Role of different childbirth strategies on pelvic organ prolapse and stress urinary incontinence: a prospective study

Background Traumatic damage to fascial and muscular support structures during childbirth may be a major factor of the development of stress urinary incontinence （SUI） and pelvic organ prolapse （POP）. The aim of this study was to prospectively investigate the role of different childbirth strategies on POP and SUI.
Methods A total of 120 selected pregnant women were recruited and divided into two groups： vaginal delivery group （n=72） and selective cesarean delivery group （n=48）. The women were questioned with SUI sheet and estimated with POP quantification （POP-Q） within 6-8 weeks after delivery. The correlations of SUI and results of POP-Q with the strategies of delivery were analyzed, ttest, X2 test, and the Mann-Witney test were used for statistical analysis.
Results Among the 120 women, SUI was developed during 29-30 gestational weeks in 20 patients （16.6%）, of whom 14 （70%） had symptoms of SUI till 6 weeks postpartum. Totally 20 （16.6%） women had SUI symptoms after delivery. The prevalence of postpartum SUI was positively correlated with the occurrence of SUI during 29-30 gestational weeks （P〈0.001）. In the vaginal delivery group, 100% of the women suffered form urinary prolapse 6 weeks postpartum, while 87.5% of those in the selective cesarean delivery group developed POP （P〈0.01）. The percentages of the first- and second-degree urinary prolapse in the vaginal delivery group were 20.8% and 79.2% respectively, which were significantly different from those in the selective cesarean delivery group （64.6% and 22.9%; both P=0.000）.
Conclusions Pregnancy and delivery play an etiologic role in the development of SUI and POP. The onset of SUI during late pregnancy implies a significant risk of postpartum SUI symptoms. The prevalence of POP is significantly higher after vaginal delivery than after cesarean delivery.     

Maternal periodontal disease and risk of preeclampsia: A meta-analysis

Research on the association between maternal periodontal disease and the risk of pree- clampsia has generated inconsistent results. This meta-analysis was conducted to evaluate the asso- ciation between maternal periodontal disease and the risk of preeclampsia. A literature search of PubMed and Embase was performed to identify relevant papers published before March 2013. Only observational studies that assessed maternal periodontal disease and the risk of preeclampsia were selected. Patients＇ periodontal status was examined at different time points during pregnancy or after delivery （at 14-32 weeks of gestation, within 48 h prior to or within 5 days after delivery）. Pooled odds ratios （ORs） and corresponding 95% confidence intervals （CIs） were calculated for cases and controls. Cases were defined as women with concurrent hypertension and proteinuria after 20 weeks of gestation. Eleven studies involving 1118 women with preeclampsia and 2798 women without preeclampsia were identified and analyzed. Women with periodontal disease before 32 weeks of ges- tation had a 3.69-fold higher risk of developing preeclampsia than their counterparts without perio- dontal disease （OR=3.69; 95% CI=2.58-5.27）. Periodontal disease within 48 h prior to delivery was associated with a 2.68-fold higher risk of preeclampsia （OR=2.68; 95% CI=1.39-5.18）. Pregnant women with periodontal disease within 5 days after delivery had a 2.22-fold higher risk of pree- clampsia than women without periodontal disease （OR=2.22; 95% CI= 1.16-4.27）. In conclusion, this meta-analysis suggests that maternal periodontal disease is an independent predictor ofpreeclampsia.     

Comparison of Thyroglobulin and Thyroid Function in Pregnant Women between Counties with a Median Urinary Iodine Concentration of 100–149 μg/L and 150–249 μg/L

Objective This study explored whether thyroglobulin and thyroid disease prevalence rates were higher in pregnant Chinese women with a median urinary iodine concentration of 100–149 μg/L,compared with those with a median urinary iodine concentration of 150–249 μg/L maintained through sustainable universal salt iodization.Methods This was a cross-sectional study in which 812 healthy pregnant women were enrolled to collect samples of their household edible salt, urine, and blood during their routin...     

