Seim A, Sivertsen B, Eriksen B C, Hunskaar S
Medical Office of Health, Rissa, Norway.
BMJ. 1996 Jun 8;312(7044):1459-62. doi: 10.1136/bmj.312.7044.1459.
To examine what is attainable when treating urinary incontinence in women in general practice.
Observational study with 12 months' follow up. Interview and clinical examination before, during, and after treatment of women seeking help for urinary incontinence in general practice.
General practice in the rural district of Rissa, Norway.
105 women aged 20 or more with urinary incontinence.
Treatment with pelvic floor exercises, electrostimulation, oestrogen, anticholinergic drugs, bladder training, and protective pads.
Subjective and objective measures of urinary incontinence; number of patients referred to a specialist.
After 12 months' follow up 70% (69/99) of the women were cured or much better; the mean score on a 100 mm visual analogue scale decreased from 37 to 20 mm; and the proportion of women who were greatly bothered by their incontinence decreased by 62%. 20% (20/98) of women became continent, and the percentage of women with severe incontinence decreased from 64% (63/99) to 28% (27/98). Mean leakage per 24 hours measured by a pad test decreased from 28 g at the start of treatment to 13 g after 12 months. The number of light weight pads or sanitary towels decreased from 1.6 to 0.6 a day. In all, 17/105 (16%) patients were referred to a specialist.
Urinary incontinence in women can be effectively managed in general practice with fairly simple treatment. Most women will be satisfied with the results.
探讨在全科医疗中治疗女性尿失禁所能达到的效果。
为期12个月随访的观察性研究。对在全科医疗中寻求尿失禁治疗帮助的女性，在治疗前、治疗期间和治疗后进行访谈及临床检查。
挪威里斯阿农村地区的全科医疗。
105名年龄在20岁及以上的尿失禁女性。
采用盆底肌锻炼、电刺激、雌激素、抗胆碱能药物、膀胱训练及防护垫进行治疗。
尿失禁的主观和客观测量指标；转诊至专科医生处的患者数量。
经过12个月的随访，70%（69/99）的女性治愈或病情大为好转；100毫米视觉模拟量表上的平均得分从37毫米降至20毫米；因尿失禁而深感困扰的女性比例下降了62%。20%（20/98）的女性实现了控尿，重度尿失禁女性的比例从64%（63/99）降至28%（27/98）。通过护垫试验测得的每24小时平均漏尿量从治疗开始时的28克降至12个月后的13克。轻质护垫或卫生巾的使用量从每天1.6片降至0.6片。总共17/105（16%）的患者被转诊至专科医生处。
在全科医疗中，通过相当简单的治疗方法就能有效管理女性尿失禁。大多数女性会对治疗结果感到满意。
