女性排便功能障碍的评估与管理
Evaluation and management of defecatory dysfunction in women.
作者信息
Pratt Toya, Mishra Kavita
机构信息
Division of Female Pelvic Medicine and Reconstructive Surgery, Department of Obstetrics and Gynecology, Kaiser Permanente East Bay-University of California, San Francisco.
Division of Urogynecology and Pelvic Reconstructive Surgery, Department of Obstetrics and Gynecology, Stanford University School of Medicine, Stanford, California, USA.
出版信息
Curr Opin Obstet Gynecol. 2018 Dec;30(6):451-457. doi: 10.1097/GCO.0000000000000495.
PURPOSE OF REVIEW
To summarize the current recommendations for the evaluation and management of defecatory dysfunction in women and highlight key relationships between defecatory dysfunction and other pelvic floor disorders, including pelvic organ prolapse, fecal incontinence, and voiding dysfunction.
RECENT FINDINGS
Conservative measures including lifestyle modifications, pharmacotherapy, and biofeedback continue to be the mainstay of treatment with newer therapies emerging. Physiologic testing and/or radiologic imaging should be considered for those who fail conservative therapy or are clinically complex. Surgical management is appropriate for carefully selected patients with anatomic causes of defecatory dysfunction. Further research is needed on surgical outcomes and patient expectations.
SUMMARY
Pelvic floor disorders, including defecatory dysfunction, have a significant societal impact and are highly prevalent among women. Given its potential complexity, a broader focus is needed when evaluating women with defecatory symptoms and effective treatment may require multidisciplinary care.
综述目的
总结目前关于女性排便功能障碍评估与管理的建议，并强调排便功能障碍与其他盆底疾病（包括盆腔器官脱垂、大便失禁和排尿功能障碍）之间的关键关系。
最新发现
包括生活方式改变、药物治疗和生物反馈在内的保守措施仍然是主要治疗方法，同时也有新的治疗方法出现。对于保守治疗失败或临床情况复杂的患者，应考虑进行生理测试和/或影像学检查。手术治疗适用于精心挑选的有解剖学原因导致排便功能障碍的患者。需要进一步研究手术效果和患者期望。
总结
盆底疾病，包括排便功能障碍，对社会有重大影响，在女性中非常普遍。鉴于其潜在的复杂性，在评估有排便症状的女性时需要更广泛的关注，有效的治疗可能需要多学科护理。
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