Urinary Incontinence and Napkins

Abstract. This questionnaire study shows the view of four influential groups on urinary incontinence and the aids used to alleviate the problem. The findings indicated education needs for all studied categories of care personnel. Education is needed primarily in diagnosis, quantitative and qualitative evaluation of aids, facts about incontinence, and information to patients. Differences in views and actual knowledge between the studied groups are probably due to different frames of reference, priorities, and professional background.     

Female Urinary Incontinence

One hundred and eighty-seven Norwegian women with urinary incontinence (UI) were interviewed after having responded to a marketing campaign for incontinence aids. Nineteen per cent stated that UI was a negligible problem. Urge incontinence was associated with more mental distress, practical inconveniences, and social restrictions than stress incontinence. Young women were more handicapped by stress incontinence than old women. Severe incontinence was associated with more mental distress and practical inconveniences than slight incontinence. A wide variety of control measures was used, the most popular being absorbent products. Only four had not used any control measure. Fifty-seven per cent had mentioned their UI-problem with a doctor. The consultation rate increased with the severity and duration of UI. Only 36% were satisfied with the outcome of the consultation.     

脑卒中后尿失禁的临床研究

目的研究脑卒中恢复期尿失禁的发生率、相关因素及不同临床表现尿失禁的比较。方法选取脑卒中恢复期患者176例,根据排尿情况分为尿失禁组和控制组,又将尿失禁患者分为有排尿意愿组和无排尿意愿组,进行回顾性分析。结果脑卒中恢复期尿失禁发生率26.1%,失禁组与控制组在性别、卒中类型及病灶侧别、部位方面无显著性差异,但在病灶单/多发方面有显著性差异（P<0.05）。有排尿意愿组和无排尿意愿组在病灶累及顶叶及认知功能方面有显著性差异（P<0.05）。结论脑卒中恢复期尿失禁高发于有多病灶患者,无排尿意愿尿失禁患者多累及顶叶,认知功能异常     

长沙市与非洲弗里敦市女性压力性尿失禁相关因素对比分析

[目的]调查分析不同人群女性压力性尿失禁发病情况.[方法]采用亚太地区尿控咨询委员会成人尿失禁问卷表于2004年至2005年先后对中国长沙市、非洲弗里敦市正常女性人群进行压力性尿失禁调查.[结果]压力性尿失禁非洲弗里敦市发病高于中国长沙市,与年龄呈正相关.不同职业及不同地域及不同医疗环境的女性病因相似,妊娠及分娩次数多、阴道难产、会阴裂伤、急产、产后过早劳动、分娩年龄≥30岁、吸烟、饮酒及合并有血管疾病、支气管炎、糖尿病、尿路感染、生殖器肿瘤、子宫脱垂等患病率增高.[结论]压力性尿失禁是女性常见病,随年龄增加患病率增加.而激素替代治疗可以减少发病.     

体检妇女尿失禁知识的健康教育

目的 探讨开展群体健康教育对妇女尿失禁认知水平的促进作用.方法 抽取参加体检的10个单位、年满18岁及以上、自愿参加的1 943名成年妇女,对其进行尿失禁相关知识的健康教育.于健康教育前、后进行尿失禁相关知识的水平测试.结果 健康教育后1 943名妇女关于尿失禁相关知识的水平测试成绩明显高于健康教育前(P＜0.01).结论 对体检妇女进行团体尿失禁知识的健康教育,能直接提高妇女对相关知识的认知水平,间接增强妇女对待尿失禁问题的积极态度,从而有效提高尿失禁妇女的就诊率及其生活质量.     

