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如何处理常见的泌尿妇科问题?

How to approach common urogynaecological problems?

作者信息

Chittacharoen Apichart

机构信息

Department of Obstetrics & Gynaecology, Faculty of Medicine, Ramathibodi Hospital.

出版信息

J Med Assoc Thai. 2005 Oct;88 Suppl 2:S124-8.

Abstract

Urogynaecology is dedicated to the treatment of women with pelvic floor dysfunction such as urinary orfecal incontinence and prolapse (bulging or falling) of the vagina, bladder and/or the uterus. Pelvic organ prolapse simply means displacement from the normal position. On average, 11% of women will undergo surgery for this condition. Pelvic organ prolapse quantification system (POP-Q) is an objective, site-specific system for describing the anatomic position that can be used to determine the stage of the prolapse. Urinary incontinence (leakage of urine) is a very common condition affecting at least 10-20% of women under age 65 and up to 56% of women over the age of 65. The most common subtypes of urinary incontinence are (1) stress urinary incontinence (SUI) ; (2) urge urinary incontinence (UUI) ; and (3) mixed urinary incontinence (MUI). Patients presenting with symptoms of pelvic organ prolapse or incontinence should undergo a thorough medical evaluation consisting of a targeted history (include bladder diary or voiding diary), physical examination, urinalysis and urine culture, and postvoid residual volume (PVRV) by pelvic ultrasound. Treatment options for patients with pelvic organ prolapse and urinary incontinence are nonsurgical (lifestyle interventions, pelvic floor muscle rehabilitation, and pessary placement) and surgical management.

摘要

泌尿妇科致力于治疗患有盆底功能障碍的女性,如尿失禁或粪失禁以及阴道、膀胱和/或子宫脱垂(膨出或下垂)。盆腔器官脱垂仅仅意味着从正常位置移位。平均而言,11%的女性会因这种情况接受手术。盆腔器官脱垂量化系统(POP-Q)是一种用于描述解剖位置的客观、特定部位的系统,可用于确定脱垂的阶段。尿失禁(尿液泄漏)是一种非常常见的情况,至少影响10 - 20%的65岁以下女性,以及高达56%的65岁以上女性。尿失禁最常见的亚型有:(1)压力性尿失禁(SUI);(2)急迫性尿失禁(UUI);以及(3)混合性尿失禁(MUI)。出现盆腔器官脱垂或尿失禁症状的患者应接受全面的医学评估,包括针对性病史(包括膀胱日记或排尿日记)、体格检查、尿液分析和尿培养,以及通过盆腔超声测量残余尿量(PVRV)。盆腔器官脱垂和尿失禁患者的治疗选择包括非手术治疗(生活方式干预、盆底肌肉康复和子宫托放置)以及手术治疗。

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