Comparative Analysis Between Urinary Complaints and the Results of the Urodinamic Study of Women Seen at a Urogynecology Ambulatory in Macapa-Aresume

Abstract

Introduction: Urinary Incontinence (UI) is investigated through clinical history, physical exam, urinalysis, voiding diary, Pad-test, urodynamic study and imaging exams. Objective: To assess the efectiveness of the urodynamic test in proving UI. Methodology: Retrospective-cross-sectional-observational descriptive quantitative study. We analyzed the medical records of 594 women treated at the Women Hospital and Maternity “Mãe Luzia” – WHML in Macapá – AP aged 18 years or older, with complaints of urinary incontinence and who underwent urodynamic examination without any Other associated conditions. Statistical analysis was performed using the Chi-squared test, Mann-Whitney U test or Kruskal-Wallis test. Values of p < 0.05 were considered statistically significant. The research received authorization from the Ethics and Research Committee of the Federal University of Amapá (FR 347446/011). Results: 49.49% presented clinical complaints. Of those, 13.9% were compatible with Overactive Bladder (OAB), 11.2% with Stress Urinary Incontinence (SUI) and 74.8% with Mixed Urinary Incontinence (MUI). 50.5% were diagnosed by urodynamics, being 0.7% normal, 15.7% OAB, 14% SUI and 69.7% MUI. 45.2% of SUI and 46.4% of MUI were concentrated in pressure loss of up to 60cmH2O. As for age, 27.7% of those with OAB were between 31-40 years old, while 38.8% with MUI 41-50 years and 28.6% with SUI 51-60. The percentagem of women who had a clinical complaint and a corresponding urodynamic finding was Only 1.7% for SUI, 52.3% for MUI and 5.7% for OAB among those evaluated. Thus, urodynmics for SUI had a sensitivity of 89.1%, specificity of 11.9%, PPV of 86.1%, NPV of 15.2%, and accuracy of 78.3%, for BH it had a senstivity of 90.5%, specificity of 36.2%, PPV of 88.4%, NPV of 41.5%, and accuracy of 82% and for IUM it has a sensitivity of 30.8% and a specificity of 75.1%, leading to a PPV of 35.0% and a NPV of 71.4%, and therefore with an accuracy of 61.7%. Conclusion: Correspondence between clinical complaint and urodynamic study was low. Further studies are still needed in this regard for a final conclusion on the effectiveness of the urodynamic test for the diagnosis of UI.