The multiplicity of factors
involved in the diagnosis and treatment of Urinary Incontinence in women, known for
several decades, have been along the years target of extensive studies, which studies
reflect in the most adequate attendance to the incontinent women and in better therapeutic
There exists a positive correlation between the index of corporeal mass (ICM) and the
prevalence of Urinary Incontinence 9,10.
Our findings confirm the previous quoted affirmations where, the index of the corporeal
mass was significantly larger in the group of incontinent women, compared to continent
The information obtained by the clinical History showed a positive predictive value of
approximately 70% for stress Urinary Incontinence, not being able to make this evaluation
in patients carriers of urgency Urinary Incontinence, reinforcing, in these cases, the
need of making complementary exams 11,12
. So, the History is not reliable to reach a precise diagnosis. This is due mainly to the
fact that the symptoms of the Urinary tract usually superpose and are not specific. In
relation to the information obtained by the clinical History, we can, according to our
findings, raise a few significant questions in this kind of evaluation. When we analyze
the number of daily urinations in the group of incontinent women compared to the continent
group we observe a larger number of urinations in the incontinent group. But, when
compared to the sub group of incontinent women we do not find significant statistical
differences showing that the number of urinations cannot be used to differ those women
with stress Urinary Incontinence with the women with urgency.
In spite of the difference observed in the number of urinations in the continent and
incontinent group, when we analyze the quantity of liquid ingested in a day there was a
variation between incontinent women and normal, there existed significant statistical
differences between the incontinent patients where the ones that suffer from Incontinence
by urgency ingest less liquids than those with stress Incontinence, probably to avoid a
greater amount of loss episodes.
When we correlate the presence of nicturia between the studied women we notice that
incontinent women show a larger number of nightly urinations than the continent women.
The presence of vaginal prolapses and infections of the Urinary tract and previous
gynecological surgeries were described by several authors 3,13 as predisponent factors of Urinary
Incontinence, which was confirmed in this study where 52.9% of incontinent women showed
genital prolapse and in 64.7% of these women previous Urinary infections were contacted
and 72.5% had previous gynecological surgeries, being that in the continent women the
values were respectively 6% and 32%, being that none of them had been submitted to any
previous gynecological surgery, having a significant statistical difference.
We evaluated with the urination interruption test the capacity of contraction and
musculature strength of the pelvic floor to interrupt the Urinary flow and we noticed that
only 25.5% of the incontinent patients possessed a capacity of interrupting the Urinary
flow and, among these 22.7% of the ones that suffered stress Incontinence could totally
interrupt and only 3.4% of those that suffered form urgency Incontinence did it. Among the
normal women 80% were capable of interrupting totally the Urinary flow showing a
significant statistic difference in the muscular capacity of these women.
We observed comparing the results of the subjective evaluation (questionnaire) and
objective (pad test), that there is a concordance between both evaluation modalities in
56.86% of the cases and that in 41.18% the data was overrated by the subjective evaluation
and that only 1.96% of the cases the data of the objective evaluation were overrated.
These show clearly that the individual perception of Urinary loss can, in some situations,
be larger than the Urinary loss really demonstrable.
The reproducibility of the pad test in our study was good in accordance with the findings
of other authors 7,14. Nevertheless, we
observed a significative variation of the result of this test in the same individual when
repeated several times 15.
Despite the assurance of this test being controversial, we observed that it may give us
important information in the diagnosis and in the evaluation of Urinary Incontinence,
before or after treatment, being clinical or surgical.