American College of Obstetricians and Gynecologists, Washington, DC (N.O., J.M.C., C.Z.).
Oregon Health & Science University, Portland, Oregon (H.D.N.).
Ann Intern Med. 2018 Sep 4;169(5):320-328. doi: 10.7326/M18-0595. Epub 2018 Aug 14.
Recommendation on screening for urinary incontinence in women by the Women's Preventive Services Initiative (WPSI), a national coalition of women's health professional organizations and patient representatives. The WPSI's recommendations are intended to guide clinical practice and coverage of services for the Health Resources and Services Administration and other stakeholders. The target audience for this recommendation includes all clinicians providing preventive health care for women, particularly in primary care settings. This recommendation applies to women of all ages, as well as adolescents.
The WPSI developed this recommendation after evaluating evidence regarding the benefits and harms of screening for urinary incontinence in women. The evaluation included a systematic review of the accuracy of screening instruments and the benefits and harms of treatments. Indirect evidence was used to link screening and health outcomes in the chain of evidence that might support screening in the absence of direct evidence. The WPSI also considered the effect of screening on symptom progression and avoidance of costly and complex treatments, as well as implementation factors.
The WPSI recommends screening women for urinary incontinence annually. Screening ideally should assess whether women experience urinary incontinence and whether it affects their activities and quality of life. The WPSI recommends referring women for further evaluation and treatment if indicated.
妇女预防服务倡议(WPSI)是一个由妇女健康专业组织和患者代表组成的国家联盟,推荐对女性尿失禁进行筛查。WPSI 的建议旨在为卫生资源和服务管理局和其他利益相关者的临床实践和服务覆盖提供指导。该建议的目标受众包括所有为女性提供预防保健的临床医生,特别是在初级保健环境中。本建议适用于所有年龄段的女性,以及青少年。
WPSI 在评估女性尿失禁筛查的益处和危害的证据后制定了本建议。评估包括对筛查工具的准确性以及治疗的益处和危害的系统评价。间接证据被用于将筛查与证据链中的健康结果联系起来,以支持在缺乏直接证据的情况下进行筛查。WPSI 还考虑了筛查对症状进展和避免昂贵和复杂治疗的影响,以及实施因素。
WPSI 建议每年对女性进行尿失禁筛查。筛查最好应评估女性是否患有尿失禁,以及尿失禁是否影响其活动和生活质量。如果有需要,WPSI 建议将女性转介进行进一步评估和治疗。