Ouslander J, Staskin D, Raz S, Su H L, Hepps K
J Urol. 1987 Jan;137(1):68-71. doi: 10.1016/s0022-5347(17)43873-0.
The clinical presentation of incontinence was compared to diagnoses based on urological and urodynamic evaluation in 135 elderly women assessed consecutively in an outpatient clinic. Most patients (64 per cent) presented with mixed symptoms: 16 per cent presented with pure stress and 16 per cent with pure urge incontinence. After evaluation 46 per cent of the patients had stress incontinence with a stable bladder, 27 per cent had detrusor instability or hyperreflexia without sphincter weakness and 19 per cent had mixed urodynamic abnormalities. Presenting symptoms were predictive of urodynamic diagnosis in 64 per cent of the patients with pure stress incontinence and 55 per cent with pure urge incontinence. In general, symptoms in our patient population were less predictive of urodynamic findings than in previously reported series of younger incontinent women but they were more predictive than in other series of elderly women. Predictive values for some urodynamic findings were enhanced by combining a symptom with certain physical findings. Implications of these data for the evaluation and treatment of incontinence in the geriatric population are discussed.
在一家门诊诊所对135名老年女性进行了连续评估，将尿失禁的临床表现与基于泌尿外科和尿动力学评估的诊断结果进行了比较。大多数患者（64%）表现为混合症状：16%表现为单纯压力性尿失禁，16%表现为单纯急迫性尿失禁。评估后，46%的患者存在压力性尿失禁且膀胱稳定，27%的患者存在逼尿肌不稳定或反射亢进且无括约肌无力，19%的患者存在混合性尿动力学异常。对于64%的单纯压力性尿失禁患者和55%的单纯急迫性尿失禁患者，其呈现的症状可预测尿动力学诊断。总体而言，与先前报道的年轻尿失禁女性系列相比，我们患者群体中的症状对尿动力学结果的预测性较低，但比其他老年女性系列更具预测性。将一种症状与某些体格检查结果相结合可提高某些尿动力学检查结果的预测价值。本文讨论了这些数据对老年人群尿失禁评估和治疗的意义。
