Doughty Dorothy B
Emory University WOC Nursing Education Center, Room AT 732, 1365 Clifton Road NE, Atlanta, GA 30322, USA.
Ostomy Wound Manage. 2003 Dec;49(12):46-52.
Urinary incontinence is a common problem, especially among women, yet it remains underreported and undertreated. This is partly due to patients' beliefs that little can be done and partly due to healthcare professionals' perception that treatment is limited to surgery, advanced behavioral strategies requiring specialized equipment, or containment devices. Nurses are in a strategic position to reduce the incidence of incontinence by teaching bladder health strategies (ie, fluid management, appropriate voiding intervals, constipation prevention, weight control, smoking cessation, and pelvic muscle exercises), actively assessing patients for incontinence, and initiating appropriate referrals and primary interventions. Patients with significant neurologic deficits, structural abnormalities such as pelvic organ prolapse, or urinary retention should be referred for further workup. However, most patients can be treated with primary continence restoration strategies, which include identifying and correcting reversible factors such as urinary tract infection or atrophic urethritis; instruction in pelvic floor muscle exercises; and instruction regarding urge inhibition strategies. Implementing these simple strategies can significantly improve bladder function and continence in the majority of patients.
尿失禁是一个常见问题，尤其在女性中更为普遍，但它仍然未得到充分报告和治疗。部分原因是患者认为对此几乎无能为力，部分原因是医疗保健专业人员认为治疗仅限于手术、需要专门设备的先进行为策略或容纳装置。护士处于通过教授膀胱健康策略（即液体管理、适当的排尿间隔、预防便秘、控制体重、戒烟和盆底肌肉锻炼）、积极评估患者是否存在尿失禁以及启动适当的转诊和初步干预措施来降低尿失禁发生率的战略地位。有明显神经功能缺损、盆腔器官脱垂等结构异常或尿潴留的患者应转诊进行进一步检查。然而，大多数患者可以采用主要的控尿恢复策略进行治疗，这些策略包括识别和纠正可逆因素，如尿路感染或萎缩性尿道炎；指导盆底肌肉锻炼；以及指导抑制尿急的策略。实施这些简单策略可以显著改善大多数患者的膀胱功能和控尿能力。