Bulbourethral suspension under urodynamic monitoring for the treatment of male acquired urinary incontinence

Objective To explore whether bulbourethral sling procedure under urodynamie monitoring is effective in the treatment of male acquired urinary incontinence of postprostatectomy and posterior urethroplasty. Methods Between October 2000 and September 2004, 25 men aged 18 to 81 years （mean age,65 years） with acquired urinary incontinence underwent bulbourethral sling procedure. The causes of urinary incontinence were as follows： post-radical prostatectomy in 4 patients, TURP for BPH in 6, post posterior urethroplasty for urethral stricture in 6, and pro-static enucleation for BPH in 9. Preoperatively, 8 patients had completely urinary incontinence and 17 had stress urinary incontinence, with 1 - 5 urinary pads （mean, 3 pads） needed per day. All the patients experienced exercise of pelvic floor muscles without results. The mean duration of urinary incontinence was 4 years （range, 1 - 12 years）.     

Effect of maternal age on pregnancy: a retrospective cohort study

Background In the last few decades,there has been a delay in first-time pregnancies,and the average age of women at the time of delivery has increased in many countries.Advanced maternal age is associated with adverse pregnancy outcomes.This study aimed to determine the present trends and pregnancy outcomes related to maternal age in China.Methods Data were collected from 39 hospitals in mainland of China.All deliveries were performed after 28 completed weeks of gestation and between January 1 and December 31,2011.In total,110 450 of 112 441 cases were included in the study.All enrolled cases were divided into 6 age groups with 5-year intervals.The x2 test or Fisher＇s exact test and unadjusted binary-Logistic regression were used for statistical analysis.Results The mean age at the time of delivery was 28.18±4.70 years （range,14-52 years）.The teenage group （15-19 years） had a higher risk than the 25-29-year old group for anemia （odds ratio （OR）,1.4）,preeclampsia （OR,1.6）,preterm birth （OR,2.1）,low birth weight neonates （OR,2.3）,and perinatal mortality （OR,3.6）.The 35-39-year old group and ≥40-year-old group had a higher risk than the 25-29-year-old group for leiomyoma （OR,4.2 vs.5.8）,pregestational diabetes （OR,2.2 vs.3.8）,chronic hypertension （OR,4.6 vs.6.5）,gestational diabetes （OR,2.6 vs.3.5）,preeclampsia （OR,2.5 vs.3.6）,premature delivery （OR,1.8 vs.2.4）,postpartum hemorrhage （OR,1.5 vs.1.7）,placenta previa （OR,2.7 vs.4.0）,placental abruption （OR,1.4 vs.2.5）,cesarean delivery （OR,2.1 vs.2.5）,macrosomia （OR,1.2 vs.1.2）,low birth weight neonates （OR,1.6 vs.2.3）,and perinatal mortality （OR,1.6 vs.3.7）.Conclusion Maternal and neonatal risks are higher during the teenage years and at an advanced maternal age; 20-30 years of age is the lowest risk period for pregnancy and delivery.     

Availability and quality of emergency obstetric care, an alternative strategy to reduce maternal mortality: Experience of Tongji Hospital, Wuhan, China

The burden of maternal mortality (MM) and morbidity is especially high in Asia. However, China has made significant progress in reducing MM over the past two decades, and hence maternal death rate has declined considerably in last decade. To analyze availability and quality of emergency obstetric care (EmOC) received by women at Tongji Hospital, Wuhan, China, this study retrospectively analyzed various pregnancyrelated complications at the hospital from 2000 to 2009. Two baseline periods of equal length were used for the comparison of variables. A total of 11 223 obstetric complications leading to MM were identified on a total of 15 730 hospitalizations, either 71.35% of all activities. No maternal death was recorded. Mean age of women was 29.31 years with a wide range of 14-52 years. About 96.26% of women had higher levels of schooling, university degrees and above and received the education of secondary school or college. About 3.74% received primary education at period two (P2) from 2005 to 2009, which was significantly higher than that of period one (P1) from 2000 to 2004 (P<0.05) (OR: 0.586; 95% CI: 0.442 to 0.776). About 65.69% were employed as skilled or professional workers at P2, which was significantly higher than that of P1 (P<0.05). About 34.31% were unskilled workers at P2, which was significantly higher than that of P1 (P<0.05). Caesarean section was performed for 9,930 women (88.48%) and the percentage of the procedure increased significantly from 19.25% at P1 to 69.23% at P2 (P<0.05). We were led to conclude that, despite the progress, significant gaps in the performance of maternal health services between rural and urban areas remain. However, MM reduction can be achieved in China. Priorities must include, but not limited to the following: secondary healthcare development, health policy and management, strengthening primary healthcare services.     

