Bradley Catherine S, Kennedy Colleen M, Nygaard Ingrid E
Department of Obstetrics and Gynecology, University of Iowa Carver College of Medicine, Iowa City, Iowa, USA.
J Womens Health (Larchmt). 2005 Mar;14(2):128-36. doi: 10.1089/jwh.2005.14.128.
To measure the prevalence of pelvic floor symptoms in noncare-seeking older women and the association between symptoms and lifestyle factors.
Women enrolled at one site of the Women's Health Initiative Hormone Therapy clinical trial completed a questionnaire, modified from the Pelvic Floor Distress Inventory, on bladder, bowel, and prolapse symptoms. Individual symptoms and symptom groups were examined in a cross-sectional analysis.
In the 297 women who participated, mean age was 68.2 years, mean body mass index (BMI) was 30.2 kg/m(2), and median vaginal parity was 3. The median number of symptoms endorsed was 3 (range 0-18). The most prevalent symptoms were stress urinary incontinence (51.2%), urge urinary incontinence (49.2%), urinary frequency (29.0%), straining for bowel movements (25.0%), a sense of incomplete bowel movements (34.8%), and involuntary loss of gas (33.0%). The symptom groups most frequently endorsed were stress urinary incontinence, overactive bladder, obstructive voiding, and obstructive colorectal groups (>/=1 symptom per group in 51.2%, 61.3%, 40.8%, and 48.3%, respectively). In analyses adjusted for age, BMI, caffeine ingesting, smoking, and exercise, older women more frequently reported incomplete bladder emptying (adjusted OR 3.4, 95% CI 1.3, 9.2), weak urinary stream (adjusted OR 6.4, 95% CI 2.0, 20.0), intermittent urinary stream (adjusted OR 4.0, 95% CI 1.6, 10.4), and a feeling of incomplete bowel movements (adjusted OR 2.7, 95% CI 1.2, 5.9). Women who exercised weekly had less fecal urgency (adjusted OR 0.3, 95% CI 0.2, 0.8). Coffee drinking was associated with difficulty emptying the bladder (adjusted OR 8.6, 95% CI 1.4, 55.0) and weak stream (adjusted OR 5.3, 95% CI 1.5, 19.0).
Pelvic floor symptoms, especially urinary incontinence and irritative and obstructive urinary and bowel symptoms, are common in older women. Some symptoms are associated with potentially modifiable lifestyle factors.
测量未寻求治疗的老年女性盆底症状的患病率以及症状与生活方式因素之间的关联。
参加妇女健康倡议激素治疗临床试验一个站点的女性完成了一份基于盆底困扰量表修改的关于膀胱、肠道和脱垂症状的问卷。在横断面分析中检查个体症状和症状组。
参与的297名女性中，平均年龄为68.2岁，平均体重指数（BMI）为30.2kg/m²，中位产次为3次。认可的症状中位数为3个（范围0 - 18个）。最常见的症状是压力性尿失禁（51.2%）、急迫性尿失禁（49.2%）、尿频（29.0%）、排便用力（25.0%）、排便不尽感（34.8%）和气失禁（33.0%）。最常认可的症状组是压力性尿失禁、膀胱过度活动症、排尿梗阻和结直肠梗阻组（每组≥1个症状的比例分别为51.2%、61.3%、40.8%和48.3%）。在对年龄、BMI、咖啡因摄入、吸烟和运动进行校正的分析中，老年女性更常报告膀胱排空不全（校正比值比3.4，95%置信区间1.3，9.2）、尿流无力（校正比值比6.4，95%置信区间2.0，20.0）、间歇性尿流（校正比值比4.0，95%置信区间1.6，10.4）和排便不尽感（校正比值比2.7，95%置信区间1.2，5.9）。每周锻炼的女性排便急迫感较轻（校正比值比0.3，95%置信区间0.2，0.8）。喝咖啡与膀胱排空困难（校正比值比8.6，95%置信区间1.4，55.0）和尿流无力（校正比值比5.3，95%置信区间1.5，19.0）有关。
盆底症状，尤其是尿失禁以及刺激性和梗阻性泌尿及肠道症状在老年女性中很常见。一些症状与潜在可改变的生活方式因素有关。
