Prevalencia de incontinencia urinaria y disfunción sexual en embarazadas atendidas en un Centro de Salud Familiar de Santiago de Chile Translated title: Prevalence of urinary incontinence and sexual dysfunction of pregnant women assisted at a Familiar Health Center in Santiago of Chile

Introduction and hypothesis Stress urinary incontinence (SUI) is the most common type of urinary incontinence (UI) in pregnant women and is known to have detrimental effects on the quality of life in approximately 54.3 %. Pregnancy is the main risk factor for the development of SUI. This review provides details of the pathophysiology leading to SUI in pregnant women and SUI prevalence and treatment during pregnancy. Methods We conducted a PubMed search for English-language and human-study articles registered from January 1990 to September 2012. This search was performed for articles dealing with prevalence and treatment of SUI during pregnancy. In the intervention studies, we included studies that used a randomized controlled trial (RCT) design or studies comparing a treatment intervention to no treatment. Results A total of 534 articles were identified; 174 full-text articles were reviewed, and 28 of them met eligibility criteria and are reported on here. The mean prevalence of SUI during pregnancy was 41 % (18.6–60 %) and increased with gestational age. The increasing pressure of the growing uterus and fetal weight on pelvic-floor muscles (PFM) throughout pregnancy, together with pregnancy-related hormonal changes, may lead to reduced PFM strength as well as their supportive and sphincteric function. These cause mobility of the bladder neck and urethra, leading to urethral sphincter incompetence. Pelvic floor muscle exercise (PFME) is a safe and effective treatment for SUI during pregnancy, without significant adverse effects. Conclusions Understanding these issues can be useful for health-care professionals when informing and counseling pregnant women to help prevent SUI during pregnancy and the postpartum period.

Objetivo. Aplicar y validar en una población chilena el "Indice de Función Sexual Femenina" establecido en el International Consensus Development Conference on Female Sexual Dysfunctions. Material y método. 383 mujeres sanas de 20 a 59 años con actividad sexual, beneficiarias del Centro de Salud "Carol Urzúa". Instrumento: cuestionario de 19 preguntas, agrupadas en seis dominios: deseo, excitación, lubricación, orgasmo, satisfacción y dolor. Análisis estadístico: Se utilizó ANOVA, Kruskall-Wallis, Chi cuadrado, regresión logística y alpha de Cronbach. Resultados. Edad media: 35,3±10,9 años, casadas (50,4%) o conviviente (17,0%), con educación media (48,2%). La consistencia interna del test fue buena (>0,70). La sexualidad logra su máxima expresión a los 35-40 años (puntaje: 29,1±4,9) para caer posteriormente (21,0±6,0), especialmente el deseo y excitación. Después de los 44 años se incrementa el riesgo de disfunción sexual (OR:3,6; IC: 2,1-6,3; p< 0,0001). La mayor educación y la estabilidad de pareja disminuyen el riesgo (OR: 0,45; IC:0,28-0,80; p< 0,005 y OR:0,58; IC:0,35-0,98; p< 0,05 respectivamente). Conclusiones. El Indice de Función Sexual Femenino es un instrumento sencillo de aplicar, con propiedades psicométricas adecuadas que permite evaluar la sexualidad en diferentes etapas de la vida. Es adecuado para estudios epidemiológicos y clínicos

OBJECTIVE: To investigate the occurrence of urinary incontinency (UI) in pregnantwomen and its relationship with socio-demographic variables and quality of life. METHODS: A descriptive cross-sectional multicenter study was conducted to investigate 495 women using the International Consultation on Incontinence Questionnaire - Short Form (ICIQ-SF). The survey was conducted on the same day of delivery, with the volunteers still in the maternity ward. Statistical analysis of the comparison between groups 1 (incontinence) and 2 (continent) was done using chi-square test for comparison of proportions of women with and without urinary incontinency and logistic regression analysis. RESULTS: From the total of 495 women studied, 352 (71%) reported having had UI during the last four weeks of pregnancy. Group 1 presented the ICIQ-SF median score of 11 (range 3- 21), considered as severe impact in quality of life. Logistic regression analysis showed that there was a closer relation between the self-report of UI with the following variables: level of education below 8 years (OR: 2.99; p < 0.001), black women (OR: 2.32; p= 0.005), women with more than 3 children (OR: 4.93; p < 0.001), obese (OR: 4.22; p < 0.001) and normal vaginal delivery (OR: 2.59; p < 0.001). CONCLUSION: The majority of pregnantwomen have UI, negatively affecting the quality of their lives.