Effects of pre-pregnancy body mass index on pregnancy outcomes

Prevalence of overweight and obesity has continued to increase among women of child bearing age all over the world in recent decades. Its impact on short-term and long-term maternal and fetal outcomes continued to grow, such as increased risk of gestational diabetes mellitus, gestational hypertension, preeclampsia, fetal macrosomia, perinatal mortality and chance for cesarean deliveries） What＇s more, underweight before pregnancy also has some hazardous effects on pregnant women and fetus, such as increased risk of delivering infants small for gestational age and preterm delivery.2 The present study determined the prevalence of each body mass index （BMI） group of an obstetric population of the mainland of China, and effects of the maternal pre-pregnancy BMI on multiple antepartum, intrapartum and neonatal outcomes.     

Effect of Body Mass Index on the Associations between Parity and Metabolic Syndrome and its Components among Northern Chinese Women

Objectives The aims of this study were to assess the associations between parity and metabolic syndrome(Met S) and its components and to evaluate the effects of body mass index(BMI) on these associations.Methods A total of 5,674 women were enrolled from Jidong and Kailuan communities(Tangshan,Hebei) in Northern China. All participants completed standardized questionnaires, physical examination,and biochemical measurements. Logistic regression analysis was used to test the associations.Results Compared with women with parity of one, nulliparous women had decreased odds ratios(ORs); those with parity of two had odds of abdominal obesity [OR = 1.45, 95% confidence interval(CI)1.17–1.81, P 0.001], high blood pressure(OR = 1.26, 95% CI: 1.03–1.54, P = 0.025), elevated fasting glucose levels(OR = 1.36, 95% CI: 1.03–1.79, P = 0.029), and Met S(OR = 1.39, 95% CI: 1.13–1.73, P =0.002); and those with parity of three or more had increased odds of elevated triglyceride levels(OR =1.42, 95% CI: 1.04–1.94, P = 0.027) and Met S(OR = 1.50, 95% CI: 1.10–2.05, P = 0.011) after complete adjustment for confounders. Furthermore, BMI and age subgroups partially modified the associations between parity and Met S and its components.Conclusions Parity is positively associated with Met S and select components in women. BMI is an important modifier involved in the associations between parity and MetS.     

Gestational weight gain and risk of gestational diabetes mellitus among Chinese women

Background Gestational diabetes mellitus （GDM） is a common complication during pregnancy,and gestational weight gain is one of the major and modifiable risk factors.This study aims to estimate the relationship between the rate of gestational weight gain before diagnosis of GDM and the subsequent risk of GDM.Methods A case-control study was conducted with 90 GDM cases and 165 women in the control group from May 2012 to August 2012 at Peking University First Affiliated Hospital.GDM was diagnosed according to the standards issued by the Ministry of Health of China in 2011.The plasma glucose levels,weights,and covariate data of the women were obtained based on medical records.Univariate analysis and unconditional Logistic regression model were used to estimate the associations.Results After adjusting for age at delivery,parity,and pre-pregnancy body mass index,the risk of GDM increased with increasing rates of gestational weight gain.Compared with the lower rate of gestational weight gain （less than 0.28 kg per week）,a rate of weight gain of 0.28 kg per week or more was associated with increased risk of GDM （odds ratio：2.03; 95％ confidence interval：1.15 to 3.59）.The association between the rate of gestational weight gain and GDM was primarily attributed to the increased weight gain in the first trimester.Conclusion High rates of gestational weight gain,particular during early pregnancy,may increase a woman＇s risk of GDM.     

