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女性尿失禁的评估与管理。

Evaluation and management of female urinary incontinence.

机构信息

Department of Urology, Sidney Kimmel Medical College at Thomas Jefferson University, Philadelphia, Pennsylvania, USA.

出版信息

Can J Urol. 2021 Aug;28(S2):27-32.

Abstract

UNLABELLED

INTRODUCTION Urinary incontinence (UI) is a common condition in all demographics of women and consists of stress UI (SUI), Urgency UI (UUI), and mixed UI (MUI). Treatment includes lifestyle modifications, medical treatment, and surgery depending on the type of UI and severity of symptoms. This review is an update on the evaluation and management of UI in women.

MATERIALS AND METHODS

This review article covers the evaluation and management options for UI in women and includes the most recent guidelines from the American Urological Association (AUA) as well as recently published literature on the management of UI.

RESULTS

Any evaluation of UI should include a thorough targeted history and physical, and counseling for treatment should consider patient goals and desired outcomes. For both SUI and UUI, behavioral therapy and lifestyle modifications are effective first line treatments. Patients with UUI can benefit from medical therapy which includes anticholinergics and ß3-agonist medications, as well as neuromodulation in treatment refractory patients. SUI patients may further benefit from mechanical inserts which prevent leaks, urethral bulking agents, and surgical treatments such as the mid urethral sling and autologous fascial pubovaginal sling.

CONCLUSIONS

Treatment of UI in women requires a graded approach that considers patient goals and symptom severity, beginning with lifestyle and behavioral modifications before progressing to more aggressive interventions.

摘要

未加标签

引言 尿失禁(UI)是所有女性人群中的一种常见病症,包括压力性尿失禁(SUI)、急迫性尿失禁(UUI)和混合性尿失禁(MUI)。治疗方法包括根据尿失禁类型和症状严重程度进行生活方式改变、药物治疗和手术治疗。本文对女性尿失禁的评估和治疗进行了更新。

材料和方法

本文综述了女性尿失禁的评估和治疗选择,包括美国泌尿外科学会(AUA)的最新指南以及最近发表的关于尿失禁治疗的文献。

结果

任何对尿失禁的评估都应包括全面的针对性病史和体格检查,治疗咨询应考虑患者的目标和预期结果。对于 SUI 和 UUI,行为疗法和生活方式改变是有效的一线治疗方法。对于 UUI 患者,药物治疗包括抗胆碱能药物和β3-激动剂药物,以及治疗抵抗患者的神经调节治疗,可以带来获益。SUI 患者可能进一步受益于机械插入物,这些插入物可以防止泄漏、尿道填充剂以及手术治疗,如中段尿道吊带和自体筋膜耻骨阴道吊带。

结论

女性尿失禁的治疗需要采用分级方法,根据患者的目标和症状严重程度进行考虑,从生活方式和行为改变开始,然后再进行更积极的干预。

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