ABSTRACT Objectives To determine the differences between voiding symptoms obtained by open anamnesis (VS-Open) versus voiding symptoms obtained by directed anamnesis (VS-Directed) to predict voiding dysfunction in women. Materials and Methods Retrospective study of women with prior anti-incontinence surgery evaluated during 5 years. In a standardized clinical history taking, each patient was asked to answer question number five of the UDI-6 questionnaire (“Do you experience any difficulty emptying your bladder?”). If the answer was positive, the following voiding symptoms spontaneously described by the patient were documented: slow urine stream, straining to void, intermittent stream and feeling of incomplete bladder emptying, which were considered VS-Open. If the answer to this question was negative or if the patient had not reported the four voiding symptoms, she was asked in a directed manner about the presence of each o Ninety-one women are analyzed. Eighteen patients presented voiding dysfunction (19.8%), There was a statistical association between voiding dysfunction and the presence of any VS-Open (p = 0.037) and straining to void obtained by open anamnesis (p = 0.013). Sensitivity, specificity, PPV, NPV, positive likelihood ratio and negative likelihood ratio, respectively, were 44.4% and 27.8%, 80.8% and 94.5%, 36.3% and 55.6%, 85.5% and 84.1%, 2.324 and 5.129, and 0.686 and 0.764. There was no statistical association between voiding dysfunction and VS-Directed. Conclusions VS-Open may predict better voiding dysfunction than VS-Directed in women.

ABSTRACT Background: Urinary incontinence (UI) is the involuntary loss of urine. The prevalence and severity of this condition increase as population ages. Objective: To describe the impact urinary incontinence in the elderly population, as well as to know its pathophysiology and implications in the quality of life. Method: Review of the literature available in PubMed, Embase and Medline using the keywords “urinary incontinence” and “elderly” between 1990 and 2018. Results: UI in the elderly has a negative impact on their quality of life, having a multiplicity of underlying causes that imply a comprehensive and multidisciplinary treatment of this pathology. Conclusion: Given the age increase in general population, knowing and managing this pathology is important for the clinician and the specialist to improve the quality of life in this age group.

RESUMEN Antecedentes: La incontinencia urinaria (IU) corresponde a la pérdida involuntaria de orina. En la medida en que la población envejece, aumenta su prevalencia y severidad. Objetivo: Describir el impacto de la incontinencia de orina en la población adulto mayor, así como conocer su fisiopatología e implicancias en la calidad de vida. Método: Revisión de la literatura disponible en PubMed, Embase y Medline utilizando los términos “urinary incontinence” y “elderly” entre los años 1990 y 2018. Resultados: La IU en el adulto mayor impacta negativamente en la calidad de vida de esta población, teniendo una multiplicidad de causas subyacentes que implican un tratamiento integral y multidisciplinario de esta patología. Conclusión: Dado el incremento de la edad en la población, conocer y manejar esta patología es importante para el clínico y el especialista para que de esta forma mejore la calidad de vida en este grupo etario.

Objectives To determine whether there are differences in pressure and flow measurements between conventional cystometry (CONV) and ambulatory urodynamic monitoring (AMB) in women with overactive bladder syndrome and urinary incontinence. Materials and Methods Retrospective study which included female subjects who underwent both CONV (with saline filling medium) and AMB, separated by less than 24 months, not using medication active on the lower urinary tract and without history of prior pelvic surgery. Both tests were carried out in compliance with the International Continence Society standards. The paired Student’s t test was used to compare continuous variables. Bland-Altman statistics were used to assess the agreement of each variable between both studies. Results Thirty women with a median (range) age of 50 (14 - 73) years met the inclusion criteria. AMB was carried out at a mean (SD) of 11 (6) months after CONV. Measurements of pves and pabd at the end of filling, and Qmax were significantly higher from AMB recordings. There were no differences in pdet at the end of filling, pdetQmax or pdetmax during voiding, nor significant difference in Vvoid. Conclusions We provide previously undocumented comparative voiding data between CONV and AMB for patients who most commonly require both investigations. Our findings show higher values of Qmax but similar values of pdetQmax measured by AMB which may partly reflect an overall lower catheter caliber, physiological filling but perhaps also more ‘normal’ voiding conditions.

Objetives: To describe the rate of infectious complications using a discontinuous scheme of oral ciprofloxacin in transurethral resection of the prostate (TUR-P). To try to weigh the influence of clinical background, operative complications and postoperative outcome on the development of such complications. To compare the results to those obtained with equal methodology using antibiotics in a continual scheme until the catheter removal. Method: a prospective open study was designed including 53 consecutive patients with sterile urine and without indwelling catheter subjected to TUR-P. Patients received oral ciprofloxacin 500 mg (4 doses) before going to the surgical room, the night of surgery, next morning of surgery and before catheter removal. Three patients were excluded after incorporation (5,6%) and all the remainders completed follow up. Results: fifty patients are analyzed. Fever was present in 8 patients (16%). Systemic clinical infection was present in 3 patients (6%). No isolated-germ postoperative bacteriuria was present. Previous urinary infection (UTI) was statistically associated to systemic clinical infection (p= 0,007) and to active chronic prostatitis on operative biopsy (p= 0,002). Conclusion: probably previous UTI antecedent made less advisable the discontinuous scheme use in TUR-P, although a greater number of patients is needed to confirm these statement. When these results are compared to those using antibiotics in a continual scheme until catheter removal, a significant higher frequency of fever is seen (p= 0,022).

Objetivos: Describir las complicaciones infecciosas con el uso de ciprofloxacino oral discontinuo en resección transuretral de próstata (RTU-P). Ponderar la influencia de los antecedentes clínicos, hallazgos y complicaciones intraoperatorias y evolución postoperatoria en el desarrollo de dichas complicaciones. Comparar los resultados con estudio previo de igual metodología en que se usó esquema antibiótico continuo hasta el retiro de la sonda uretrovesical. Método: Estudio prospectivo abierto de 53 pacientes consecutivos con orina estéril no usuarios de sonda uretrovesical, sometidos a RTU-P. Los pacientes recibieron ciprofloxacino 500 mg. oral (4 dosis) antes de su traslado a pabellón, la noche de la operación, la mañana siguiente de ésta y antes de retirar la sonda uretrovesical. Se excluyeron 3 pacientes después de su incorporación (5,6%) y no hubo pérdidas en el seguimiento. Resultados: Se analizan 50 pacientes. Se presentó fiebre en 8 pacientes (16%). Se presentó infección clínica sistémica en 3 pacientes (6%). No se presentó bacteriuria postoperatoria aislada. El antecedente de ITU previa presentó asociación estadística con el desarrollo de infección clínica sistémica (p= 0,007) y con el hallazgo de prostatitis crónica activa en la biopsia operatoria (p= 0,002). conclusión: Probablemente el antecedente de ITU previa hace menos aconsejable el uso de esquema antibiótico discontinuo en RTU-P, aunque se requiere de un mayor número de pacientes para confirmar este planteamiento. Al comparar estos resultados con aquellos obtenidos usando un esquema antibiótico continuo, se observa una significativa mayor frecuencia de fiebre durante la evolución (p= 0,022).