Relation of supplementary feeding to resumptions of menstruation and ovulation in lactating postpartum women

Background Resumption of menstrual cycles is one of the indicators for restoration of reproductive capability in postpartum women. However, menstruation does not necessarily mean that ovulation has taken place. The aim of this study was to investigate the relation of supplementary feeding to return of menstruation and ovulation after delivery. Methods A questionnaire was used to obtain data from 101 breastfeeding mothers. The following elements were analyzed: age, education level, breastfeeding practice, time of return of menstruation, contraceptive practice, and starting time of supplementary feeding during the lactation at intervals of 6 weeks to 18 months after delivery. The ovulation was continuously monitored by ultrasonography and basal body temperature (BBT) measurement.Results By ultrasonography, 53 of the 101 women (52.5%) had the first ovulation (follicle &gt;1.8 cm in diameter) within 154 days after delivery on average, among whom 11 (10.9%, 11/101) had restoration of ovulation within 4 months and 42 (41.6%, 42/101) had it after 4 months. In women with follicles &gt;1.8 cm in diameter (n=53), the menstruation resumed (138±84) days after delivery, and the supplementary feeding was started at (4.0±1.1) months, which were significantly earlier than those in the women with follicular diameter &lt;1.7 cm (n=48; (293±88) days, (5.1±1.3) months; t=9.003, P&lt;0.01 and t=4.566, P&lt;0.01). In the women with follicles &gt;1.8 cm in diameter, 30 had return of menstruation before the end of ultrasonographic monitoring, while only 8 in the women with follicular diameter &lt;1.7 cm had menstrual resumption at the same time (χ&sup2;=16.91, P&lt;0.01). The starting time of supplementary feeding was positively correlated with the time of the restoration of menstruation (n=100, r=0.4764, P&lt;0.01) and first ovulation after delivery (n=53, r=0.5554, P&lt;0.01). In this series, no woman had pregnancy within 18 months postpartum.Conclusion Supplementary feeding can affect the restoration of menstrual cycles and ovulation in lactating postpartum women.     

北京地区成年女性尿失禁的流行病学研究

目的明确北京地区成年女性尿失禁的患病率、各种类型尿失禁的患病特点和相关影响因素。方法对北京市城区和郊区农村采用整群分层随机方法,抽取20岁以上成年女性5300人进行《国际下尿路症状问卷》现场调查。从20岁起,每10岁为一个年龄段,分为8组。结果共获得资料完整问卷5221份,未婚409人,已婚4812人。被调查的对象年龄22~99,平均年龄(46±17)岁。北京地区成年女性尿失禁的患病率为38·5%(2008/5221),压力性尿失禁、急迫性尿失禁和混合性尿失禁的患病率分别为22·9%(1197/5221)、2·8%(147/5221)和12·4%(649/5221)。随着年龄的增长,混合性尿失禁患病率明显增加。北京地区压力性、急迫性、混合性及其他类型尿失禁的构成比分别为59·6%(1197/2008),7·3%(147/2008)、32·3%(649/2008)和0·7%(15/2008)。多因素logistic回归表明:年龄、分娩方式、体重指数、高血压(舒张压高)、吸烟、便秘和慢性盆腔痛是北京地区成年女性压力性尿失禁发生的影响因素。结论北京地区成年女性尿失禁患病率比较高,是影响女性生活质量的主要疾病;尿失禁中以压力性尿失禁为主,其他依次为混合性尿失禁和急迫性。高龄、阴道分娩、体重指数高、高血压(舒张压高为主)、吸烟、便秘、慢性盆腔痛是北京地区成年女性压力性尿失禁的危险因素,剖宫产是其保护因素。     

