Incontinência urinária em mulheres assistidas na atenção primária à saúde: prevalência, gravidade e impacto na qualidade de vida

Abstract

Urinary incontinence (UI) is a very prevalent health condition in women, especially in advanced age, which considerably affects their quality of life (QoL), interfering with their activities and social participation, and, therefore, with their functionality. Primary Health Care (PHC) is the gateway to this complaint, so the management of UI should start with conservative treatments still in the PHC. The aim of this study was to assess the prevalence of UI, severity and impact on the QoL of women attended in Primary Health Care (PHC), as well as to identify factors associated with UI severity and quality of life. This is a cross-sectional observational study. The research was conducted in a Primary Health Care Unit (PHCU) inserted in the Regional Secretariat III of the city of Fortaleza/CE, from October 2020 to January 2021. The reference population consisted of women aged from 18 years of age assisted at the PHCU. The International Consultation on Incontinence Questionnaire-Short Form (ICIQ-SF) was used to screen women with UI. The women answered the Pelvic Floor Impact Questionnaire (PFIQ-7) to assess the impact on QoL, the Incontinence Severity Index (ISI) to classify severity and the form containing sociodemographic and clinical data. Data were analyzed by measure of central tendency, dispersion and percentages. For the bivariate analysis, Student's T or ANOVA tests were performed for continuous variables and the Chi-square test for categorical variables, adopting a significance level of 5%. A total of 313 women responded to the ICIQ, with a mean age of 46.91 (± 15.27), with a prevalence of UI of 44.7% (95%CI 39.3%-50.2%). Of these incontinent women, 71 were individually assessed and had a mean age of 56.9 (±12.2) years. The majority (45.1%) had stress urinary incontinence (SUI). Severity was classified as mild (14%), moderate (46.9%), severe (26.7%) and very severe (12.6%) and the QoL impact score had a mean of 42.85 (± 25.12). It was observed that the greater the severity of the UI, the greater the impact on QoL, as well as mixed race or black women with hypertension had worse QoL scores. It was concluded that there was a high prevalence of UI in women assisted in PHC, with a predominance of moderate to severe UI that negatively affects QoL. Therefore, screening for UI symptoms, as well as the classification of its severity, especially in women with risk factors, is essential to define the management of UI in women assisted in PHC. Thus, the early implementation of conservative treatments in women with mild to moderate symptoms, even in PHC, could avoid the burden of referral to Secondary Care, reduce treatment costs and improve the QoL and functionality of women with UI.