Seim A, Hermstad R, Hunskaar S
Rissa Primary Health Care Center, Norway.
Br J Gen Pract. 1998 Nov;48(436):1731-4.
Several reports have been published showing that women with urinary incontinence (UI) can be taken care of and treated satisfactorily in general practice.
To find out whether the treatment of women with UI in general practice is effective also in the long term.
One hundred and five women with UI who consulted their general practitioner (GP) were examined and treated according to a treatment protocol. Treatment options were pelvic floor exercises, electrical stimulation, oestrogen supplements, bladder training, and protective pads. Three to six years after inclusion, all women received a postal questionnaire to evaluate the long-term effectiveness of treatment. Women who had been referred to a specialist were excluded.
Eighty out of 82 eligible patients answered the questionnaire after a mean follow-up period of 56 months. Twenty-seven per cent were continent, 26% much better, 23% a little better, 21% unchanged, and 3% were worse compared with before the treatment. The median score on a 100 mm visual analogue scale was 16 compared with 31 before treatment, and the percentage of women that were 'much' or 'a great deal' bothered by UI was reduced from 35% to 12%. The percentage of women with severe UI was reduced from 59% to 30%, and the number of women using pads was reduced from 62% to 39%.
This study confirms that management of female UI in general practice is effective also in the long term.
已有多篇报道表明,尿失禁(UI)女性患者在全科医疗中能够得到满意的护理和治疗。
探究全科医疗中对尿失禁女性患者的治疗从长期来看是否有效。
105名向全科医生(GP)咨询的尿失禁女性患者按照治疗方案接受了检查和治疗。治疗选择包括盆底肌锻炼、电刺激、雌激素补充、膀胱训练和使用防护垫。纳入研究三至六年后,所有女性都收到了一份邮寄问卷,以评估治疗的长期效果。已转诊至专科医生处的女性被排除在外。
82名符合条件的患者中有80名在平均随访56个月后回答了问卷。与治疗前相比,27%的患者尿失禁症状消失,26%的患者症状明显改善,23%的患者症状稍有改善,21%的患者症状无变化,3%的患者症状恶化。在100毫米视觉模拟量表上的中位数得分从治疗前的31分降至16分,因尿失禁而“非常”或“极其”困扰的女性比例从35%降至12%。重度尿失禁女性的比例从59%降至30%,使用防护垫的女性人数从62%降至39%。
本研究证实,全科医疗中对女性尿失禁的管理从长期来看也是有效的。