McKertich Karen
Urology Department, Cabrini Medical Centre and The Alfred Hospital, Melbourne, Victoria.
Aust Fam Physician. 2008 Mar;37(3):112-7.
The aims of assessing urinary incontinence in women are to define the diagnosis, exclude other pathology and guide management. Treatment can be initiated when urinary incontinence is categorised as stress, urge or mixed incontinence. Once conservative measures have been exhausted, the management of stress incontinence is largely surgical, while that of urge urinary incontinence is largely medical.
This article discusses the clinical assessment of urinary incontinence in women with emphasis on the primary care assessment and indications for specialist referral.
History taking is the cornerstone of urinary incontinence assessment and in combination with physical examination allows categorisation of patients into stress, urge or mixed urinary incontinence. Basic assessment includes investigations such as urine testing, bladder residual volume measurement, and a bladder diary. Urodynamic testing is not required in all patients or before initiating conservative treatment. Indications for specialist referral and urodynamic testing are discussed.
评估女性尿失禁的目的是明确诊断、排除其他病理情况并指导治疗。当尿失禁被分类为压力性、急迫性或混合性尿失禁时，即可开始治疗。一旦保守治疗措施用尽，压力性尿失禁的治疗主要是手术治疗，而急迫性尿失禁的治疗主要是药物治疗。
本文讨论女性尿失禁的临床评估，重点是初级保健评估和专科转诊指征。
病史采集是尿失禁评估的基石，结合体格检查可将患者分类为压力性、急迫性或混合性尿失禁。基本评估包括尿液检测、膀胱残余尿量测量和膀胱日记等检查。并非所有患者或在开始保守治疗前都需要进行尿动力学检查。文中讨论了专科转诊和尿动力学检查的指征。
