女性尿失禁的处理

根据国际尿失禁学会的定义，尿失禁是指能客观显示的尿液不自主流出并造成社会和健康问题的一种病状。尿失禁不仅仅造成患者个人的不适，对英国国家医疗卫生服务体系(NHS)也造成影响，每年有关尿失禁处理的耗资大约4，24亿英镑，而女性尿失禁的发生率高达20，2％。     

针灸疗法对压力性尿失禁的研究

中医认为,压力性尿失禁的发生与肺、脾、胃、心、肝、肾、三焦的功能密切相关,其病位在膀胱,多由于肾气亏虚、下元不固或气血亏虚、膀胱失约或湿热下注、积于膀胱导致。针灸具有疏通经络、调和阴阳的作用,治疗压力性尿失禁的方法主要包括毫针、电针、穴位注射以及针灸并用、针灸结合盆底肌训练等,主要通过其调节排尿中枢的作用发挥疗效。今后针灸治疗本病的研究方向应为增加辨证分型,统一疗效标准,并采用多中心、大样本、随机对照,合理设计的临床实验以增强针灸治疗本病的说服力。     

Vulval adhesions causing urinary incontinence.

An elderly patient complained of urinary incontinence which was found to be due to vulval fusion. Surgical division followed by local oestrogen cream was curative.     

恒河猴括约肌无力性尿失禁模型的建立

目的　建立恒河猴括约肌无力性尿失禁模型。方法　分离膀胱颈和后尿道支持组织 ,并剥除膀胱颈前壁1cm× 1cm大小肌层组织 ,雄猴还在尿道球部后方 ,贴近尿道两侧切断尿生殖膈肌层组织。结果　雄猴、雌猴术后均呈尿失禁状态。结论　通过破坏尿道内、外括约肌及膀胱颈、后尿道支持组织的方法建立恒河猴括约肌无力性尿失禁模型 ,效果稳定 ,操作简单     

Understanding and evaluating chronic urinary incontinence.

Urinary incontinence is a geriatric syndrome of large proportions financially and psychosocially. It may be one of the most neglected ailments. An understanding of the anatomy and pathophysiology of the problem is necessary to creatively assess and treat individual cases. The physician should have in mind an orderly and reasonably complete classification of urinary incontinence and be familiar with the terms traditionally used to describe various mechanisms and phenomena related to the condition. Evaluation of patients involves a discriminating selection of studies and, at times, trials of therapy. A "bedside cystometrogram" may yield much information.     

Investigation and treatment of female urinary incontinence

There are four main types of urinary incontinence in the female namely stress incontinence, urge incontinence, overflow incontinence due to retention of urine and total incontinence. It is important to differentiate them to institute proper treatment. It is the aim of this paper to present a simple clinical evaluation of an incontinent woman. The different methods of surgical correction of stress incontinence are discussed. The latest trend is the paraurethral suspension of the bladder neck. 39 cases of Grade II stress incontinence were treated by paraurethral suspension of the bladder neck at "A" Unit, Kandang Kerbau Hospital and Dept. of Urology, SGH. 33 cases were cured. 4 improved with occasional stress incontinence, frequency and urgency. Of these, 3 were cured with imipramine. One failed because of a fixed, "lead pipe" rigid urethra from previous multiple operations to the bladder neck.     

简易尿动力学检查在女性压力性尿失禁诊断中的意义

对50例通过压力试验证实有腹压增加下尿失禁的患者先行简易尿动力学检查后行标准尿动力学检查。以标准尿动力学检查作为尿失禁诊断的标准,采用简易尿动力学检查诊断压力性尿失禁的敏感度为87％（33／38）,特异度为9／12,阳性预测值为92％（33／36）,阴性预测值为9／14。简易尿动力学检查测得的最大膀胱容量、平均尿流率与标准尿动力学检查结果差异无统计学意义。提示,简易尿动力学检查可作为术前筛查项目。     

压力性尿失禁的病因学研究

目的　绝经后压力性尿失禁 (SUI)患者补充雌激素的临床疗效尚有争议。本研究通过对血雌二醇 (E2 )浓度及子宫韧带的雌激素受体 (ER)的观察 ,分析雌激素与SUI和盆底组织膨出 (POP)发生的关系。方法　绝经前、后对照组、POP组和绝经后SUI组共 5组 73例子宫全切患者 ,免疫组化方法测定主韧带、宫骶韧带ER含量。结果　 ( 1)绝经前POP组血E2 浓度 ( 4 7.2 9pg ml± 38.30pg ml)、韧带ER值明显低于绝经前对照组 (E2 73.83pg ml± 5 2 .72pg ml;ER主韧带9.5 8%± 2 .39% ,ER宫骶韧带11.6 4 %±2 .6 8% ) ,差异非常显著 (P <0 .0 1)。 ( 2 )绝经后韧带ER值 :对照组 (ER主韧带10 .89%± 2 .5 4 % ,ER宫骶韧带13.0 9%± 3.0 3% )、POP组 (ER主韧带11.85 %± 2 .89% ,ER宫骶韧带13.2 1%± 3.4 6 % )及SUI组 (ER主韧带9.6 4 %± 5 .0 1% ,ER宫骶韧带11.12 %± 6 .13% )之间无显著差异 ( P >0 .0 5 )。 ( 3)绝经前、后对照组韧带ER值无显著差异 (P >0 .0 5 )。绝经前对照组月经增生期、分泌期韧带ER值无显著差异 (P >0 .0 5 )。血E2 浓度与韧带ER值无相关性。 ( 4 )绝经后对照组绝经时间与主韧带ER值成正相关 ,与宫骶韧带ER值无相关性。绝经后POP组和SUI组主韧带、宫骶韧带ER值与绝经时间成正相关。 ( 5 )各组研究对?     

女性尿失禁患者尿动力学检查

目的:了解尿动力学检查在诊断女性尿失禁中的意义.方法:选取200例女性尿失禁患者为病例组和因上尿路疾病需要手术治疗而下尿路功能正常的20例女性患者为对照组.病例组依据临床和尿动力学检查结果分为急迫性尿失禁患者90例,真性压力性尿失禁患者70例,充溢性尿失禁患者40例.比较各组病例与对照组之间尿动力学参数的差异.结果:真性压力性尿失禁组的最大逼尿肌排尿压、最大尿流率时逼尿肌压力、最大尿道压和最大尿道闭合压显著低于对照组(P＜0.05);急迫性尿失禁组最大膀胱压测定容量显著低于对照组(P＜0.05);充溢性尿失禁组最大尿流率、膀胱顺应性、最大逼尿肌排尿压和最大尿流率时逼尿肌压力显著低于对照组,残余尿量和排尿前最大逼尿肌压力显著高于对照组(P＜0.05).结论:尿动力学检查能为女性尿失禁患者的诊断和治疗提供客观依据.     

压力性尿失禁手术治疗的进展

<正>伴随人口老龄化,老年女性的盆底功能障碍性疾病(pelvic floor dysfunctional,PFD)问题亟待解决。PFD包括盆底脏器脱垂(pelvic organ prolapse,POD)、压力性尿失禁(stress urinary incontinence,SUI)、性功能障碍(sexual dysfunction,SD)和粪失禁(fecal inconti-nence,FI)。其中,压力性尿失禁(stress urinary inconti-