河北保定市成年女性尿失禁的流行病学调查

目的调查保定市成年女性尿失禁(UI)的患病率及其相关影响因素。方法根据随机抽样原则,对2010年11月~2011年11月于保定市第三中心医院体检中心体检的年龄≥18岁的女性进行现场问卷调查。结果共获得有效问卷3 986份。调查结果显示,保定市成年女性UI患病率为26.39%(1 052/3 986),其中,以压力性尿失禁为主,其患病率为21.70%(865/3 986)。各类型尿失禁的患病率均随着年龄的增加而增加,绝经期后趋于稳定。χ2检验表明,成年女性尿失禁的影响因素是年龄、体重指数、重体力劳动、慢性盆腹痛、便秘、绝经、慢性咳嗽、慢性高血压病和生育史(P<0.05),2型糖尿病与成年女性尿失禁无关(P>0.05)。经阴道分娩与计划性剖宫产,以及梗阻性难产剖宫产与计划性剖宫产对压力性尿失禁的影响比较差异均有统计学意义(P<0.05),而经阴道分娩与梗阻性难产剖宫产对压力性尿失禁的影响差异无统计学意义(P>0.05)。结论保定市成年女性尿失禁患病率较高,且以压力性尿失禁为主。年龄、体重指数、重体力劳动、慢性盆腹痛、便秘、绝经、慢性咳嗽、慢性高血压病、生育史是保定市成年女性尿失禁发生的影响因素,而计划性剖宫产是压力性尿失禁的保护性因素。     

乌鲁木齐市部分社区成年女性压力性尿失禁的流行病学及危险因素分析

目的目前,国内对压力性尿失禁(stress urinary incontinence,SUI)的流行病学研究报告较少涉及到经济和医疗条件相对落后、多民族聚居的农牧区,对少数民族患病状况及发病因素的流行病学报道亦少见。新疆维吾尔族自治区有汉族、维吾尔族等47个民族,以农牧区为主,经济及生活条件相对滞后,早婚、多产现象较多见,健康意识欠缺。文中探讨乌鲁木齐市部分社区成年女性SUI的发病情况及危险因素,以求制订适合新疆地区的SUI防治措略,填补国内此方面的研究空白。方法于2010年5月至8月以问卷调查方式在乌鲁木齐市部分社区收集18岁以上女性资料共5552例,调查项目包括一般情况及分娩相关情况,慢性疾病以及尿失禁患病情况等。排除急迫性尿失禁和混和性尿失禁者383例,对其余5169例的数据进行各项因素的患病率分析。通过单因素、多因素logistic回归分析确定导致SUI发生的危险因素。结果乌鲁木齐市部分社区5169例成年女性中SUI患病率为23.6%。年龄、体重指数(body mass index,BMI)、腰臀比、分娩方式、产次、难产、会阴撕裂、会阴侧切、慢性咳嗽、便秘等因素可能为SUI发生的危险因素。结论女性SUI是由多种因素共同参与而发生,其所引发或伴随的一系列症状严重影响患者的生活质量及心身健康,早期预防对于避免或减少本病的发生具有积极意义。     

中国成年女性混合性尿失禁的流行病学调查

目的 研究中国成年女性混合性尿失禁(MUI)的患病率、危险因素以及高危人群等.方法 2006年2月至7月对中国6大地区(西北、西南、华北、华东、东北、中南)具有当地户籍或固定居住在当地10年以上的成年女性19 024人,使用问卷对于个体调查对象的一般情况和下尿路症状进行现场调查.结果 中国成年女性MUI患病率是9.4%,随着年龄的增长,MUI患病率升高.多因素Logistic回归分析表明:年龄、阴道分娩、便秘、盆腔器官膨出、慢性盆腔疼痛、呼吸系统疾病、月经紊乱、泌尿系统疾病、饮酒、盆腔手术、肥胖和文化程度高是中国成年女性MUI发生的独立影响因素.结论 中国成年女性MUI的发生随着年龄的增加而升高,是老年女性健康的常见问题.阴道分娩、便秘和盆腔器官膨出等是中国成年女性MUI患病的危险因素,而文化程度高是其保护性因素.     