Assessment‐Guided Therapy of Urinary Incontinence After Stroke

Urinary incontinence (UI) frequently occurs after stroke and often remains an extensive problem for these patients and their relatives even after discharge from the hospital. Therapeutic interventions, such as behavioral training, can help manage UI. Recently, a multimodal application of nursing interventions was recommended ( Wilbert‐Herr, Hürlimann, Imhof & Wilbert, 2006 ). The primary goals of the study discussed in this article were to introduce therapeutic interventions of UI management into clinical rehabilitation practice based on a structured process of interdisciplinary caregiving and test the treatment effect. Forty‐four patients who had suffered a cerebrovascular accident (CVA) were included in the study. Nursing interventions included distinction of stress or urge UI and the assessment of different forms of UI The latter intervention was based on the functional independence measure (FIM Item G—bladder management), the protocol of micturition, urine dipstick, and ultrasound measurement of post‐void residual urine (PVR). Interventions were applied according to the recommendations of the 3rd International Consultation on Incontinence. An algorithm of the interdisciplinary process was implemented, and the nursing staff received specific education regarding the interventions. Twenty‐one (47%) of the patients in the study were diagnosed with UI; 67% of these patients achieved the targeted level of continence by individually tailored interventions, which consisted of a systematic nursing assessment and standards for prompted voiding, timed voiding, and habit training. Planned processes, including screening procedures, assessment, profile of continence, intervention, and education and evaluation, increase the likelihood of positive results of rehabilitation of patients after CVA. Additional intervention studies are suggested to investigate the effectiveness of the algorithm used in this study.     

阴道内电刺激治疗产后压力性尿失禁的临床效果

目的观察阴道内电刺激治疗产后压力性尿失禁(SUI)的近期临床效果。方法产后42 d SUI产妇64例分为观察组(n=28)和对照组(n=36),两组均给予产后健康训练指导,观察组给予阴道内电刺激治疗12周。分别于产后6个月及12个月通过标准评分问卷、尿垫试验、盆底肌张力强度评分和治愈率观察效果。结果观察组各时间点各项指标均优于对照组(P<0.05)。结论阴道内电刺激可以有效治疗女性产后SUI。     

Adapting Incontinent Patients Incontinence Aids to their Leakage Volumes

The importance of adapting incontinence aids according to the patients leakage volume and comfort was investigated in 28 urinary incontinent 85-year-old men and women who were living at home. The patients incontinence was quantified by a 48-hour pad test and was graded as slight (max. leakage per pad < 5 g; total leakage/48 h <30 g), moderate (max. leakage per pad 5–15 g; total leakage/48 h 30–70 g) or severe (max. leakage per pad > 15 g; total leakage/48 h >70g). Four women had slight urinary incontinence, eight were moderately incontinent and nine were severely incontinent. The corresponding figures for the seven men were as follows: slight, one; moderate, one; severe, five. After the primary assessment, incontinence aids were prescribed based on the measured leakage volumes. The correctly selected and adapted incontinence aid brought the patient better comfort and security. The importance of careful information and instructions how to apply the pad is emphasised. There is also a need to see the patient again at intervals as leakage volumes may vary. Thus, smaller packages of pads should be supplied as the choice of pad may need to be modified. The latter is also important from a financial point of view as the expense of otherwise wasted pads would unnecessarily increase costs.     

Pad Weighing Test—a Simple Method to Quantitate Urinary Incontinence

This paper reviews the litterature on pad weighing tests designed to measure urinary incontinence. These can be divided into short-term (one to two hours), as suggested by the International Continence Society, or long-term (12 to 48 hours). Apart from practical disadvantages the short-term tests have a low sensitivity and require retrograde filling of the bladder to reach acceptable reproducibility. The long-term tests have practical advantages, better sensitivity and acceptable reproducibility. The validity of the long-term test as a measure of the symptom of incontinence is evident, whereas it is unclear what the short term test measures. An evaluation of the value of pad-weighing tests in different kinds of incontinence is lacking.     

