Jodie McDonald, David Homewood, Courtenay West, Eva Fong, Sandra Elmer
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引用次数: 0
摘要
背景:尿失禁是全科常见病,会严重影响患者的生活质量。国际尿失禁协会(International Continence Society)将压力性尿失禁(SUI)定义为 "在用力或体力消耗(如体育活动)时,或在打喷嚏或咳嗽时出现的任何不自主遗尿的主诉"。初级医疗服务提供者在女性 SUI 的评估和管理中扮演着重要角色:目的:强调全科医疗中女性 SUI 的主要诊断和处理原则,并讨论处理方案:讨论:通常可根据临床病史和有针对性的体格检查来诊断 SUI。盆底物理治疗和生活方式干预,包括体重调整和合并症管理,是重要的一线疗法。针对顽固性或复杂性 SUI 的手术方案包括尿道膨出剂、Burch 结肠悬吊术和耻骨阴道筋膜吊带术。合成(网状)尿道中段吊带仍是 SUI 妇女的可行手术选择。
Managing female stress urinary incontinence in a post mesh era: What to do and when to refer.
Background: Urinary incontinence is a common presentation in general practice and can significantly affect a patient's quality of life. Stress urinary incontinence (SUI) is defined by the International Continence Society as 'the complaint of any involuntary loss of urine on effort or physical exertion (eg sporting activities), or on sneezing or coughing'. There is a key role for primary care providers in the assessment and management of female SUI.
Objective: To highlight the key diagnostic and management principles of female SUI in general practice and discuss management options.
Discussion: SUI can usually be diagnosed based upon clinical history and targeted physical examination. Pelvic floor physiotherapy and lifestyle interventions, including weight modification and management of co-morbidities, are important first-line therapies. Surgical options for both persistent or complex SUI include urethral bulking agents, Burch colposuspension and pubovaginal fascial slings. Synthetic (mesh) mid-urethral slings remain a viable surgical option for women suffering SUI.
期刊介绍:
The Australian Journal of General Practice (AJGP) aims to provide relevant, evidence-based, clearly articulated information to Australian general practitioners (GPs) to assist them in providing the highest quality patient care, applicable to the varied geographic and social contexts in which GPs work and to all GP roles as clinician, researcher, educator, practice team member and opinion leader. All articles are subject to peer review before they are accepted for publication.