Coyne K S, Zhou Z, Thompson C, Versi E
MEDTAP International, Bethesda, MD 20814, USA.
BJU Int. 2003 Nov;92(7):731-5. doi: 10.1046/j.1464-410x.2003.04463.x.
To examine the impact of each type of urinary incontinence (stress, urge, and mixed) on health-related quality of life (HRQL).
The USA National Overactive Bladder Evaluation (NOBLE) programme of prevalence was used to identify respondents with incontinence based upon telephone survey responses. A nested case-control study was then conducted on respondents with symptoms of an overactive bladder (OAB), and on age and gender-matched controls; this consisted of the respondents completing a series of questionnaires, including the OAB-q (an HRQL scale for OAB), the Medical Outcomes Study (MOS) Short-Form-36 (SF-36), the MOS Sleep Scale, and the Center for Epidemiological Studies - Depression (CES-D) scale. Respondents were categorized into subgroups according to the primary cause of urine loss, i.e. sudden/uncomfortable urge to urinate (urge, UI), physical pressure (stress, SI), or both (mixed, MI). Descriptive analyses, t-tests and analysis of variance with post hoc comparisons were used.
Of the 919 participants in the nested case-control study, 171 reported incontinence, i.e. UI (69), SI (62) and MI (40). Among this cohort, 82.5% were female, 85.4% were Caucasian and the population had a mean age of 55.9 years. All OAB-q subscale scores were significantly (P < 0.01) worse among those with MI than with SI. Respondents with UI reported significantly higher levels of symptom bother and lower sleep scores (both P < 0.001) than those with SI. There were no differences in HRQL between the MI and UI groups. Voiding frequency and nocturia episodes did not differ among the groups but compared with the SI group, both UI and MI groups reported significantly higher ratings of urinary urge intensity (P < 0.001) and rated their need for medical care significantly higher (P < 0.01). The MI group reported more incontinence episodes (P = 0.02) than the SI group.
Compared with SI, respondents with UI and MI reported not only significantly greater ratings of urinary urge intensity and more incontinence episodes, but also significantly worse HRQL. These results are consistent with previous findings which indicated a greater impact on HRQL for the urge component of MI than for the stress component.
探讨每种类型的尿失禁（压力性、急迫性和混合性）对健康相关生活质量（HRQL）的影响。
美国国家膀胱过度活动症评估（NOBLE）患病率项目通过电话调查答复来确定尿失禁受访者。然后对有膀胱过度活动症（OAB）症状的受访者以及年龄和性别匹配的对照组进行巢式病例对照研究；这包括受访者完成一系列问卷，包括OAB-q（一种用于OAB的HRQL量表）、医学结局研究（MOS）简表36（SF-36）、MOS睡眠量表以及流行病学研究中心抑郁（CES-D）量表。受访者根据尿失禁的主要原因分为亚组，即突然/不适的排尿冲动（急迫性，UI）、身体压力（压力性，SI）或两者兼有（混合性，MI）。采用描述性分析、t检验和事后比较的方差分析。
在巢式病例对照研究的919名参与者中，171人报告有尿失禁，即UI（69人）、SI（62人）和MI（40人）。在这个队列中，82.5%为女性，85.4%为白种人，人群平均年龄为55.9岁。MI组的所有OAB-q子量表得分均显著（P<0.01）低于SI组。与SI组相比，UI组受访者报告的症状困扰程度显著更高，睡眠得分更低（均P<0.001）。MI组和UI组之间的HRQL没有差异。各组间排尿频率和夜尿次数没有差异，但与SI组相比，UI组和MI组报告的尿急强度评分显著更高（P<0.001），且对医疗护理的需求评分显著更高（P<0.01）。MI组报告的尿失禁发作次数比SI组更多（P=0.02）。
与SI组相比，UI组和MI组受访者不仅报告的尿急强度评分显著更高、尿失禁发作次数更多，而且HRQL显著更差。这些结果与先前的研究结果一致，即MI的急迫性成分对HRQL的影响大于压力性成分。
