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根治性膀胱切除术和原位新膀胱术后尿失禁的管理:国际实践的范围综述。

Management of urinary incontinence after radical cystectomy and orthotopic neobladder: A scoping review of international practices.

机构信息

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

Department of Urology, Shantou Central Hospital, Shantou, China.

出版信息

Nurs Open. 2023 Oct;10(10):6618-6634. doi: 10.1002/nop2.1924. Epub 2023 Jul 5.

Abstract

OBJECTIVES

To identify and describe international practice in incontinence management after radical cystectomy and orthotopic neobladder.

MATERIALS AND METHODS

A systematic scoping review following the methodology of the Joanne Briggs Institute was conducted in which the application searched 15 data sources to identify papers published in English, from 1979 to 2022.

RESULTS

Of the 16 papers that met the eligibility criteria, articles in Eastern countries mainly focus on the effect of conservative treatment, while in Western countries, more attention is paid to the effect of surgical treatment. Clinical characteristics of patients included conservative treatment failure, duration of post-operative intervention and unique differential treatment of male and female patients. Reported factors influencing the achievement of urinary incontinence (UI) include lack of evidence to guide management practice, limited value of conservative treatment, high risk of surgical treatment and uncertainty of efficacy; currently, early behavioural research and multimodal rehabilitation training have good results.

CONCLUSIONS

UI in neobladder patients is a distressing condition that is difficult to treat and often requires high-quality rehabilitation guidance and surgical intervention. Further research to address current knowledge gaps is important to inform practice.

摘要

目的

确定和描述根治性膀胱切除术和原位新膀胱术后尿失禁管理的国际实践。

材料与方法

采用乔安妮·布里格斯研究所(Joanne Briggs Institute)方法学进行系统范围审查,应用程序搜索了 15 个数据源,以确定 1979 年至 2022 年期间以英文发表的论文。

结果

在符合入选标准的 16 篇论文中,东方国家的文章主要关注保守治疗的效果,而西方国家则更关注手术治疗的效果。患者的临床特征包括保守治疗失败、术后干预持续时间以及男性和女性患者的独特差异治疗。报告的影响尿失禁(UI)实现的因素包括缺乏指导管理实践的证据、保守治疗的价值有限、手术治疗风险高以及疗效不确定;目前,早期行为研究和多模式康复训练有较好的效果。

结论

新膀胱患者的 UI 是一种难以治疗的痛苦状况,通常需要高质量的康复指导和手术干预。解决当前知识空白的进一步研究对于指导实践很重要。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/7b38/10495704/9dc01fd5649e/NOP2-10-6618-g001.jpg

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