Raquel Henriques Jácomo

Relationship between anxiety and overactive bladder syndrome in older women

PURPOSE The objective of this study was to investigate the relationship between overactive bladder syndrome and anxiety in older women. METHODS Of the 198 older women who were invited, 29 were excluded and 166 were then divided into two groups according to the Advanced Questionnaire of Overactive Bladder (OAB-V8): one group with overactive bladder symptoms (OAB-V8≥8) and the other without the symptoms of an overactive bladder (OAB-V8<8). The purpose was to conduct a frequency analysis and to investigate the relation of the social demographic data and anxiety in the two groups. The Beck Anxiety Inventory (BAI) was used to evaluate the level of anxiety. The Kolmogorov-Smirnov test was used to determine the distribution of the data. The differences between the two groups for the continuous variables were analyzed by the Mann-Whitney U test, the differences for the categorical variables were analyzed by the Chi-Square test and the association between the continuous variables was analyzed by the Spearman Correlation test. The tests were two-tailed with a confidence level of 5%. RESULTS Overall, the frequency of an overactive bladder was present in 117 (70.5%) of the participants. The body mass index (BMI) of the group with overactive bladder symptoms was significantly higher than the BMI of those without these symptoms (p=0.001). A higher prevalence of mild, moderate and severe anxiety was observed among older women with overactive bladder symptoms. In addition, the overactive bladder symptoms group presented a positive low correlation with anxiety symptoms (r=0.345) and with BMI (r=0.281). There was a small correlation between BMI and anxiety symptoms (r=0.164). CONCLUSIONS Overactive bladder syndrome was prevalent among older women and the existence of these symptoms was linked to the presence of mild, moderate and/or severe anxiety symptoms.

Association Between Overactive Bladder Syndrome and Depression Among Older Women

Objective: To evaluate the association between overactive bladder syndrome (OBS) and depression among older women. Methods: One hundred sixty-nine older women answered 2 questionnaires: the Overactive Bladder (OAB-V8) and the Yesavage Geriatric Depression Scale. Results: One hundred twenty-nine participants (76.3%) had symptoms of OBS (OAB-V8 ≥ 8 points). Among those with OBS, 42.6% exhibited mild or severe depression. A significant correlation was found between OBS and depression (r = 0.354; P = .001). Conclusions: A high prevalence rate of OBS was found in older women and a large portion of these women exhibited symptoms of mild and severe depression.

Factors associated with overactive bladder syndrome in the elderly community: a cross-sectional study

Objective: to identify risk factors related to overactive bladder syndrome. Method: a cross-sectional study was performed with elderly women (>60 years) from the community of Ceilândia, in the Distrito Federal, Brazil, with or without symptoms of OBS, who were evaluated through interviews and questionnaires. The clinical and sociodemographic variables analyzed were: age; body mass index (BMI); parity, schooling, previous abdominal and urogynecologic surgeries, physical activity, smoking, constipation, systemic arterial hypertension (SAH), diabetes mellitus; depression and anxiety. The questionnaires applied were the Overactive Bladder Awareness Tool (OAB-V8), the Geriatric Depression Scale and the Beck Anxiety Scale. Data were analyzed descriptively. Binary logistic regression was used to evaluate the significant associations between the independent variables and the outcome of interest. Risk ratios were calculated for each independent variable with 95% confidence intervals. Result: A total of 372 volunteers were recruited, 292 of whom were eligible. Of these, 172 were allocated to the case group (58.9%) and 120 (41.1%) were control subjects. The two groups were homogeneous between one another. There was a high prevalence of OBS in the study population and significant differences for the variables presence of SAH, abdominal surgery and pelvic surgery, with the case group presenting a higher frequency of these events. In multivariate analysis, it was observed that an active sexual life reduces the chance of having OBS by 70.8%, while urogynecologic surgeries increase this risk 3.098 times. Conclusion: In univariate logistic regression analysis, BMI, SAH, a previous history of abdominal and urogynecologic surgery, number of abortions and the presence of symptoms of depression and anxiety, were found to be factors associated with OBS.

