Van Brummen Henriette Jorien, Bruinse Hein W, Van de Pol Geerte, Heintz A Peter M, Van der Vaart C Huub
Department of Perinatology and Gynaecology, University Medical Centre Utrecht, the Netherlands.
BJU Int. 2006 Feb;97(2):296-300. doi: 10.1111/j.1464-410X.2006.05936.x.
To evaluate the effect of overactive bladder symptoms (OAB) on women's quality of life (QoL) during and after the first pregnancy, using self-reported symptom-based QoL questionnaires.
In a prospective cohort study, 474 women were asked to complete four self-reported questionnaires. Urogenital symptoms were assessed with the Urogenital Distress Inventory (UDI) and the Incontinence Impact Questionnaire (IIQ). A women was considered to experience 'dry' OAB if she replied positively to the following two questions: 'do you experience a strong feeling of urgency to empty your bladder?'; and 'do you experience frequent urination?'. A women was considered to experience 'wet' OAB if she replied positively to all of the following questions: 'do you experience a strong feeling of urgency to empty your bladder?'; 'do you experience frequent urination?'; and 'do you experience urine leakage related to the feeling of urgency?'.
In all, 344 (72.6%) women who returned all four questionnaires were included in the analysis. After first childbirth there was a rapid decline in the prevalence of dry OAB (45.2% to 7.9%, P < 0.001). In pregnancy the prevalence of wet OAB increased significantly, but a year after childbirth the prevalence of wet OAB decreased and was similar to that at 12 weeks of gestation (P = 0.289). Women with wet OAB had higher scores on all IIQ domains than those with no OAB symptoms at 36 weeks of gestation. Women with dry or wet OAB all had higher scores on the mobility domain than those with no OAB. The scores on the physical, social and emotional functioning domains were low, suggesting a minimal restriction of lifestyle.
OAB symptoms are common during pregnancy; dry OAB had no negative effect on QoL, whereas wet OAB compromised QoL both during and after pregnancy, mainly in the 'mobility' and 'embarrassment' domains. The urge urinary incontinence symptom in wet OAB seems to profoundly compromise QoL. Apparently, in young mothers with wet OAB, limitations in mobility are especially stressful and these symptoms can be embarrassing.
使用基于症状的自我报告生活质量问卷，评估膀胱过度活动症（OAB）症状对首次怀孕期间及产后女性生活质量（QoL）的影响。
在一项前瞻性队列研究中，474名女性被要求完成四份自我报告问卷。使用泌尿生殖系统困扰量表（UDI）和尿失禁影响问卷（IIQ）评估泌尿生殖系统症状。如果女性对以下两个问题回答为“是”，则被认为经历“干性”OAB：“你是否有强烈的尿急感想要排空膀胱？”以及“你是否尿频？”。如果女性对以下所有问题回答为“是”，则被认为经历“湿性”OAB：“你是否有强烈的尿急感想要排空膀胱？”、“你是否尿频？”以及“你是否有与尿急感相关的漏尿？”。
总共344名（72.6%）返回所有四份问卷的女性被纳入分析。首次分娩后，干性OAB的患病率迅速下降（从45.2%降至7.9%，P<0.001）。在孕期，湿性OAB的患病率显著增加，但产后一年，湿性OAB的患病率下降，且与妊娠12周时相似（P = 0.289）。在妊娠36周时，患有湿性OAB的女性在所有IIQ领域的得分均高于无OAB症状的女性。患有干性或湿性OAB的女性在活动能力领域的得分均高于无OAB的女性。身体、社会和情感功能领域的得分较低，表明对生活方式的限制最小。
OAB症状在孕期很常见；干性OAB对生活质量没有负面影响，而湿性OAB在孕期和产后都会损害生活质量，主要在“活动能力”和“尴尬”领域。湿性OAB中的急迫性尿失禁症状似乎严重损害了生活质量。显然，对于患有湿性OAB的年轻母亲来说，活动能力的限制尤其令人压力大，而且这些症状可能会令人尴尬。
