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膀胱过度活动症——管理与治疗选择

Overactive bladder syndrome - management and treatment options.

作者信息

Arnold Janine, McLeod Nicholas, Thani-Gasalam Ruban, Rashid Prem

机构信息

Department of Surgery, Bendigo Hospital, Victoria.

出版信息

Aust Fam Physician. 2012 Nov;41(11):878-83.

Abstract

BACKGROUND

Overactive bladder syndrome is a symptom-based clinical diagnosis. It is characterised by urinary urgency, frequency and nocturia, with or without urge urinary incontinence. These symptoms can often be managed in the primary care setting.

OBJECTIVE

This article provides a review on overactive bladder syndrome and provides advice on management for the general practitioner.

DISCUSSION

Overactive bladder syndrome can have a significant effect on quality of life, and affects 12-17% of the population. Prevalence increases with age. The management of overactive bladder syndrome involves exclusion of underlying pathology. First line treatment includes lifestyle interventions, pelvic floor exercises, bladder training and antimuscarinic agents. Failure of conservative management necessitates urology referral. Second line therapies are more invasive, and include botulinum toxin, neuromodulation or surgical interventions such as augmentation cystoplasty or urinary diversion.

摘要

背景

膀胱过度活动症是一种基于症状的临床诊断。其特征为尿急、尿频和夜尿症,伴有或不伴有急迫性尿失禁。这些症状通常可在基层医疗环境中得到处理。

目的

本文对膀胱过度活动症进行综述,并为全科医生提供管理建议。

讨论

膀胱过度活动症会对生活质量产生重大影响,影响12%至17%的人群。患病率随年龄增长而增加。膀胱过度活动症的管理包括排除潜在病理状况。一线治疗包括生活方式干预、盆底肌锻炼、膀胱训练和抗毒蕈碱药物。保守治疗失败需要转诊至泌尿外科。二线治疗更具侵入性,包括肉毒杆菌毒素、神经调节或手术干预,如膀胱扩大术或尿流改道。

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