Berghmans Bary, Nieman Fred, Leue C, Weemhoff M, Breukink S, van Koeveringe G
Pelvic Care Centre Maastricht, Maastricht University Medical Centre, Maastricht, The Netherlands.
Department of Clinical Epidemiology & Medical Technology Assessment, Maastricht University Medical Centre, Maastricht, The Netherlands.
Neurourol Urodyn. 2016 Apr;35(4):487-91. doi: 10.1002/nau.22733. Epub 2015 Jan 25.
(i) To describe and analyse pelvic floor dysfunction symptoms in men referred to a Pelvic Care Centre (PCC). (ii) To describe the triage process of the same patients based on response to a first-contact interview.
Triage started with a telephone interview using previously constructed questions, asking for six types of PF complaints during the preceding 6 months. If present, complaint severity was registered on a 0-10 scale. Next, these first-contact complaints were used to describe patient case mix profiles using cross-tabular analysis. Later on, at first PCC visit, an intake questionnaire regarding specific PF health problem(s) was filled out. This procedure contributed to a firm baseline characterization of the individual patient profile and a clinically valid allocation to structured, predefined assessment and treatment.
From 2005 to 2013 985 first-time patients (mean age 58.2 years (SD 15.3) have been referred to the PCC. Most frequently mentioned complaints: voiding dysfunctions (73.9%), urinary incontinence (29.5%), sexual problems (16.6%), faecal incontinence (13.9%), constipation (9.6%), and prolapse (0.3%). A first appointment to a single specialist was determined in 805 (81.7%) patients, in 137 (13.9%) consultation of >1 specialist. Data analysis revealed higher-order interactions between PF complaints, suggesting patient profile complexity and patient population heterogeneity.
One out of seven PCC patients showed multifactorial problems, needing >1 specialist. PF complaints either turned out to stand alone or cluster with others, or even to strengthen, weaken, nullify or inverse relationships. Neurourol. Urodynam. 35:487-491, 2016. © 2015 Wiley Periodicals, Inc.
（i）描述并分析被转诊至盆底护理中心（PCC）的男性盆底功能障碍症状。（ii）根据首次接触访谈的回复描述同一批患者的分诊过程。
分诊始于电话访谈，使用预先设计的问题，询问患者在过去6个月内的六种盆底功能障碍相关主诉。若有相关主诉，依据0至10分的量表记录严重程度。接下来，利用交叉表分析，根据这些首次接触时的主诉描述患者病例组合概况。随后，在首次到PCC就诊时，填写一份关于特定盆底健康问题的问诊问卷。这一流程有助于对个体患者概况进行稳固的基线特征描述，并在临床上有效地分配至结构化、预先定义的评估和治疗。
2005年至2013年期间，985名首次就诊患者（平均年龄58.2岁（标准差15.3））被转诊至PCC。最常提及的主诉为：排尿功能障碍（73.9%）、尿失禁（29.5%）、性功能问题（16.6%）、大便失禁（13.9%）、便秘（9.6%）以及脱垂（0.3%）。805名（81.7%）患者确定预约了单一专科医生，137名（13.9%）患者咨询了不止一名专科医生。数据分析揭示了盆底功能障碍主诉之间的高阶相互作用，表明患者概况的复杂性和患者群体的异质性。
七分之一的PCC患者存在多因素问题，需要不止一名专科医生。盆底功能障碍主诉要么单独出现，要么与其他主诉聚集，甚至会加强、削弱、抵消或反转相互关系。《神经泌尿学与尿动力学》35:487 - 491, 2016。© 2015威利期刊公司。
