DeLancey J O
Department of Obstetrics and Gynecology, University of Michigan Medical School, Ann Arbor, USA.
Am J Obstet Gynecol. 1996 Aug;175(2):311-9. doi: 10.1016/s0002-9378(96)70140-0.
Stress urinary incontinence results from specific damage to the muscles, fascial structures, and nerves of the pelvic floor. Scientific data are accumulating about the nature of each of these injuries. As we begin to define the damage occurring in each element of the continence mechanism, we should be able to precisely select treatment plans on the basis of the abnormality found in individual patients. For example, a woman who has lost all neural control of her pelvic muscles could be saved the useless frustration of attempting pelvic muscle strengthening, whereas a woman with intact but weak muscles can be made continent with exercise. Before these advances can be realized, we must change our current empiric approach that assigns women to treatment because they have stress urinary incontinence to one that asks about the status of each part of the continence mechanism.
压力性尿失禁是由盆底肌肉、筋膜结构和神经的特定损伤引起的。关于这些损伤中每一种损伤的性质，科学数据正在不断积累。当我们开始明确控尿机制中每个组成部分所发生的损伤时，我们应该能够根据个体患者所发现的异常情况精确地选择治疗方案。例如，一位已经失去对其盆底肌肉所有神经控制的女性，可以避免尝试进行盆底肌肉强化训练的徒劳挫折，而一位肌肉完整但较弱的女性则可以通过锻炼实现控尿。在实现这些进展之前，我们必须改变当前的经验性方法，即仅仅因为女性患有压力性尿失禁就为她们分配治疗方案，转而采用询问控尿机制每个部分状况的方法。
