女性尿失禁的处理方法。家庭医生的诊断与管理。
Approach to urinary incontinence in women. Diagnosis and management by family physicians.
作者信息
O'Neil Barbara, Gilmour Donna
机构信息
Department of Family Medicine, Dalhousie University, Halifax, NS.
出版信息
Can Fam Physician. 2003 May;49:611-8.
UNLABELLED
OBJECTIVE; To outline an approach to diagnosis and management of the types of urinary incontinence seen by family physicians.
SOURCES OF INFORMATION
Recommendations for diagnosis are based on consensus guidelines. Treatment recommendations are based on level I and II evidence. Guidelines for referral are based on the authors' opinions and experience.
MAIN MESSAGE
Diagnoses of stress, urge, or mixed urinary incontinence are easily established in family physicians' offices by history and gynecologic examination and sometimes a urinary stress test. There is little need for formal diagnostic testing. Management by family physicians (without need for specialist referral) includes lifestyle modification, pelvic floor muscle strengthening, bladder retraining, and pharmacotherapy with muscarinic receptor antagonists. Patients with pelvic organ prolapse might require specialist referral for consideration of pessaries or surgery, but family physicians can provide follow-up care. Women with more complex problems, such as severe prolapse or failed continence surgery, require referral.
CONCLUSION
Urinary incontinence is a common condition in women. In most cases, it can be diagnosed and managed effectively by family physicians.
未标注
目的；概述家庭医生对所见尿失禁类型的诊断和管理方法。
信息来源
诊断建议基于共识指南。治疗建议基于I级和II级证据。转诊指南基于作者的意见和经验。
主要信息
通过病史、妇科检查，有时还需进行尿动力学压力试验，家庭医生可在其诊室轻松确诊压力性、急迫性或混合性尿失禁。几乎无需进行正式的诊断测试。家庭医生的管理（无需转诊至专科医生）包括生活方式调整、盆底肌肉强化、膀胱再训练以及使用毒蕈碱受体拮抗剂进行药物治疗。盆腔器官脱垂患者可能需要转诊至专科医生以考虑使用子宫托或进行手术，但家庭医生可提供后续护理。存在更复杂问题的女性，如严重脱垂或尿失禁手术失败，则需要转诊。
结论
尿失禁在女性中很常见。在大多数情况下，家庭医生可有效诊断和管理尿失禁。
Zotero 插件