Ando M, Nagamatsu H, Tanizawa A, Oshima H, Takagi K, Ajima J, Mizuo T, Ushiyama T
Department of Urology, Tokyo Medical and Dental University School of Medicine.
Nihon Hinyokika Gakkai Zasshi. 1991 Aug;82(8):1299-304. doi: 10.5980/jpnjurol1989.82.1299.
Urinary incontinence among institutionalized elderly were analyzed from clinical and social viewpoints. The patient group included 25 males and 107 females with an average age of 78 years (ranged from 66 to 92). They had neither highly impaired performance status nor severe dementia. Forty-nine of them (37%) underwent urological examination. Urge incontinence was common among male patients, while urge, stress or mixed incontinence were prevalent in female patients. Thirty-six per cent of the patients had to use pads, diapers and others for their incontinence, while other needed no special protection for their incontinence. Incontinence caused limitation of social activity in 30% of the patients. Many causal factors were assumed for incontinence in elderly; weakness of the pelvic muscles, urinary tract infection, cerebrovascular disorders, neurological disorders and prior pelvic surgery. Prostatic carcinoma or urethral stricture caused overflow incontinence in a few patients. Diuretics or tranquilizers appeared to lead incontinence in some patients. Nine of 18 patients undergoing cystometry had overactive detrusor. Majority of the incontinent elderly showed no intention to visit clinics. Therefore, it recommended to keep staffs in elderly institutions as well as elderly themselves informed that incontinence in the elderly should be treated, which in turn improves the quality of life.
从临床和社会角度对机构养老老年人的尿失禁情况进行了分析。患者组包括25名男性和107名女性,平均年龄78岁(年龄范围为66至92岁)。他们的身体功能状态未严重受损,也没有严重痴呆。其中49人(37%)接受了泌尿外科检查。急迫性尿失禁在男性患者中较为常见,而急迫性、压力性或混合性尿失禁在女性患者中更为普遍。36%的患者因尿失禁不得不使用尿垫、尿布等,而其他患者的尿失禁无需特殊防护。尿失禁导致30%的患者社交活动受限。老年人尿失禁有多种潜在病因,包括盆底肌肉无力、尿路感染、脑血管疾病、神经疾病以及既往盆腔手术。少数患者因前列腺癌或尿道狭窄导致充溢性尿失禁。利尿剂或镇静剂似乎在一些患者中导致了尿失禁。18名接受膀胱测压的患者中有9人的逼尿肌过度活跃。大多数尿失禁老年人无意就诊。因此,建议告知养老机构工作人员以及老年人,老年人的尿失禁应接受治疗,这反过来会提高生活质量。