Castleden C M, Duffin H M, Asher M J, Yeomanson C W
Age Ageing. 1985 Sep;14(5):303-7. doi: 10.1093/ageing/14.5.303.
The majority of elderly incontinent patients with detrusor instability in whom various medical treatments had been tried and failed, became dry or very significantly improved following attendance at a Continence Clinic. The reason for this was not only because this clinic had access to specialized investigational equipment, but also because patients received individual psychological and practical management of their incontinence. All were given time to discuss their problems, had imipramine titrated against effect, and practised habit-retraining programmes. Treatment was started in hospital if there was any doubt of the patients misunderstanding or not complying with such regimens. Patients did best if they were sensible and mobile. Urodynamic measurements seemed less important individually, although overall final outcome correlated with the severity of the instability.
大多数患有逼尿肌不稳定的老年失禁患者，在尝试了各种药物治疗但均告失败后，在前往尿失禁诊所就诊后变得不再失禁或有显著改善。原因不仅在于该诊所能够使用专门的检查设备，还在于患者在那里接受了针对其失禁问题的个性化心理和实际管理。所有患者都有时间讨论他们的问题，根据效果调整丙咪嗪的剂量，并实施习惯再训练计划。如果怀疑患者误解或不遵守这些治疗方案，就在医院开始治疗。明智且行动自如的患者治疗效果最佳。虽然总体最终结果与不稳定的严重程度相关，但尿动力学测量单独来看似乎不那么重要。
