Disfunções do assoalho pélvico e sintomas urinários em mulheres hospitalizadas com doenças respiratórias

Abstract

Introduction: Individuals affected by respiratory conditions may develop biomechanical and neuromuscular impairments associated with symptoms and dysfunctions of the pelvic floor. However, few studies have examined this set of conditions and analyzed their impacts on quality of life and survival, hospitalization, occurrence of infections, length of stay, and clinical outcomes. Objective: To analyze factors associated with pelvic floor dysfunction and urinary symptoms in hospitalized women affected by respiratory conditions. Method: This is a primary, observational, cross-sectional, descriptive, and analytical study conducted at the University Hospital of Lagarto (HUL). Participant selection and data collection were carried out in three stages. The first stage involved using electronic medical records to collect sociodemographic, anthropometric, functional, and clinical data. In the second stage, cognitive screening was performed using the 10-CS-Edu, and direct data on obstetric and urogynecological history were collected through interviews. In the third stage, the questionnaires used were: Pelvic Floor Disability Index (PFDI-20) (pelvic floor discomfort) and Chalder Fatigue Questionnaire (CFQ-11) (physical and mental fatigue symptoms). Results: A total of 92 women were evaluated, with a mean age of 70.93 years; most had low body weight, low education, and restrictive and infectious respiratory conditions. For the second stage, 64 (69.56%) participants were excluded due to clinical instability, motor, cognitive, or consciousness deficits. Twenty-one women were recruited for the administration of the PFDI-2 and CFQ-11 questionnaires. Quantitative analyses were performed on data from 73 of the 92 participants using Stata 17.0® software, with statistical significance set at a 5% level (p < 0.05). Differences in sample characteristics based on urinary tract infection and indwelling urinary catheter (IUC) were analyzed using chi-square tests, analysis of variance (ANOVA), and Tukey's post hoc test. A total of 66.7% of participants self-reported mild pelvic floor dysfunction symptoms, with a mean score of 5.28 (± 6.47) on the urinary symptom subscale (UDI-6). Additionally, 66.7% exhibited signs of fatigue, with a mean score of 7.71 (± 6.09) in the physical domain. The prevalence of urinary tract infection and use of an indwelling urinary catheter (IUC) in the population was 48.39%, with 21.43% having isolated urinary tract infections and 51.61% having IUCs. After adjusting for confounding variables (age, marital status, BMI, and current IMS), the association between IUC use and urinary tract infection remained significant (adjusted OR = 3.98; 95% CI: 1.13 - 14.00; p = 0.031). Conclusion: Therefore, women with reduced functionality who use IUCs are at an increased risk of developing urinary tract infections in the hospital setting.