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EAU 指南:尿失禁的评估和非手术治疗。

EAU Guidelines on Assessment and Nonsurgical Management of Urinary Incontinence.

机构信息

Department of Urology, Freeman Hospital, Newcastle-upon-Tyne, UK.

Department of Urology, University Medical Centre Utrecht, Utrecht, The Netherlands.

出版信息

Eur Urol. 2018 Apr;73(4):596-609. doi: 10.1016/j.eururo.2017.12.031. Epub 2018 Feb 3.

Abstract

CONTEXT

The European Association of Urology guidelines on urinary incontinence (UI) have been updated in cyclical fashion with successive major chapters being revised each year. The sections on assessment, diagnosis, and nonsurgical treatment have been updated as of mid-2016.

OBJECTIVE

We present a condensed version of the full guideline on assessment and nonsurgical management of UI, with the aim of improving accessibility and increasing their dissemination.

EVIDENCE ACQUISITION

Our literature search was updated from the previous cut-off of July 2010 up to April 2016. Evidence synthesis was carried out by a pragmatic review of current systematic reviews and any newer subsequent high-quality studies, based on Population, Interevention, Comparator, and Outcome questions. Appraisal was conducted by an international panel of experts, working on a strictly nonprofit and voluntary basis, to develop concise evidence statements and action-based recommendations using modified Oxford and GRADE criteria.

EVIDENCE SYNTHESIS

The guidelines include algorithms that summarise the suggested pathway for standard, uncomplicated patients with UI and are more useable in daily practice. The full version of the guideline is available at http://uroweb.org/guideline/urinary-incontinence/.

CONCLUSIONS

These updated guidelines provide an evidence-based summary of the assessment and nonsurgical management of UI, together with a clear clinical algorithm and action-based recommendations. Although these guidelines are applicable to a standard patient, it must be remembered that therapy should always be tailored to individual patients' needs and circumstances.

PATIENT SUMMARY

Urinary incontinence is a very common condition which negatively impacts patient's quality of life. Several types of incontinence exist and since the treatments will vary, it is important that the diagnostic evaluation establishes which type is present. The diagnosis should also identify patients who need rapid referral to an appropriate specialist. These guidelines aim to provide sensible and practical evidence-based guidance on the clinical problem of urinary incontinence.

摘要

背景

欧洲泌尿外科学会(EAU)的尿失禁(UI)指南已进行周期性更新,每年修订一次主要章节。截至 2016 年中期,已更新评估、诊断和非手术治疗部分。

目的

我们提供了该指南关于 UI 评估和非手术管理的浓缩版本,旨在提高其可及性并增加其传播。

证据获取

我们的文献检索自上次截止日期 2010 年 7 月更新至 2016 年 4 月。综合证据是通过对当前系统评价的务实审查以及任何更新的高质量后续研究进行的,基于人群、干预、比较和结局问题。评估由一个国际专家小组进行,他们在严格的非营利和自愿基础上开展工作,根据修改后的牛津和 GRADE 标准制定简洁的证据陈述和基于行动的建议。

证据综合

指南包括总结标准、无并发症 UI 患者建议途径的算法,更便于日常实践使用。指南的完整版本可在 http://uroweb.org/guideline/urinary-incontinence/ 上获取。

结论

这些更新的指南提供了 UI 评估和非手术管理的循证总结,以及清晰的临床算法和基于行动的建议。尽管这些指南适用于标准患者,但必须记住,治疗应始终根据患者的个体需求和情况进行调整。

患者总结

尿失禁是一种非常常见的疾病,会对患者的生活质量产生负面影响。存在几种类型的失禁,由于治疗方法会有所不同,因此重要的是诊断评估确定存在哪种类型。诊断还应确定需要快速转介给适当专家的患者。这些指南旨在为尿失禁的临床问题提供合理且实用的循证指导。

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