ=0.364), finding the body proportional (ρ=0.412), touching the body generally (ρ=0.554) and recognising the smell of the body (ρ=0.454). Primigravidas found their bodies more beautiful and were more satisfied with their bodies. On a scale of 0 to 6, multigravid participants expressed a greater wish than primigravid participants to be thinner (median difference 2, 95% confidence interval 0-3, P=0.03). Pelvic floor strength did not differ between groups. CONCLUSIONS The results suggest a relationship between pelvic floor muscle strength and body self-perception. Professionals involved in womens health may have a role in helping their patients to understand their bodies.

Força dos músculos do assoalho pélvico e função sexual em gestantes

BACKGROUND: Sexual well-being depends on pelvic floor muscles (PFMs) that are strong enough to maintain their function. During pregnancy, both the sexual function and the strength of the PFMs may be altered. OBJECTIVES: to compare the degree of PFM strength and the sexual function of pregnant women in the second and the third trimesters. METHODS: a descriptive, causal-comparative study was carried out with 37 pregnant women in Florianopolis (18 in the second trimester and 19 in the third trimester) with a mean age of 25.22 years (±5.7 years). The instruments used were the Female Sexual Function Index (FSFI) Questionnaire and the Manual Test of Pelvic Floor Muscle Strength, using the modified Oxford scale to grade strength. The data were analyzed using descriptive and inferential statistics (independent t test, the Mann-Whitney U test, Spearmans correlation) with a significance level of 0.05. RESULTS: There was no significant difference between the mean rank values of PFM strength of pregnant women in the second and third trimester (U=150.5; p=0.512). However, the sexual function of the pregnant women in the second trimester of pregnancy was better than that of the women in the third trimester (U=104; p=0.042). In addition, PFM strength had statistically significant correlations with age (ρ=0.320, p=0.041) and with FSFI score (ρ=0.540, p<0.001). CONCLUSIONS: Sexual function decreased significantly from the second to the third trimester while PFM strength did not differ between trimesters.

Association between participation in community groups and being more physically active among older adults from Florianópolis, Brazil

OBJECTIVE: In Brazil, older adults frequently participate in community groups. However, the influence of this participation on physical activity levels has not been fully investigated. It is known that both regular physical activity and social support are beneficial for health. The aim of this study is to evaluate the association between participation in community groups and physical activity among older adults from Florianópolis, Brazil. METHODS: The sample consisted of 1062 adults with a mean age of 71.9 (±7.6) years. Among these individuals, 293 subjects participated in community groups and 769 did not. A questionnaire to collect sociodemographic data and the long version of the International Physical Activity Questionnaire were used for the assessment. RESULTS: The prevalence of active older adults was 66.6% among participants in community groups and 58.4% among non-participants. Participation in these groups was significantly associated with being more physically active in the transportation and domestic domains, but with being less physically active in the leisure-time domain. Some changes in these associations were observed when the sample was stratified by age, gender, body mass index, and health status. With respect to total physical activity, participation in community groups was associated with being more physically active in only two strata (subjects younger than 70 years and women). CONCLUSION: The results of this study indicate that older adults who participate in community groups are characterized by a greater probability of being more physically active. However, longitudinal studies are needed to determine whether participation in community groups facilitates the adoption of physically active behavior.

The development and psychometric evaluation of a self-efficacy scale for practicing pelvic floor exercises

BACKGROUND Self-efficacy has been shown to be a predictor of many health-related behaviors, including the practice of pelvic floor exercises with a focus on prevention or cure. OBJECTIVES To describe the process of construction and the psychometric properties of the scale of self-efficacy for the practice of pelvic floor exercises (EAPEAP). METHOD A cross-sectional study of validation was carried out with 81 from community and 96 postpartum women, 54.8% of them complained of urinary leakage. An exploratory factor analysis and internal consistency analysis was performed. To check predictive capacity, we analyzed the adherence at 3 months post - intervention and compared the scores of self-efficacy between adherent and non-adherent women. Reliability was analyzed by split half procedure. RESULTS The instrument showed α=0.923, and revealed three factors: performance expectation considering the action, performance expectation considering the preparation for action and outcome expectations. These factors accounted for 65.32% of the total variance. The instrument was able to differentiate between women who adhere and have not adhered to the exercises (U=352, p=0.013) and there was strong correlation between the two halves of the instrument (rho=0.889, p<0.001). CONCLUSION The scale is a valid and reliable tool to measure self-efficacy to practice pelvic floor exercises.

Fatores sociodemográficos e imagem corporal em adolescentes do ensino médio

The scope of this article is to investigate associations between body image dissatisfaction and sociodemographic indicators among adolescents. Participants included 1126 high school students in the city of Santa Maria in the State of Rio Grande do Sul. Aspects regarding body image dissatisfaction and sociodemographic indicators were analyzed. Association analyses were performed using crude Poisson regression duly adjusted for sex and age. Boys were found to be dissatisfied due to slimness and girls due to excess weight. Adolescents where the parents had less schooling, as well as those from lower socioeconomic classes and with lower income were found to be more likely to have body image dissatisfaction due to slimness. However, those where the parents had completed higher education and those living in the downtown area were more likely to have body image dissatisfaction due to excess weight. Sociodemographic indicators are closely associated with body image dissatisfaction. Body image dissatisfaction due to slimness can be explained by the lower level of schooling of the parents, lower socioeconomic class and lower income. Dissatisfaction due to excess weight can be explained by the higher schooling of the parents and the fact of living in the downtown area.

