Dennis P J, Rohner T J, Hu T W, Igou J F, Yu L C, Kaltreider D L
Division of Urology, Pennsylvania State University, Milton S. Hershey Medical Center, Hershey.
Urology. 1991 Feb;37(2):173-9. doi: 10.1016/0090-4295(91)80220-2.
We present a descriptive analysis of the functional, mental, and urodynamic status of a population of incontinent elderly female nursing home patients. One hundred fifty-five intermediate care female patients with a mean age of 85.5 years were identified as being incontinent of urine at least once daily. After urologic evaluation, each patient was classified into one of four categories: incontinence with normal cystometrogram 68 (44%), detrusor instability (DI) 52 (34%), stress incontinence (SI) 27 (17%), or overflow incontinence (OI) 7 (4%). Thirteen weeks later, patients were again studied using simple water cystometry. At follow-up evaluation, 45 patients (33%) had urodynamic findings which differed from the initial evaluation. Of these women, 10 with DI, 12 with SI, and 2 with OI were found to have normal cystometric parameters at the time of follow-up study, while 19 (14%) who initially had normal cystometric findings had evidence of DI (11) or SI (3). Strong correlation between urinary incontinence in patients with normal cystometric findings and moderate to severe cognitive impairment was present. Simple urodynamic evaluation did identify patients with SI and OI who might benefit from specific therapy. Urodynamic evaluation of incontinent elderly female nursing home patients is indicated and may provide direction for planning treatment strategies.
我们对老年女性养老院尿失禁患者群体的功能、心理及尿动力学状况进行了描述性分析。155名平均年龄为85.5岁的中级护理女性患者被确定为每天至少有一次尿失禁。经过泌尿科评估，每位患者被分为以下四类之一：膀胱测压图正常的尿失禁68例（44%）、逼尿肌不稳定（DI）52例（34%）、压力性尿失禁（SI）27例（17%）或充溢性尿失禁（OI）7例（4%）。13周后，再次使用简易水囊膀胱测压法对患者进行研究。在随访评估中，45例患者（33%）的尿动力学检查结果与初始评估不同。在这些女性中，随访研究时发现10例DI患者、12例SI患者和2例OI患者的膀胱测压参数正常，而最初膀胱测压结果正常的19例患者（14%）有DI（11例）或SI（3例）的证据。膀胱测压结果正常的患者尿失禁与中度至重度认知障碍之间存在强相关性。简易尿动力学评估确实能识别出可能从特定治疗中获益的SI和OI患者。对老年女性养老院尿失禁患者进行尿动力学评估是有必要的，可为制定治疗策略提供指导。
