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Biomedical subjects

D Castro Díaz

Publications and source records attributed to D Castro Díaz.

12 recordsLinked to original sources

[Validity of the King's Health questionnaire in the assessment of quality of life of patients with urinary incontinence. The King's Group].

BACKGROUND: To assess the validity of the Spanish version of the King's Health Questionnaire (KHQ) for measuring the quality of life of women with different types of urinary incontinence. PATIENTS AND METHODS: 77 women with urinary stress incontinence (USI), 51 with urge incontinence (UUI) and 34 with mixed urinary incontinence (MUI) were consecutively recruited. Subjects were diagnosed using urodynamic tests. Patients completed the KHQ and SF-36 questionnaires on inclusion in the study, after 15 days, and again after one month. RESULTS: There were no significant differences in socio-demographic and QOL characteristics between different UI groups. UUI and MUI patients had greater urinary frequency and urge than USI patients, and USI and MUI patients had a greater number of leakage episodes than UUI patients. Correlations between dimensions on the KHQ and the SF-36 were moderate to strong. Women with greater urinary frequency, greater urgency, more incontinence episodes during the week and who used pads and nappies perceived a worse quality of life. Changes in these variables correlated with changes in HRQOL. The internal consistency of dimensions was good (0.65-0.92) as was test-retest reliability (0.68-0.88). Dimensions most sensitive to change after one month of treatment were impact of UI, seriousness of UI, and the symptoms scale (effect size greater than 0.6). CONCLUSION: The KHQ is a valid instrument for measuring the quality of life of patients with different types of UI. Improvements in urinary frequency, urinary urgency, number of leakage episodes, and changes in the type of protective material produces an increase in HRQOL.

Evaluation Studies as Topic↗

[Pollakiuria and idiopathic hypercalciuria in childhood].

OBJECTIVE: To determine the incidence of pollakiuria in children with idiopathic hypercalciuria. METHODS: The clinical records of 56 children with idiopathic hypercalciuria were reviewed. In addition to pollakiuria, they were evaluated for other associated disorders, maximum urinary osmolality, urodynamic study and overall clinical course. RESULTS: Nine children (16%), 4 boys and 5 girls, presented with pollakiuria associated with urgency, nocturnal enuresis, hematuria and urinary incontinence. Two showed normal urodynamic studies and unstable bladder was observed in another case. All but one patient preserved normal renal concentration capacity. The course of the micturition symptoms was satisfactory and only three cases required pharmacological treatment. CONCLUSIONS: In the absence of urinary infection, pollakiuria might suggest the presence of hypercalciuria, a condition that can be managed successfully following correct diagnosis and treatment. Renal concentration capacity is not reduced by hypercalciuria.

Calcium↗

[Bladder instability and abdominal pain in children].

We are presenting herein three patients with bladder instability and recurrent abdominal pain whose symptoms disappeared after anticholinergic treatment. We propose urodynamic study in children with recurrent abdominal pain associated to frequency, incontinence, urgency or recurrent urinary infection.

Child↗

[SAFYRE. A new concept for adjustable minimally invasive sling for female urinary stress incontinence].

INTRODUCTION: SAFYRE is a new readjustable and minimally invasive sling for the treatment of stress urinary incontinence (SUI). Attempts to restore the normal suburethral hammock using an anatomical approach have been made in recent years. The authors report their experience with this device, which associates the efficacy of slings with readjustability. MATERIAL AND METHODS: A total of 100 consecutive patients with clinical and urodynamic diagnosis of SUI underwent SAFYRE sling procedure. The age range was from 40 to 71, mean age 63 years. Seventy-five patients (75%) presented previous failed anti-incontinence procedures. Physical clinical examination, stress test, pad use and a urodynamic study were performed before the surgery. All the patients presented symptoms of SUI and 30% also reported mild urgency. RESULTS: The average follow up period was 14 months (12-30 months). The mean operative time was of 25 minutes. Dystopia repair was performed whenever necessary, during the same procedure. The average hospital stay was 24 hours. In 3% of the implants, bladder perforation occurred. During the postoperative period, 26 patients developed urgency symptoms. During that follow up period, 92% were found to be continent, 3% reported an improvement and 5% were dissatisfied. CONCLUSION: SAFYRE is a safe and quick procedure that allows for postoperative readjustment. This technique may be an attractive alternative if the good result obtained so far proves to be long lasting.

Adult↗

[The development and preliminary validation of the IU-4 questionnaire for the clinical classification of urinary incontinence].

RATIONALE: To prepare and validate a simple and self-administered questionnaire for the clinical rating of patients with urinary incontinence (UI) for use in the clinical practice. METHODS: The questionnaire was prepared based on a review of the literature on urinary incontinence and the views of 7 urodynamic urologists. The initial questionnaire UI-5 included 5 items related to UI symptoms that divided patients into three categories: stress incontinence (UEI), urge incontinence (UUI) or mixed urinary incontinence (MUI). An additional question evaluates the impact of UI type on the quality of life. The of construct validity was analyzed correlating the responses to UI-5 items and the question on quality of life. The area under the ROC curve was calculated for each UI type correlating the UI-5 scores and the results of the urodynamic test. The cut-off values for each scale were determined based on sensitivity (SE) and specificity (SP). RESULTS: The study included 188 females with UI (73.4% with UEI, 13.3% with UUI and 13.3% with MUI; based on the urodynamics). Only 4.3% patients did not answer some UI-5 items. One item related to the protective material used was excluded as it was not related to UI types, and so the final questionnaire included only 4 items (UI-4). The results show that UI-4 discriminates the different types of incontinence: UEI (SE: 0.69/SP: 0.76; 1 item), UUI (SE: 0.83/SP: 0.65; 2 items), MUI (SE: 0.72/SP: 0.65; 1 item). 100% patients with MUI, 84% with UUI and 59.9% with UEI report some impact on their quality of life. CONCLUSIONS: UI-4 is simple, valid and easy to administer, and can be particularly valuable in the clinical rating of UI in settings where urodynamic testing is not easily available such is primary health care.

Adult↗

[Artificial urinary sphincter in the treatment of urinary incontinence caused by sphincter insufficiency].

OBJECTIVE: To evaluate the results relative to continence and the complications of the artificial urinary sphincter in the treatment of urinary incontinence due to sphincter incompetence. METHODS: The artificial urinary sphincter model AS 800 was implanted in 35 patients with incontinence arising from various causes. Follow-up ranged from 14 to 108 months (mean 39.8). Patients ages ranged from 4 to 68 years (mean 44.4). There were 17 female (49%) and 18 male patients (51%). The cuff was implanted around the bladder neck in 25 patients (71%) and around the bulbous urethra in 10 (29%). RESULTS: There were 2 mechanical device failures, 2 pump erosion and 1 tube erosion through the abdominal wall in a patient who had had a perforation of an augmentation cystoplasty. Thirty-one patients (88%) became continent. Ten patients (28%) had another operation for device revision or relapse. CONCLUSION: The artificial urinary sphincter is a valid alternative in the treatment of urinary incontinence due to sphincteric incompetence. It is possible to achieve good continence rates, although there is a high revision rate and lifetime follow-up is required.

Adolescent↗