Peggs J F
University of Michigan Medical School, Ann Arbor.
Am Fam Physician. 1992 Dec;46(6):1763-9.
Treatment of acute urinary incontinence should be directed toward the underlying cause, such as infection, medication side effect, atrophic vaginitis, anxiety, depression and restricted mobility. Pharmacologic treatment depends on identification of one of the four subtypes of chronic urinary incontinence: stress, urge, overflow or mixed. Stress incontinence responds to alpha-adrenergic agents, which increase sphincter tone. Urge incontinence is the most common type of incontinence in the elderly; it can be treated with anticholinergic agents, smooth muscle relaxants, estrogen replacement therapy in women and, possibly, calcium antagonists. Overflow incontinence is caused by neurologic deficits, such as diabetes, or outflow obstruction, such as from prostatic enlargement, urethral stricture and tumors. Anticholinergic agents and alpha-adrenergic agents should be considered only after existing outflow obstruction is surgically corrected or intermittent catheterization is unsuccessful.
急性尿失禁的治疗应针对潜在病因，如感染、药物副作用、萎缩性阴道炎、焦虑、抑郁和活动受限。药物治疗取决于慢性尿失禁四种亚型之一的确定：压力性、急迫性、充溢性或混合性。压力性尿失禁对增加括约肌张力的α-肾上腺素能药物有反应。急迫性尿失禁是老年人中最常见的尿失禁类型；可用抗胆碱能药物、平滑肌松弛剂、女性雌激素替代疗法以及可能的钙拮抗剂进行治疗。充溢性尿失禁由神经功能缺损（如糖尿病）或流出道梗阻（如前列腺增生、尿道狭窄和肿瘤）引起。仅在手术纠正现有流出道梗阻或间歇性导尿不成功后，才应考虑使用抗胆碱能药物和α-肾上腺素能药物。
