Walters M D, Realini J P, Dougherty M
Case Western Reserve University, Division of Urogynecology, University MacDonald Womens Hospital, Cleveland, OH 44106.
Curr Opin Obstet Gynecol. 1992 Aug;4(4):554-8.
Genuine stress urinary incontinence can be treated by surgical or nonsurgical methods. Conservative treatments include pelvic muscle exercises, hormonal and nonhormonal pharmacologic therapy, and functional electrical stimulation with vaginal or anal electrodes. All of these methods improve or cure stress incontinence in a significant proportion of selected women, with less cost and morbidity. Patients with genuine stress incontinence generally should have a trial of conservative therapy before corrective surgery is offered. Behavioral and pharmacologic methods, alone and in combination, are used for women with detrusor instability. Behavioral regimens, including bladder retraining and biofeedback, are particularly effective for urge and stress incontinence, but are dependent on compliance and motivation of both patient and caregiver. Drug therapy is effective, but with potential morbidity. As with genuine stress incontinence, surgical methods should only be employed for patients with detrusor instability who do not respond to nonsurgical treatment.
真性压力性尿失禁可通过手术或非手术方法治疗。保守治疗包括盆底肌肉锻炼、激素和非激素药物治疗，以及使用阴道或肛门电极的功能性电刺激。所有这些方法在相当一部分选定的女性中可改善或治愈压力性尿失禁，且成本和发病率较低。真性压力性尿失禁患者在接受矫正手术前通常应先进行保守治疗试验。行为和药物方法单独或联合用于逼尿肌不稳定的女性。行为疗法，包括膀胱再训练和生物反馈，对急迫性和压力性尿失禁特别有效，但取决于患者和护理人员的依从性和积极性。药物治疗有效，但有潜在的发病率。与真性压力性尿失禁一样，手术方法仅应用于对非手术治疗无反应的逼尿肌不稳定患者。
