O'Sullivan R, Simons A, Prashar S, Anderson P, Louey M, Moore K H
The Pelvic Floor Unit, St George Hospital, University of New South Wales, Sydney, Australia.
Int Urogynecol J Pelvic Floor Dysfunct. 2003 Aug;14(3):193-8; discussion 198. doi: 10.1007/s00192-003-1062-3. Epub 2003 Jul 16.
Because the prognostic value of 1-h pad testing has received scant attention, we tested the hypothesis that mild incontinence of any etiology is more readily cured than moderate incontinence. A consecutive series of 150 patients with mild (2-9.9 g) to moderate (10-49.9 g) incontinence (as judged by weight gain on 1-h pad testing) [1] attending a urogynecology unit were recruited, of whom 145 completed all baseline objective measures: 110 completed 12 weeks of conservative therapy, with follow-up data at 2 years available for 51 subjects. At 12 weeks 81% of 'mild' patients became 'dry' on the 1-h pad test versus 36.8% in the moderate group (chi2<0.0001). Interestingly the post-treatment changes seen in all other outcomes demonstrated equally positive responses for the mild and moderate groups. At 2-year follow-up 29/71 (40.8%) of patients with mild incontinence and 22/74 (29.7%) of patients with moderate incontinence were satisfied and had no requirement for further therapy, the remainder having sought other treatments (chi2=1.963 P=0.161). Of the responders, (11/29) (37.9%) of mildly incontinent patients and (8/22 (36.4%)) of moderately affected subjects remained continent (on 20-point incontinence score < or =2 m, chi2=0.013, P=0.9087). Improvements in quality of life persisted to an equal degree in both groups.
由于1小时护垫试验的预后价值很少受到关注，我们检验了这样一个假设，即任何病因引起的轻度尿失禁比重度尿失禁更容易治愈。我们招募了连续的150例患有轻度（2 - 9.9克）至中度（10 - 49.9克）尿失禁（根据1小时护垫试验的增重判断）[1]的患者，他们在一家泌尿妇科就诊，其中145例完成了所有基线客观测量：110例完成了12周的保守治疗，51例患者有2年的随访数据。在12周时，81%的“轻度”患者在1小时护垫试验中变为“干爽”，而中度组为36.8%（卡方检验<0.0001）。有趣的是，在所有其他结果中观察到的治疗后变化显示，轻度和中度组的反应同样积极。在2年随访时，71例轻度尿失禁患者中有29例（40.8%）、74例中度尿失禁患者中有22例（29.7%）感到满意且无需进一步治疗，其余患者寻求了其他治疗（卡方检验=1.963，P = 0.161）。在有反应的患者中，轻度尿失禁患者中有11/29（37.9%）、中度受影响患者中有8/22（36.4%）保持无尿失禁状态（在20分尿失禁评分中≤2分，卡方检验=0.013，P = 0.9087）。两组患者的生活质量改善程度相当。
