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压力性尿失禁:转诊至泌尿妇科单位的女性中失禁的首要原因

[Stress urinary incontinence: first cause of incontinence among women referred to an urogynecologic unit].

作者信息

Espuña Pons Montserrat, Puig Clota Montserrat, Pérez González Amelia, Rebollo Alvarez Pablo

机构信息

Institut Clínic de Ginecología, Obstetricia i Neonatología, Hospital Clinic, Universidad de Barcelona, España.

出版信息

Arch Esp Urol. 2004 Jul-Aug;57(6):633-40.

Abstract

OBJECTIVES

To analyze the distribution by symptoms, signs, and urodynamic diagnosis of women with urinary incontinence referred for study and treatment to the urogynecologic unit of a third level hospital.

METHODS

Descriptive epidemiological study of 1713 consecutive women with symptoms of urinary incontinence referred for study and treatment to the urogynecologic unit between January 1998 and December 2002. Urogynecologic history, physical examination and urodynamic study were performed to all patients. Patients with genital prolapse greater than grade II were excluded. We analyzed the general characteristics of this group of patients, the distribution by main urinary symptoms, and the urodynamic diagnosis.

RESULTS

Among 1732 patients complying with inclusion criteria, 1386 (80%) referred symptoms of urine loss with effort, 977 (56.4%) urgency incontinence, and 795 (45.9%) presented the association of both. 1175 patients (67.8%) presented symptoms of urine losses with effort associated to other symptoms suggestive of mixed UI (frequency, urgency, nicturia, or urgency UI). Urodynamic diagnosis of stress urinary incontinence was obtained in 782 patients (45.2%); detrusor hyperactivity was found in 290 (16.7%); mixed urinary incontinence 413 (23.8%); 142 patients (8.2%) were grouped under the concept of other diagnosis and 105 (6.1%) had a normal study.

CONCLUSIONS

Stress urinary incontinence is the most frequently referred symptom in patients with symptoms of incontinence without symptomatic genital prolapse. In most cases it is associated to other urinary symptoms suggestive of mixed UI. The urodynamic diagnosis of stress urinary incontinence is the most frequent in this kind of patients.

摘要

目的

分析因研究和治疗而转诊至三级医院泌尿妇科的尿失禁女性患者的症状、体征及尿动力学诊断分布情况。

方法

对1998年1月至2002年12月间连续转诊至泌尿妇科进行研究和治疗的1713例有尿失禁症状的女性进行描述性流行病学研究。对所有患者进行泌尿妇科病史、体格检查及尿动力学研究。排除生殖器脱垂超过Ⅱ度的患者。我们分析了该组患者的一般特征、主要泌尿系统症状分布及尿动力学诊断。

结果

在符合纳入标准的1732例患者中,1386例(80%)有用力时漏尿症状,977例(56.4%)有急迫性尿失禁,795例(45.9%)两者皆有。1175例患者(67.8%)有用力时漏尿症状并伴有其他提示混合性尿失禁的症状(尿频、尿急、夜尿或急迫性尿失禁)。782例患者(45.2%)尿动力学诊断为压力性尿失禁;290例(16.7%)发现逼尿肌过度活动;混合性尿失禁413例(23.8%);142例患者(8.2%)归为其他诊断类别,105例(6.1%)检查正常。

结论

在无明显症状性生殖器脱垂的尿失禁患者中,压力性尿失禁是最常见的症状。在大多数情况下,它与其他提示混合性尿失禁的泌尿系统症状相关。在这类患者中,压力性尿失禁的尿动力学诊断最为常见。

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