Schumacher S
Department of Urology, Zayed Military Hospital, P.O. Box 35644, Abu Dhabi.
Urologe A. 2007 Apr;46(4):357-8, 360-2. doi: 10.1007/s00120-007-1315-8.
Urinary incontinence is an important and common health problem, whose prevalence increases with age. Often quality of life is clearly affected for persons concerned. In the group of elderly individuals (> or =60 years of age) 19.3% of women and 10.4% of men report urinary incontinence. Women most frequently describe urinary stress incontinence followed by incontinence with urge symptoms (urge incontinence, mixed incontinence). In men urinary incontinence without any symptoms of stress or urge incontinence is most common followed by incontinence with urge symptoms and stress incontinence. Urinary incontinence in the elderly is rarely due to a single reason but rather due to multiple factors. In urinary stress incontinence, a differentiation can be made between mechanical and functional problems of the sphincter mechanism caused by myogenic, neurogenic, hormonal, or iatrogenic factors as well as changes in connective tissue. In urinary incontinence with urge symptoms, geriatric detrusor function is mostly affected by neurogenic, myogenic, or urothelial factors whereas the detrusor muscle shows characteristic ultrastructural changes. In chronic urinary retention with consecutive urinary incontinence, especially in men infravesical obstruction is more often the reason than a geriatric bladder dysfunction.
尿失禁是一个重要且常见的健康问题，其患病率随年龄增长而增加。对于相关人群而言，生活质量常常会受到明显影响。在老年人群体（≥60岁）中，19.3%的女性和10.4%的男性报告有尿失禁。女性最常描述的是压力性尿失禁，其次是伴有急迫症状的尿失禁（急迫性尿失禁、混合性尿失禁）。在男性中，无任何压力或急迫性尿失禁症状的尿失禁最为常见，其次是伴有急迫症状的尿失禁和压力性尿失禁。老年人尿失禁很少是由单一原因引起的，而是多种因素导致的。在压力性尿失禁中，可区分由肌源性、神经源性、激素性或医源性因素以及结缔组织变化引起的括约肌机制的机械性和功能性问题。在伴有急迫症状的尿失禁中，老年逼尿肌功能大多受神经源性、肌源性或尿路上皮因素影响，而逼尿肌会出现特征性超微结构变化。在伴有连续性尿失禁的慢性尿潴留中，尤其是男性，膀胱颈以下梗阻往往比老年膀胱功能障碍更常见。
