Fantl J A, Wyman J F, McClish D K, Harkins S W, Elswick R K, Taylor J R, Hadley E C
Department of Obstetrics and Gynecology, Virginia Commonwealth University/Medical College of Virginia, Richmond.
JAMA. 1991 Feb 6;265(5):609-13.
The efficacy of bladder training was evaluated in a randomized clinical trial involving 123 noninstitutionalized women 55 years and older with urinary incontinence. Subjects were urodynamically categorized as those with urethral sphincteric incompetence (N = 88) and those with detrusor instability with or without concomitant sphincteric incompetence (N = 35). Bladder training reduced the number of incontinent episodes by 57%; the effect was similar for both urodynamic diagnostic groups. The quantity of fluid loss was reduced by 54%. This was greater for patients with detrusor instability than for those without it. Diurnal and nocturnal voluntary micturitions were also reduced. The effect on nocturnal micturition, however, was not observed in subjects with unstable detrusor function. It is recommended that bladder training be considered as an initial step in treatment of women with urinary incontinence. Provided prior comprehensive clinical evaluation is done, it can be prescribed without the need for urodynamic characterization.
在一项随机临床试验中，对123名年龄在55岁及以上、患有尿失禁的非机构养老女性进行了膀胱训练疗效评估。受试者经尿动力学检查分为尿道括约肌功能不全组（N = 88）和逼尿肌不稳定伴或不伴括约肌功能不全组（N = 35）。膀胱训练使尿失禁发作次数减少了57%；两个尿动力学诊断组的效果相似。液体丢失量减少了54%。这在逼尿肌不稳定的患者中比没有逼尿肌不稳定的患者更明显。日间和夜间的自主排尿次数也减少了。然而，在逼尿肌功能不稳定的受试者中未观察到对夜间排尿的影响。建议将膀胱训练视为治疗女性尿失禁的初始步骤。如果事先进行了全面的临床评估，则无需进行尿动力学特征分析即可开出处方。
