Abstract

RUIZ CERDA, J.L. et al. Analysis of the spanish urologists adherence to the recomendations of the guidelines on diagnostic and treatment of urinary incontinence. Actas Urol Esp [online]. 2007, vol.31, n.10, pp.1148-1160. ISSN 0210-4806.

Objetive: Data regarding the degree of adherence to urinary incontinence guidelines are not available. The aim of this study was to know how the spanish urologist diagnos and treat urinary incontinence. Material and methods: This is an opinion poll from 202 urologist underwent in 20 representative meetings of the Spain. The poll consisted of 2 questions about diagnostic and 2 about treatment of urinary incontinence. The anwsers were grouped by ideas. The focal group method dinamized by "structured brain storming" was used. We evaluate the adherence to the incontinence guide lines analizing the agreement between the recommendations and the real practice. We average acording all obtained responses. Results: The adherence were: history 88%, physical examination 78%, blood test 47%, urunalysis 72% and urine culture 67%. The adherence for urodynamic investigation was 23%. The use of symptom and quality of life cuestionares was minority (14% y 26%). The adherence to the right questions about the type of incontinece was very high. An average of 2.7 questions to reach correct diagnoses was needed. A 85% of urologist treat urge compenent of mixed incontinence firstly and 11% the stress component. The 27% considered the availability of drug as the main reason for such prioritization. The adherence of treating urge incontinence with antimuscarics was 98% and of life style interventions 50%. For treating stress urinary incontinence, the adherence to pelvic floor muscle training was 81% and to surgery 53%. Conclusions: Spanish urologist adherence to incontinence urinary guidelines is far from the ideal. Although this study may have bias, the outcome can be considered as representative of the situation. It is desirable that, in the process of guidelines creation, specific parameters to assess the degree of adherence be designed.

Keywords : Adherence; Guidelines; Urinary incontinence.

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