无张力阴道吊带术微创治疗女性压力性尿失禁

目的:评价无张力阴道吊带术(TVT)治疗女性压力性尿失禁的疗效。方法:对21例压力性尿失禁或混合性尿失禁的女性患者进行了TVT手术治疗。结果:平均手术时间38min(35～45min),术后平均住院天数3.5d(2～5d)。18例单纯性SUI患者治愈17例,治愈率94.4%,显效1例(5.6%);3例混合性尿失禁患者中治愈2例,显效1例。膀胱穿孔1例,经积极处理后痊愈。21例随访均无SUI复发。结论:TVT手术因其简单、微创、疗效好、并发症少,目前可作为女性压力性尿失禁手术治疗的首选术式。     

针灸结合盆底肌训练治疗产后压力性尿失禁

目的观察针灸结合盆底肌训练治疗产后压力性尿失禁的疗效。方法 100例符合筛选条件、自然分娩的产妇分成对照组50例和治疗组50例。对照组单纯采用盆底肌训练,治疗组采用针灸(毫针针刺、艾灸)和盆底肌训练综合治疗。于治疗4周后进行疗效评定。结果治疗组总有效率84%,对照组总有效率56%(χ2=10.54,P<0.01)。结论针灸治疗可提高盆底肌训练对产后压力性尿失禁的疗效。     

围绝经期妇女压力性尿失禁的康复治疗分析

目的探讨围绝经期妇女压力性尿失禁的康复治疗方法。方法选取60例围绝经期压力性尿失禁妇女进行治疗,随机分为A组、B组和C组,每组20例。A组给予盆底锻炼,即Kegel训练;B组联合雌激素局部治疗;C组联合低频电刺激联合生物反馈治疗。结果尿失禁量与Kupperman评分呈正相关(r=0.752,P<0.01)。与治疗前比较,治疗1个月、3个月后Kupperman评分A组、B组、C组均明显降低(P<0.01);治疗1个月后,A组与B组比较差异无统计学意义;C组Kupperman评分明显降低(P<0.01),治疗3个月后进一步降低(P<0.01)。与治疗前比较,治疗1个月、3个月后尿失禁量A组、B组、C组均明显降低(P<0.01);A、B两组比较,尿失禁量治疗1个月、3个月后差异无统计学意义(P>0.05);C组与A、B两组比较,治疗1个月,3个月后尿失禁量明显降低(P<0.01)。结论盆底锻炼、低频电刺激联合生物反馈疗法可以明显减轻围绝经期妇女压力性尿失禁的症状。     

老年男性尿失禁用物的调查研究

目的：了解成都市住院老年男性尿失禁患者尿失禁处理用物的使用及并发症发生情况。方法：用自行设计的量表对188位尿失禁老人的一般情况、尿失禁的分级及处理用物等进行调查。结果：随着尿失禁的严重程度的增加,患者或其家人选择的处理用物增加。男性尿失禁的不同处理用物被选用的多少依次为：尿布（58.5%）、尿壶（34.0%）、一次性尿垫（25.5%）、保鲜袋（18.6%）、避孕套式尿袋（6.9%）、留置导尿（3.7%）及假性尿器（2.7%）,不同尿失禁分级的患者对处理用物的选择差异有统计学意义（P〈0.05）;2周患者39.9%发生漏尿,13.3%局部皮肤发红,2.7%皮肤糜烂及2.1%尿路感染。结论：临床工作中应该根据尿失禁的不同分级及患者的综合情况指导患者及其照顾者选择合适的处理用物,目前老年男性尿失禁患者仍然欠缺舒适、经济、实用的接尿设备。     

盆底生物反馈治疗前列腺术后尿失禁

目的:探讨盆底生物反馈治疗经尿道前列腺电切术后尿失禁的效果及优点。方法:采用盆底生物反馈电刺激治疗仪治疗12例经尿道前列腺电切术后尿失禁患者,并进行随访。结果:10例Ⅰ-Ⅱ度患者在完成2-3个月的治疗后,可感知的漏尿事件均消失;2例Ⅲ度患者延长治疗时间至6个月,每日仅使用尿垫1-2块或不用。治疗前患者的腹腔漏尿点压力(77.50±18.89)cmH2O,治疗后升高至(110.83±11.39)cmH2O(P<0.05)。结论:盆底生物反馈电刺激治疗尿失禁安全、有效。