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女兵运动性尿失禁的行为治疗

Behavioral treatment of exercise-induced urinary incontinence among female soldiers.

作者信息

Sherman R A, Davis G D, Wong M F

机构信息

Department of Clinical Investigation, Madigan Army Medical Center, Tacoma, WA 98431, USA.

出版信息

Mil Med. 1997 Oct;162(10):690-4.

PMID:9339085
Abstract

One-third of 450 female soldiers surveyed indicated that they experienced problematic urinary incontinence during exercise and field training activities. The other crucial finding of this survey was probably that 13.3% of the respondents restricted fluids significantly while participating in field exercises. Although only 5.3% of respondents felt that their urine leakage had a significant impact on their regular duties, it is obvious that many more are sufficiently worried about leakage to put themselves at significant risk for dehydration-related injuries. This study tested whether behavioral interventions effective among older people could help younger soldiers. Thirty-nine female soldiers reporting exercise-induced urinary incontinence underwent urodynamic assessments of bladder capacity, urethral closure pressure, and detrusor contraction pressures as well as a symptom questionnaire before and after therapy. They were stratified by diagnosis of physical stress incontinence or mixed urge/stress incontinence and randomized into two groups. Twenty-three participants performed pelvic muscle exercises with urethral biofeedback for 8 weeks, and 16 participants performed pelvic muscle exercises alone. Patient reports as well as the post-treatment examinations indicated that all subjects improved significantly. Only five subjects in the biofeedback/exercise and three in the exercise-only group desired further treatment. All subjects initially diagnosed with detrusor dysfunction had normal readings at the end of the study. Thus, behavioral treatments can be effective against exercise-induced urinary incontinence among most female soldiers.

摘要

在接受调查的450名女兵中,三分之一表示她们在运动和野外训练活动中出现了问题性尿失禁。这项调查的另一个关键发现可能是,13.3%的受访者在参加野外训练时大幅限制了液体摄入量。尽管只有5.3%的受访者认为尿液泄漏对她们的日常任务有重大影响,但显然有更多人非常担心泄漏问题,以至于使自己面临与脱水相关损伤的重大风险。这项研究测试了在老年人中有效的行为干预措施是否能帮助年轻士兵。39名报告有运动性尿失禁的女兵在治疗前后接受了膀胱容量、尿道闭合压力和逼尿肌收缩压力的尿动力学评估以及症状问卷调查。她们根据身体应激性尿失禁或混合性急迫性/应激性尿失禁的诊断进行分层,并随机分为两组。23名参与者进行了为期8周的伴有尿道生物反馈的盆底肌肉锻炼,16名参与者仅进行了盆底肌肉锻炼。患者报告以及治疗后的检查表明,所有受试者都有显著改善。生物反馈/锻炼组只有5名受试者,仅锻炼组只有3名受试者希望进一步治疗。所有最初被诊断为逼尿肌功能障碍的受试者在研究结束时读数均正常。因此,行为治疗对大多数女兵的运动性尿失禁可能有效。

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