Farrell Scott A, Singh Baljit, Aldakhil Lateefa
Department of Obstetrics and Gynaecology, Dalhousie University, Halifax, NS.
J Obstet Gynaecol Can. 2004 Feb;26(2):113-7. doi: 10.1016/s1701-2163(16)30486-8.
To evaluate the effectiveness of continence pessaries for the management of urinary incontinence in women.
A retrospective review of the records of 100 women who chose to try a pessary to treat their urinary incontinence. Demographic data, presenting symptoms, physical findings, results of objective testing (pad tests and urodynamics), and incontinence outcomes were abstracted. Factors such as age, pelvic prolapse, presenting symptoms, pessary type, and history of previous incontinence surgery were examined using the Student t-test, chi-square test, or Fisher exact test where appropriate.
The mean age of the women was 56 years (range, 28-86 years) and mean parity was 2.5 (range, 0-13). Presenting complaints included stress incontinence in 41 women, mixed incontinence in 53 women, urge incontinence in 3 women, and combined prolapse and incontinence in 3 women. All 100 women returned for follow-up visits. Forty women had their pessary size or type adjusted at the first follow-up visit. At a mean follow-up time of 11 months (range, 2-42 months), 59 women continued to experience a complete resolution or decrease in their incontinence and chose to continue use of a pessary. Age, presenting symptoms, degree of pelvic prolapse, and type of pessary did not affect the success of pessary treatment. Women who had undergone incontinence surgery prior to pessary fitting had a higher failure rate, with relative risk (RR) of 1.6.
Urinary incontinence pessaries are effective. More than 50% of women who try a continence pessary will continue to use it to manage their urinary incontinence.
评估子宫托对女性尿失禁的治疗效果。
回顾性分析100例选择试用子宫托治疗尿失禁的女性患者的病历。提取人口统计学数据、症状表现、体格检查结果、客观测试（护垫试验和尿动力学）结果及尿失禁结局。在适当情况下，使用Student t检验、卡方检验或Fisher精确检验对年龄、盆腔脏器脱垂、症状表现、子宫托类型及既往尿失禁手术史等因素进行分析。
这些女性的平均年龄为56岁（范围28 - 86岁），平均产次为2.5次（范围0 - 13次）。症状表现包括41例压力性尿失禁、53例混合性尿失禁、3例急迫性尿失禁及3例合并脏器脱垂和尿失禁。所有100例女性均进行了随访。40例女性在首次随访时调整了子宫托的尺寸或类型。平均随访时间为11个月（范围2 - 42个月），59例女性的尿失禁持续完全缓解或减轻，并选择继续使用子宫托。年龄、症状表现、盆腔脏器脱垂程度及子宫托类型均不影响子宫托治疗的成功率。在使用子宫托前接受过尿失禁手术的女性失败率较高，相对危险度（RR）为1.6。
尿失禁子宫托是有效的。超过50%试用子宫托的女性会继续使用它来治疗尿失禁。
