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泌尿科医生需要了解的大便失禁是什么?

What Is Fecal Incontinence That Urologists Need to Know?

作者信息

Kim HongWook, Shim Jisung, Seo Yumi, Lee Changho, Chang Youngseop

机构信息

Department of Urology, Konyang University College of Medicine, Daejeon, Korea.

Konyang University Myunggok Medical Research Institute, Daejeon, Korea.

出版信息

Int Neurourol J. 2021 Mar;25(1):23-33. doi: 10.5213/inj.2040240.120. Epub 2021 Jan 19.

Abstract

Fecal incontinence (FI) undoubtedly reduces quality of life and adversely affects the social life of the affected individual. FI has a higher prevalence with age and has an equivalent prevalence to urinary incontinence in patients with genitourinary disease, but is often not confirmed in these cases. A thorough investigation is needed to diagnose FI, with the common etiology of this condition in mind, and several questionnaires can be used to identify symptoms. The physical examination contains digital rectal examination carries out to identify the patient's condition. Ultrasound, colonoscopy, and rectum pressure test can be performed. Patients educated in diet-related issues, bowel movements, and defecation mechanism. Nonoperative options such as diet control and Kegel exercise should be performed at first. Surgical treatment of FI is considered when conservative management and oral medications produce no improvement. Surgical options include less invasive procedures like bulking agent injections, and more involved approaches from sacral nerve stimulation to invasive direct sphincter repair and artificial bowel sphincter insertion. Good outcomes in FI cases have also recently been reported for barrier devices.

摘要

大便失禁(FI)无疑会降低生活质量,并对受影响个体的社交生活产生不利影响。FI的患病率随年龄增长而升高,在泌尿生殖系统疾病患者中,其患病率与尿失禁相当,但在这些病例中往往未得到确诊。诊断FI需要进行全面调查,同时要考虑到这种情况的常见病因,并且可以使用几种问卷来识别症状。体格检查包括进行直肠指检以确定患者的病情。还可以进行超声、结肠镜检查和直肠压力测试。对患者进行饮食相关问题、排便和排便机制方面的教育。首先应采取饮食控制和凯格尔运动等非手术选择。当保守治疗和口服药物治疗无效时,考虑对FI进行手术治疗。手术选择包括注射填充剂等侵入性较小的手术,以及从骶神经刺激到侵入性直接括约肌修复和人工肛门括约肌植入等更复杂的方法。最近也有报道称屏障装置在FI病例中取得了良好效果。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/16ef/8022170/6eb7283e9784/inj-2040240-120f1.jpg

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