Viktrup Lars, Lose Gunnar
Department of Obstetrics and Gynecology, Glostrup County Hospital, University of Copenhagen, Copenhagen, Denmark.
J Urol. 2008 Sep;180(3):992-7. doi: 10.1016/j.juro.2008.05.027. Epub 2008 Jul 17.
We estimated the incidence and remission of lower urinary tract symptoms during the 12 years following the first pregnancy and delivery.
In a cohort study 242 primiparae were questioned about lower urinary tract symptoms 3 months, 5 years and 12 years after the first delivery.
From 3 months to 5 years after first delivery the incidence of stress urinary incontinence, urge urinary incontinence, urgency, diurnal frequency and nocturia was 56 of 213 cases (26.3%), 33 of 219 (15.1%), 33 of 206 (16.0%), 49 of 219 (22.4%) and 6 of 225 (2.7%), respectively. Remission of stress urinary incontinence, urge urinary incontinence, urgency, diurnal frequency and nocturia during the same period occurred in 1 of 11 cases (9.1%), 2 of 5 (40%), 2 of 5 (40%), 4 of 7 (57.1%) and 1 of 1 (100%), respectively. From 5 to 12 years after the first delivery the incidence of stress urinary incontinence, urge urinary incontinence, urgency, diurnal frequency and nocturia was 40 of 158 cases (25.3%), 25 of 188 (13.3%), 24 of 175 (13.7%), 40 of 174 (23.0%) and 13 of 220 (5.9%), respectively. Remission of stress urinary incontinence, urge urinary incontinence, urgency, diurnal frequency and nocturia during the same period occurred in 14 of 66 cases (21.2%), 13 of 36 (36.1%), 22 of 36 (61.1%), 14 of 52 (26.9%) and 4 of 6 (66.7%), respectively. Of 62 women with pure stress urinary incontinence during the first pregnancy and puerperium 20 (32.2%) had pure stress urinary incontinence, 3 (4.8%) had pure urge urinary incontinence and 15 (24.2%) had mixed urinary incontinence 12 years later. Of 13 women with pure urge urinary incontinence during the first pregnancy and puerperium 3 (23.1%) had pure urge urinary incontinence, 2 (15.4%) had pure stress urinary incontinence and 3 (23.1%) had mixed urinary incontinence 12 years later. The overall prevalence of lower urinary tract symptoms 12 years after the first delivery increased significantly.
The incidence and remission of lower urinary tract symptoms after the first pregnancy and delivery fluctuate and the types of urinary incontinence may interchange, while the overall prevalence of lower urinary tract symptoms increases in the long term.
我们评估了首次妊娠和分娩后12年内下尿路症状的发生率及缓解情况。
在一项队列研究中，对242名初产妇在首次分娩后3个月、5年和12年时询问其下尿路症状。
首次分娩后3个月至5年，压力性尿失禁、急迫性尿失禁、尿急、日间尿频和夜尿症的发生率分别为213例中的56例（26.3%）、219例中的33例（15.1%）、206例中的33例（16.0%）、219例中的49例（22.4%）和225例中的6例（2.7%）。同期压力性尿失禁、急迫性尿失禁、尿急、日间尿频和夜尿症的缓解率分别为11例中的1例（9.1%）、5例中的2例（40%）、5例中的2例（40%）、7例中的4例（57.1%）和1例中的1例（100%）。首次分娩后5至12年，压力性尿失禁、急迫性尿失禁、尿急、日间尿频和夜尿症的发生率分别为158例中的40例（25.3%）、188例中的25例（13.3%）、175例中的24例（13.7%）、174例中的40例（23.0%）和220例中的13例（5.9%）。同期压力性尿失禁、急迫性尿失禁、尿急、日间尿频和夜尿症的缓解率分别为66例中的14例（21.2%）、36例中的13例（36.1%）、36例中的22例（61.1%）、52例中的14例（26.9%）和6例中的4例（66.7%）。首次妊娠和产褥期有单纯压力性尿失禁的62名女性中，12年后20名（32.2%）仍为单纯压力性尿失禁，3名（4.8%）为单纯急迫性尿失禁，15名（24.2%）为混合性尿失禁。首次妊娠和产褥期有单纯急迫性尿失禁的13名女性中，12年后3名（23.1%）仍为单纯急迫性尿失禁，2名（15.4%）为单纯压力性尿失禁，3名（23.1%）为混合性尿失禁。首次分娩后12年下尿路症状的总体患病率显著增加。
首次妊娠和分娩后下尿路症状的发生率及缓解情况有波动，尿失禁类型可能相互转换，而下尿路症状的总体患病率长期呈上升趋势。
