Johnson D E, Muncie H L, O'Reilly J L, Warren J W
Department of Medicine, University of Maryland School of Medicine, Baltimore.
J Am Geriatr Soc. 1990 Sep;38(9):1016-22. doi: 10.1111/j.1532-5415.1990.tb04426.x.
Urinary incontinence is common in aged women, may precipitate nursing home admission, and may prompt use of a urine collection device, usually an indwelling urethral catheter. The safety and efficacy of a new external urine collection device for women that is affixed to the perineum by an adhesive developed for ostomy bags was evaluated. Applied to 26 aged women, 78% of 2,264 devices were leak-free for 24 hours and 49% for 48 hours. The incidence of new bacteriuria was less than half that found in our earlier studies of long-term urethral catheters in the same institution. Perineal erythema was infrequent and preexisting decubitus ulcers improved or did not change. Four patients were withdrawn, one each because of periurethral itching, diminished urine output, recurrent wetness, and fracture of the proximal femur associated with severe osteoporosis. This device may offer an alternative to urethral catheters for management of urinary incontinence but should not be used on women with urine retention and should be used with care on women with severe osteoporosis. Controlled trials must determine effects upon bacteriologic complications and health-care costs.
尿失禁在老年女性中很常见，可能促使她们入住养老院，还可能促使使用尿液收集装置，通常是留置导尿管。我们评估了一种新型女性外用尿液收集装置的安全性和有效性，该装置通过为造口袋开发的粘合剂固定在会阴部位。将该装置应用于26名老年女性，在2264个装置中，78%在24小时内无渗漏，49%在48小时内无渗漏。新发菌尿的发生率不到我们之前在同一机构对长期使用尿道导尿管的研究中所发现发生率的一半。会阴红斑很少见，原有的褥疮有所改善或没有变化。有4名患者退出研究，原因分别是尿道周围瘙痒、尿量减少、反复潮湿，以及与严重骨质疏松相关的股骨近端骨折。对于尿失禁的管理，这种装置可能是尿道导尿管的一种替代选择，但不应在尿潴留女性中使用，对于患有严重骨质疏松的女性应谨慎使用。必须通过对照试验来确定其对细菌学并发症和医疗费用的影响。