南宁市成年女性尿失禁流行病学调查

目的：了解南宁市成年女性尿失禁（UI）的患病率以及UI不同类型构成比特征;探讨UI发病的危险因素。方法：采用整群抽样的方法,于2012年7月至2012年12月对南宁市22～78岁的1080名不同职业常住女性进行面对面[《国际下尿路症状问卷》及一般情况（人口学资料,疾病相关因素等）]调查,所得数据采用Epidata软件建立数据文件,采用SPSS13．0统计软件对资料进行统计分析。结果：合格问卷1052份,南宁市成年女性UI患病率为37．2％（391／1052）;压力性尿失禁（SUI）、混合性尿失禁（MUD和急迫性尿失禁（UUI）分别为19．2％（202／1052）、15．7％（165／1052）、2．3％（24／1052）。UI中以SUI为主,其余依次为MUI和UUI。多因素Logistic回归表明：高龄、阴道分娩、高血压、绝经、慢性咳嗽、盆腔手术以及便秘是南宁市成年女性UI的危险因素。结论：南宁市成年女性UI患病率与国内调查结果相近,分型以SUI为主。高龄、阴道分娩、高血压、绝经、慢性咳嗽、盆腔手术以及便秘是南宁市成年女性UI的危险因素。     

北京市密云地区女性压力性尿失禁发病影响因素分析

了解北京市密云地区女性压力性尿失禁的发病情况及发病危险因素,在密云部分乡镇招募志愿者,由调查员进行面对面问卷调查,获得有效资料8663份。成年女性尿失禁患病率为34．43％（2983例）。压力性尿失禁、急迫性和混合性尿失禁分别为20．66％（1790例）、4．78％（414例）和8．99％（779例）。调查发现高龄（OR=1．555）、BMI≥24kg／m^2（OR=0．556）、饮酒（OR=1．308）、便秘（OR=1．360）、分娩次数93次（OR=1．998）、生育巨大儿史（OR=0．572）是密云地区成年女性压力性尿失禁的危险因素。     

女性盆腔脏器脱垂和尿失禁的危险因素

目的：分析女性盆腔脏器脱垂和尿失禁的危险因素并探讨其发病机制。方法：选取2014年7月至2015年 10月在中南大学湘雅三医院健康管理中心行盆底功能筛查的女性共2 668人，按照有无尿失禁、盆腔脏器脱垂将其分 为尿失禁组、盆腔脏器脱垂组、两者均有组及正常组；比较各组年龄、BMI、绝经率、孕产次、分娩方式、盆腹协 调性的差异。结果：4组年龄、BMI差异均有统计学意义(P<0.05)；正常组的绝经率、孕产次与其他3组差异均有统 计学意义(P<0.05)，脏器脱垂组的绝经率、孕产次与两者均有组差异有统计学意义(P<0.05)，而尿失禁组的绝经率、 孕产次与脏器脱垂组、两者均有组差异无统计学意义(P>0.05)；正常组的分娩方式与其他3组差异均有统计学意义 (P<0.05)，两者均有组的分娩方式与脏器脱垂组、尿失禁组差异均有统计学意义(P<0.05)，而尿失禁组的分娩方式与 脏器脱垂组之间差异无统计学意义(P>0.05)。4组盆腹协调性均存在差异(P<0.05)，其中正常组的协调性最好，其次是 脏器脱垂组、尿失禁组，两者均有组最差。结论：年龄、绝经与否、妊娠及分娩次数、BMI、分娩方式均与盆腔脏 器脱垂和尿失禁的发生密切相关。出现尿失禁或脏器脱垂的女性盆腹协调性较差。     

成都地区产后早期尿失禁的危险因素分析

  目的  分析成都地区产妇产后早期尿失禁的发病情况,寻找其高危因素,为临床诊治提供参考。  方法  收集2014年1月至2018年1月在四川大学华西第二医院分娩并于分娩后6周复查的产妇9 918例,采用问卷调查方式,分析产妇产后6周尿失禁的患病率;采用χ2检验及多因素logistic回归分析影响其患病率的危险因素。  结果  实际有效调查9 550例产妇。成都地区产妇产后6周尿失禁的患病率为15.53%(1 483/9 550),其中以压力性尿失禁(73.03%,1 083/1 483)最常见。单因素分析显示:年龄、盆腔手术史、产前体质量指数(body mass index, BMI)、妊娠期尿失禁、新生儿体质量、产次、分娩方式、会阴侧切、会阴撕裂及第二产程时长均与产后6周尿失禁的发生有关(P < 0.05)。多因素logistic回归分析显示,相对于阴道分娩(顺产),剖宫产可降低尿失禁的发生概率〔比值比(odds ratio, OR)=0.373,P < 0.001〕;年龄≥35岁(OR=1.803,P=0.001)、有盆腔手术史(OR=1.260,P=0.003)、产前肥胖(BMI≥28 kg/m2)(OR=1.694,P=0.025)、妊娠期有尿失禁(OR=2.605,P < 0.001)、分娩新生儿体质量≥4 kg(OR=2.307,P=0.040)、经产(OR=1.284,P=0.023)及有会阴撕裂(OR=1.372,P=0.035)是产后6周尿失禁发生的独立危险因素。  结论  产后6周尿失禁在成都地区产妇中并不少见,以压力性尿失禁为主。顺产、高龄产妇、经产妇、盆腔手术史、产前肥胖、妊娠期尿失禁、新生儿体质量大及会阴撕裂是产后6周尿失禁的危险因素。     

