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男性尿失禁的非药物和非手术干预措施:范围综述。

Non-pharmacological and nonsurgical interventions in male urinary incontinence: A scoping review.

机构信息

Department of Nursing, The First Affiliated Hospital, Zhejiang University School of Medicine, Shangcheng District, Hangzhou, China.

Zhejiang University School of Medicine, Shangcheng District, Hangzhou, China.

出版信息

J Clin Nurs. 2023 Sep;32(17-18):6196-6211. doi: 10.1111/jocn.16749. Epub 2023 May 9.

Abstract

AIMS

To describe and synthesize non-pharmacological and nonsurgical interventions for male urinary incontinence from the existing literature.

METHODS

A scoping review was conducted following the methodology suggested by Arksey and O'Malley: (1) identification of the research questions; (2) identification of relevant studies using a three-step search recommended by JBI: an initial search within PubMed and CINAHL, a comprehensive literature search within PubMed, CINAHL, EMBASE, PsycINFO, Cochrane Library, and literature search of references lists; (3) study selection; (4) data extraction and charting; (5) collation, summarization, and reporting of the results. The PRISMA-ScR Checklist was used to report.

RESULTS

A total of 4602 studies were identified, of which 87 studies were included. Approximately 78% were randomized controlled trials. More than 88% of the participants were men with prostate cancer. Exercising pelvic floor muscles 30 times per day for 12 weeks was the most frequently reported. Parameters of electrical stimulation were typically set up to 50 Hz and 300 μs for frequency and width of pulse, respectively, and lasted for 15 min. Pure pelvic floor muscle training, Pilates, Yoga, whole body vibration, diaphragm/abdominal muscle training, micturition interruption exercise, acupuncture, and auriculotherapy showed positive effects on reducing urinary incontinence.

CONCLUSION

The findings suggested implementing pelvic floor muscle training alone before or after surgery can both prompt the recovery of continence in men after prostate cancer surgery. The decision to use biofeedback or electrical stimulation to enhance the therapeutic effect of pelvic floor muscle training should be approached with caution. More rigorous designed studies are needed to validate the effectiveness of Traditional Chinese Medicine techniques and diverse novel methods.

RELEVANCE TO CLINICAL PRACTICE

Physicians and nurses need to be up to date on the latest evidence-based non-pharmacological and nonsurgical interventions in male urinary incontinence and select appropriate interventions based on available medical resources and patient preferences.

摘要

目的

从现有文献中描述和综合非药物和非手术干预男性尿失禁的方法。

方法

采用 Arksey 和 O'Malley 建议的方法进行范围综述:(1)确定研究问题;(2)使用 JBI 推荐的三步搜索法识别相关研究:在 PubMed 和 CINAHL 中进行初步搜索,在 PubMed、CINAHL、EMBASE、PsycINFO、Cochrane 图书馆和文献检索中进行全面文献检索;(3)研究选择;(4)数据提取和图表绘制;(5)结果的整理、总结和报告。使用 PRISMA-ScR 清单进行报告。

结果

共确定了 4602 项研究,其中包括 87 项研究。大约 78%是随机对照试验。超过 88%的参与者是患有前列腺癌的男性。每天进行 30 次、每次 30 次的骨盆底肌肉锻炼,持续 12 周,是最常报道的。电刺激的参数通常设置为 50 Hz 和 300 μs,分别为频率和脉冲宽度,持续 15 分钟。单纯骨盆底肌肉训练、普拉提、瑜伽、全身振动、膈肌/腹肌训练、排尿中断运动、针灸和耳穴疗法均显示出减少尿失禁的积极效果。

结论

研究结果表明,在前列腺癌手术后,单独或联合手术前进行骨盆底肌肉训练都可以促进男性术后尿失禁的恢复。谨慎地决定使用生物反馈或电刺激来增强骨盆底肌肉训练的治疗效果。需要进行更严格设计的研究来验证中药技术和各种新方法的有效性。

临床相关性

医生和护士需要了解最新的男性尿失禁非药物和非手术干预措施的循证依据,并根据可用的医疗资源和患者偏好选择合适的干预措施。

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