波兰压力性尿失禁女性尿失禁垫使用情况及求助行为分析。
Analysis of the usage of continence pads and help-seeking behavior of women with stress urinary incontinence in Poland.
作者信息
Grzybowska Magdalena Emilia, Wydra Dariusz, Smutek Jerzy
机构信息
Department of Gynecology, Gynecologic Oncology and Gynecologic Endocrinology, Medical University of Gdańsk, Kliniczna 1a, 80-402, Gdańsk, Poland.
Department of Perinatology, Medical University of Gdańsk, Kliniczna 1a, 80-402, Gdańsk, Poland.
出版信息
BMC Womens Health. 2015 Sep 30;15:80. doi: 10.1186/s12905-015-0238-6.
BACKGROUND
Urinary incontinence (UI) in women is a chronic disorder which has a negative impact on health-related quality of life. Only 45 % of the affected individuals report the problem with continence to their doctor. The aim of the study was to assess the duration of stress urinary incontinence (SUI), time from disease onset to the first medical consultation and in-depth diagnosis, as well as the need for using continence pads in various grades of SUI.
METHODS
We conducted a cross-sectional study in women who presented at the urogynecologic ambulatory center and reported urinary incontinence. A total of 420 subjects were interviewed and underwent urogynecologic and urodynamic examinations. A group of 147 patients with urodynamic SUI was enrolled in the study.
RESULTS
All women were graded according to the Stamey severity score: grade 1 - 56 (38.1 %), grade 2 - 68 (46.3 %), and grade 3 - 23 (15.6 %). Mean time elapsed between disease onset and presentation at the urogynecologic ambulatory center was 17.4 ± 11.8 years (grades 1, 2 and 3 for 11.6 ± 11.8, 14.9 ± 10.8, and 22.2 ± 12.1 years, respectively; p = 0.0002). Patients with SUI started perceiving their condition as a problem 4.7 ± 5.4 years before referral to urodynamics; 58.3 % of the SUI patients reported their problems with continence to a physician. Average time between the onset of UI symptoms and seeking medical help was 13.28 ± 12.3 years. Mean duration of using continence pads during the day was 4.2, 5.4 and 10.2 years in grades 1, 2 and 3, respectively (p = 0.0002). The number of patients using continence pads in and outside the home, as compared to outside only, was: grade 1 - 44.6 % vs. 28.6 %, grade 2 - 77.6 % vs. 13.4 %, and grade 3 - 86.4 % vs. 9.1 % (p = 0.004). Mean use of continence pads at night was 3.3, 6.1, and 9.1 years in grades 1, 2 and 3, respectively. The differences were not statistically significant. Protective continence products were used at night by 26.7 % of the SUI patients: 16.1 %, 25 % and 59.1 % in grades 1, 2 and 3, respectively (p = 0.004).
CONCLUSIONS
Women with SUI delay seeking medical help for over a decade. The severity of SUI is associated with duration and increased use of continence pads.
背景
女性尿失禁（UI）是一种慢性疾病，对健康相关生活质量有负面影响。只有45%的受影响个体向医生报告了尿失禁问题。本研究的目的是评估压力性尿失禁（SUI）的持续时间、从疾病发作到首次就医和深入诊断的时间，以及不同程度SUI患者使用尿失禁垫的需求。
方法
我们对在泌尿妇科门诊中心就诊并报告有尿失禁的女性进行了一项横断面研究。共采访了420名受试者，并进行了泌尿妇科和尿动力学检查。147例尿动力学确诊的SUI患者纳入研究。
结果
所有女性均根据Stamey严重程度评分进行分级：1级 - 56例（38.1%），2级 - 68例（46.3%），3级 - 23例（15.6%）。从疾病发作到在泌尿妇科门诊中心就诊的平均时间为17.4±11.8年（1级、2级和3级分别为11.6±11.8、14.9±10.8和22.2±12.1年；p = 0.0002）。SUI患者在转诊至尿动力学检查前4.7±5.4年开始将其病情视为问题；58.3%的SUI患者向医生报告了尿失禁问题。UI症状出现到寻求医疗帮助的平均时间为13.28±12.3年。1级、2级和3级患者白天使用尿失禁垫的平均持续时间分别为4.2年、5.4年和10.2年（p = 0.0002）。与仅在户外使用尿失禁垫的患者相比，在家内外都使用尿失禁垫的患者比例为：1级 - 44.6%对28.6%，2级 - 77.6%对13.4%，3级 - 86.4%对9.1%（p = 0.004）。1级、2级和3级患者夜间使用尿失禁垫的平均时间分别为3.3年、6.1年和9.1年。差异无统计学意义。26.7%的SUI患者夜间使用了保护性尿失禁产品：1级、2级和3级分别为16.1%、25%和59.1%（p = 0.004）。
结论
SUI女性延迟就医超过十年。SUI的严重程度与尿失禁垫使用时间的延长和使用频率的增加有关。
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