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[老年人尿失禁:能做什么以及应该做什么?]

[Urinary incontinence in the elderly: what can and should be done?].

作者信息

Amend B, Kruck S, Bedke J, Ritter R, Arenas da Silva L, Chapple C, Stenzl A, Sievert K-D

机构信息

Klinik für Urologie, Universitätsklinikum Tübingen, Hoppe-Seyler-Straße 3, 72072 Tübingen, Deutschland.

出版信息

Urologe A. 2013 Jun;52(6):805-12. doi: 10.1007/s00120-012-3061-9.

Abstract

The demographic development of society shows a clear increase in the elderly population in the coming decades, which will result in an increasing prevalence of urinary incontinence. Diagnosis and treatment of many patients is not carried out for a myriad of reasons and thus incontinence care is often inadequate. A detailed medical history is the basis of identification of the problem and underpins the effective diagnostic and therapeutic management of the problem. In this context, the algorithms based on the national and international guidelines and age-specific characteristics should be considered. The initial focus should be on conservative management. In a few cases of elderly patients, invasive diagnostics using urodynamics or cystoscopy might be indicated. The increased use of medication in the elderly both from an etiological and therapeutic point of view, especially in terms of drug/drug interactions requires special consideration. In particular cognitive impairment using pharmacological approaches should be avoided. Although incontinence surgery of the patient applies less often with increasing age it still plays a role in the appropriate selection of treatment.

摘要

社会人口发展趋势表明,在未来几十年中,老年人口将显著增加,这将导致尿失禁的患病率不断上升。由于种种原因,许多患者未得到诊断和治疗,因此失禁护理往往不足。详细的病史是识别问题的基础,也是有效诊断和治疗该问题的支撑。在此背景下,应考虑基于国家和国际指南以及特定年龄特征的算法。初始重点应放在保守治疗上。在少数老年患者中,可能需要进行尿动力学或膀胱镜检查等侵入性诊断。从病因和治疗的角度来看,老年人用药的增加,尤其是在药物相互作用方面,需要特别考虑。特别是应避免使用药物治疗认知障碍。尽管随着年龄的增长,患者接受失禁手术的情况较少,但在适当选择治疗方法时,手术仍发挥着作用。

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