上海地区2410例女性压力性尿失禁流行病学研究

目的 研究上海地区女性压力性尿失禁(SUI)的流行病学特点,寻找其高危因素,为临床诊治提供参考.方法 采用多级抽样法将上海地区10区县2600例28～89岁女性作为调查对象,包括工人、教师、职员、医护人员和公务员等职业.调查问卷共发放2600份,回收有效问卷2410份,应答率为92.7％.问卷设计包括年龄、职业、身高、体质量、内科并发症、生育情况和流产次数.并整合生活质量量表(QOL)及国际前列腺症状评分(IPSS).结果 2410例中急迫性尿失禁患者288例(11.9％),混合型尿失禁患者334例(13.8％),单纯SUI患者699例(29.0％),无尿失禁患者1089例.699例SUI女性平均年龄(54.4±12)岁,非SUI女性平均年龄(48.4±11)岁(P=0.000).SUI女性平均体质量指数(BMI)23.2±4.0,非SUI女性平均BMI 22.3±3.1(P =0.000).SUI女性合并代谢综合征共403例,非SUI女性合并代谢综合征352例(x2=111.97,P=0.000).SUI女性合并慢性便秘共491例,无尿失禁患者合并慢性便秘共322例(x2=284.07,P=0.000).SUI女性合并慢性支气管炎共213例,无尿失禁患者合并慢性支气管炎共174例(x2=52.74,P=0.000).生育与否与SUI发生率呈显著相关(x2 =29.81,P=0.000);多次分娩较单次分娩SUI发病率显著增高(x2=13.68,P=0.000).SUI女性平均QOL评分10.97分,平均IPSS为3.76分,两者显著相关(P=0.000);且SUI女性年龄与QOL评分呈显著相关(P=0.000).结论 SUI已成为我国中老年女性重要的排尿障碍性疾病,其发病率呈逐年增长态势.SUI的高发年龄呈双峰型,主要发病年龄段分别为40 ～ 59岁及80岁以上.发病率与年龄呈显著相关.肥胖、合并代谢综合征、慢性便秘、慢性支气管炎、生育和多次分娩均是SUI发病的高危因素.在SUI患者中,除漏尿外下尿路症状亦是影响其生活质量的重要因素,选择性M受体阻滞剂的应用可能对改善其生活质量有益.     

绝经后妇女尿失禁患病率及相关因素

目的研究北京市4个中心城区老年妇女尿失禁及泌尿道萎缩症状的患病情况并分析尿失禁的相关因素.方法通过分层多级整群抽样,对北京市4个中心城区的1 257名60岁及以上绝经后妇女进行各种下泌尿道症状及治疗情况的问卷调查及临床检查,计算各种泌尿道症状患病率,Logistic回归方法分析尿失禁的相关因素.结果绝经后妇女总的尿失禁患病率为61.0%,其中以张力性尿失禁所占比例最高(64.5%);夜尿频患病率66.8%.张力性尿失禁发病与肥胖、受教育年限长,长时间站立、弯腰或下蹲能力差有关,而握力大可减少张力性尿失禁发病;急迫性尿失禁发病与肥胖有关,而受教育年限长、握力大可减少急迫性尿失禁发病.结论北京市4个中心城区60岁及以上绝经后妇女尿失禁症状患病率高于以往文献报道,肥胖和肌肉力量与尿失禁有关.