Old Women Body Balance: Does the Pelvic Organ Prolapse Matter?

Pelvic organ prolapse (POP) is a common condition in older women. We have observed that patients with advanced POP complain of body imbalance. The purpose of this study was to investigate impact of advanced POP on older womens body balance. Thirty-eight consecutive women were selected. Body balance was assessed by stabilometric measures (SM) and the Berg Balance Scale (BBS). Groups, nonadvanced versus advanced POP, were statistically similar on the BBS and all SM, but median center of pressure displacement speed (COPd-speed) was P = .04. A univariate analysis did not confirm any association between advanced POP and increased COPd-speed. Advanced POP may have no impact on older womens body balance.

Effect of Increasing Awareness of Genital Anatomy on Pelvic Floor Muscle Strength in Postmenopausal Women: A Randomized Controlled Trial

Pelvic floor muscles (PFMs) are those that help support the pelvic organs during rest and participate in the occlusion of the urogenital hiatus, playing an important role in maintaining urinary and fecal continence. Womens lack of knowledge or ignorance of these muscles makes awareness a mandatory step in any perineal reeducation intervention. The aim of the study was to evaluate and quantify the influence of knowledge of genital anatomy on the function of contraction of these muscles. It is a prospective, randomized, and blinded study including 43 volunteers divided into 2 groups: with an explanation (WE) group, consisting of 18 women who received an explanation of pelvic anatomy, and a no explanation (NE) group, with 19 women. Explanations were given regarding location of the genital structures and purposes of the PFM. To find out whether the patients understood the explanation, they were asked to confirm some questions. Patients who gave incorrect responses to the questions were excluded. NE measurements were carried out before and after a casual conversation who were not given any guidance. An evaluation of the PFM, using a perineometer (Peritron, Australia), was performed before and after intervention. PFM strength was analyzed for normality using the Shapiro-Wilk test, and analysis of variance for repeated measures with the Tukey post hoc was used for comparison of the pre- and postintervention means. Statistical analysis was performed using SPSS. The WE group had 12.6 (±1.3) and 15.2 (±2.01) mm Hg in pre- and postmeasurement, respectively. Providing education about genital anatomy and PFM function can immediately improve the strength of the PFM contraction by 20% (P = .005). The brief anatomical explanation produced positive effects on the function of the PFM and recommended that professionals provide these explanations during the evaluation of pelvic floor function and before starting treatment for pelvic floors dysfunction.

The effect of pelvic floor muscle training in urinary incontinent elderly women: a sistematic review

Introduction The International Continence Society (ICS) determines that the pelvic floor muscles training (PFMT) is the first-choice treatment of urinary symptoms in women. Objective The aim of this study was to systematize randomized controlled clinical trials that address the effects of PFMT in the treatment of urinary symptoms in older women using objective outcome measures. Method Systematic review search was performed eletronic the following databases: Medline, Pubmed, Lilacs, PEDro and manual research conducted in the references of the studies. Were considered eligible women aged over 60 years who performed PFMT in isolation, without the involvement of another technique. The PFMT performed in clinic or at home, with or without the supervision of a therapist and with or without the use of biofeedback as an adjunct. Considered as outcome measures urodynamic studies, voiding diary that assesses daytime urinary frequency, nocturnal urinary frequency, urinary incontinence and exchange absorbent, and, finally, the absorbent test that quantifies loss urinary grams. The assessment of methodological quality of the studies was conducted by PEDro scale. Results Three studies were reviewed in full. Only one trial was rated high methodological quality. There was significant improvement in urinary symptoms after treatment proposed in the three selected studies. Conclusion Considering the studies available so far are weak the evidence for the use of PFMT in the treatment of urinary symptoms in elderly women.