Hadley E C
JAMA. 1986 Jul 18;256(3):372-9.
In recent years, several studies have reported that bladder training, a behavioral intervention in which the interval between voluntary voidings is gradually extended, is an effective therapy for "urge" urinary incontinence (incontinence often associated with inability to inhibit detrusor contractions). Related behavioral therapies may also be effective for incontinence associated with impaired mobility and cognitive status. Because all of these types of incontinence are particularly common among older persons, the effectiveness of these therapies in this age group deserves attention. However, few well-controlled trials have been conducted with older subjects. There are many pathophysiologic types of incontinence among the older population, which is also heterogeneous in important clinical and functional characteristics that affect response to treatment. Hence, clinical trials that characterize subjects' urodynamic, neurologic, cognitive, and functional status, as well as the presence of other diseases and medication use, are needed to determine which elderly persons are likely to respond to particular behavioral regimens for urinary incontinence.
近年来，多项研究报告称，膀胱训练是一种行为干预方法，即逐渐延长自主排尿的间隔时间，是治疗“急迫性”尿失禁（常与无法抑制逼尿肌收缩相关的失禁）的有效疗法。相关行为疗法对与行动能力和认知状态受损相关的失禁可能也有效。由于所有这些类型的失禁在老年人中尤为常见，这些疗法在该年龄组中的有效性值得关注。然而，针对老年受试者进行的对照良好的试验很少。老年人群中存在多种病理生理类型的失禁，在影响治疗反应的重要临床和功能特征方面也存在异质性。因此，需要进行临床试验来描述受试者的尿动力学、神经学、认知和功能状态，以及其他疾病的存在情况和药物使用情况，以确定哪些老年人可能对特定的尿失禁行为方案有反应。