Excessive daytime sleepiness and nocturia in women

OBJECTIVE To investigate associations between excessive daytime sleepiness and nocturia in women. METHOD A total of 488 women aged 18-89 years who underwent screening for cervical cancer at one institution in Florianópolis, Brazil, took part in this investigation. Sleep issues and daytime sleepiness, urinary frequency, and nutritional status were investigated. RESULTS The prevalence of excessive daytime sleepiness was 31.3%. Most of the women reported having nocturia, since 32.4% reported one nocturnal voiding, and 24.3% two or more nocturnal voidings. Higher nocturnal voiding frequency was identified in women who spent longer in bed (P=0.028) and had worse quality of sleep (P<0.001), higher daytime sleepiness (P=0.016) and excess body weight (P<0.001). A higher prevalence of daytime sleepiness was also observed in those women assumed to have urine leakage (P=0.006). Women with two or more nocturnal voidings presented 1.58 (CI: 1.06-2.37) higher prevalence of daytime sleepiness independent of time in bed (P=0.030). CONCLUSION Women with at least two nocturnal voidings presented higher prevalence of daytime sleepiness, worse sleep quality, and longer time in bed. Moreover, women with daytime sleepiness presented higher frequency of urine leakage.

Prevalência e variáveis associadas à incontinência urinária no terceiro trimestre gestacional

OBJETIVOS: descrever a prevalencia de incontinencia urinaria (IU) no terceiro trimestre gestacional e verificar quais variaveis estao associadas a IU nesse periodo. METODOS: consiste em um estudo transversal, realizado com 242 mulheres que se encontravam no puerperio imediato no Hospital e Maternidade Carmela Dutra, da cidade de Florianopolis. Foram avaliados fatores sociodemograficos, historia clinica, antecedentes ginecologicos e obstetricos, alem de problemas associados. A avaliacao das perdas urinarias foi realizada por meio do ICIQ - Short Form. Os dados foram analisados com os testes qui-quadrado e U de Mann Whitney, sendo p<0,05. RESULTADOS: observouse uma prevalencia de IU no terceiro trimestre gestacional de 59,5% (n=144), e as variaveis associadas a tal condicao nesse periodo foram: idade (p<0,019), numero de gestacoes (p=0,021), estado marital (viver com parceiro) (p=0,032), constipacao antes da gestacao (p=0,013), bronquite cronica (p=0,011), IU antes da gestacao (p=0,013) e sintomas depressivos (p=0,049). CONCLUSOES: mesmo diante dos cuidados disponiveis e em expansao para prevencao de IU, sua prevalencia durante a gestacao ainda e elevada, configurando pouca importância atribuida ao fator preventivo.

Corporeidade e sexualidade em dançarinos de rua: axé e hip hop

Analisaram-se aspectos da corporeidade e sexualidade em dancarinos de hip hop e axe (35 homens e 49 mulheres) comparativamente a individuos nao-dancarinos expectadores da plateia (21 homens e 19 mulheres), via questionario anonimo. Os dancarinos de axe foram os mais satisfeitos com suas vidas sexuais, com as preliminares sexuais e os que mais gostavam de se masturbarem em relacao aos de hip hop e plateia. Dancarinos do axe apresentaram uma sexualidade mais vinculada ao conhecimento corporal e conexoes afetivas. Em ambos estilos, os dancarinos homens davam maior enfase a genitalia e a libido em relacao aos aspectos da afetividade.

Prevalência de dispareunia na gravidez e fatores associados

Objetivos: verificar a prevalencia de dispareunia no terceiro trimestre gestacional e fatores associados. Metodos: foram avaliadas 202 puerperas. Para a coleta de dados foram utilizados um questionario sociodemografico; questionario ICIQ-Short Form; questionario de constipacao intestinal e, para a avaliacao da dispareunia foram utilizadas as questoes do questionario FSFI. Os dados foram analisados com os testes qui quadrado, U de Mann Whitney e teste de Wilcoxon, p<0,05. Resultados: a prevalencia de dispareunia no 3o trimestre gestacional foi de 48,5% (n=98), enquanto antes da gestacao era de 15,3% (n=31). Os fatores associados a dispareunia nesse periodo foram: constipacao no terceiro trimestre da gestacao (p=0,05); incontinencia urinaria no terceiro trimestre da gestacao (p<0,001) e dispareunia antes da gestacao (p=0,01). A media de idade das mulheres com dispareunia foi significativamente maior que as sem dispareunia (p=0,01). Conclusoes: a prevalencia da dispareunia e alta no periodo gestacional e esta associada a alteracoes das funcoes do assoalho pelvico, como presenca de incontinencia urinaria e constipacao, alem da presenca previa de dispareunia.