首页 | 本学科首页   官方微博 | 高级检索  
相似文献
 共查询到20条相似文献,搜索用时 15 毫秒
1.
背景:盆底磁刺激是近年来兴起的治疗尿失禁的新疗法.目前关于盆底磁刺激治疗根治性前列腺切除术后尿失禁国外仅有一个中心的研究报道.目的:对比分析了盆底磁刺激和盆底肌锻炼治疗根治性前列腺切除术后尿失禁患者的疗效.设计、时间及地点:随机对照临床试验,于2005-02/2007-02在解放军第四军医大学西京医院泌尿外科完成.对象:根治性前列腺癌切除术后出现尿失禁患者24例,随机分为盆底磁刺激组和盆底肌锻炼组,每组12例.方法:分别接受盆底磁刺激和盆底肌锻炼治疗,盆底磁刺激频率为10 Hz,间歇持续10 min后休息3 min,继而调节频率为50 Hz,反复刺激20 min,每次治疗过程为30 min左右,每周2次.盆底肌锻炼治疗患者取侧卧位,嘱其作肛门收缩与放松动作,并类似于排尿时突然中断排尿样收缩肛门括约肌,同时保持腹肌松弛.每次收缩持续3 s,然后缓慢放松3 s,连续训练20min,每日3次.连续治疗6周.主要观察指标:采用生活质量评分和国际尿失禁咨询委员会制定的尿失禁问卷表简表评分进行疗效评价.结果:24例患者全部进入结果分析.治疗前,2组尿失禁问卷表简表评分差异无显著性意义,治疗1个月后盆底磁刺激组和盆底肌训练组患者尿失禁评分和生活质量评分均下降(P<0.05~0.01),两组比较差异无显著性意义,治疗后3个月及6个月两组评分继续降低,盆底磁刺激治疗组患者尿失禁评分和生活质量评分均低于盆底肌训练组(P<0.05).两组均无治疗并发症发生.结论:盆底磁刺激疗法对于根治性前列腺切除术后尿失禁的治疗效果显著,优于盆底肌锻炼.  相似文献   

2.
Prostate cancer is one of the most prevalent malignancies diagnosed in North American men. Typically, men diagnosed with localized prostate cancer have two options for curative treatment: radiation therapy or radical prostatectomy (RP). Many men choose RP to remove the cancer; however, the intervention has two possible side effects that patients dread: erectile dysfunction and urinary incontinence (UI). At least 50% of men who undergo RP suffer from UI, which can lead to embarrassment, loss of a sense of control, depression, and decreased social interactions. The Human Response to Illness Model provides a framework to gain a comprehensive understanding of the physiologic, pathophysiologic, behavioral, and experiential perspectives as well as personal and environmental factors related to UI following RP. Knowledge gained from these perspectives will help nurses design strategies that facilitate coping and improve outcomes in men with UI following RP.  相似文献   

3.
Management of urinary incontinence following radical prostatectomy   总被引:1,自引:0,他引:1  
INTRODUCTION: The impact of a urology oncology nurse specialist in the practice environment to assist with both pre and postoperative education needs of men undergoing genitourinary surgery for cancer was evaluated. OBJECTIVE: This study aimed to improve the preoperative process and teaching for men planning surgery for genitourinary cancers, including the delivery of pathology results. A secondary aim was to decrease the incidence of postoperative incontinence. METHODS: Male patients undergoing a radical prostatectomy were recruited. Patients who underwent surgery were evaluated both before and after the urology oncology nurse specialist role was established. Followup was via phone call interview and International Prostate Symptom Score questionnaire. RESULTS: Men who received the personalized education from the urology oncology nurse specialist had a higher return of continence postoperatively, as well as higher satisfaction scores with the outcome of their surgery, including higher quality of life scores. CONCLUSION: The urology oncology nurse specialist role had a significant impact on the postoperative incontinence rate and provided a missing patient education piece that improved the overall patient satisfaction rate with oncology-related care.  相似文献   

4.
本文综述了前列腺癌根治患者术后尿失禁自我管理措施现状及存在问题,旨在为临床护理及健康宣教提供更系统、全面的参考和借鉴,使患者掌握多元的尿失禁应对方法,提高其生活质量水平,从身体到心理快速回归社会.  相似文献   

5.
目的:总结良性前列腺增生癌患者耻骨上经膀胱前列腺切除术和经尿道前列腺电切除术术后尿失禁的影响因素、预防措施及手术时机的选择。方法:将415例患者分为2组:197例行耻骨上经膀胱前列腺切除术,218例行经尿道前列腺电切除术。术前行相关尿流动力学检查,术后2组患者行1个月,6个月,12个月追踪随访。结果:80%以上的良性前列腺增生症患者术前合并膀胱功能改变,术后尿失禁患者均发生于失代偿的患者。结论:前列腺切除术后尿失禁的因素是多方面,膀胱功能障碍是其主要原因之一,通过尿流动力学检查术前评估患者的膀胱和括约肌功能,合理把握手术时机,争取在膀胱代偿期解决梗阻,可以减少术后尿失禁的发病率。  相似文献   

6.
Urinary incontinence (UI) is a major complication after a radical prostatectomy and this problem can last for over a year after surgery. There is a need for valid research instruments to assess the extent of this problem. The purpose of this study was to assess the reliability and validity of a urinary incontinence scale after radical prostatectomy (UISRP). Psychometric testing of the UISRP using a sample of 124 patients who had been diagnosed with prostate cancer and undergone radical prostatectomy was conducted to determine the quality of items, internal consistency reliability, test–retest reliability, construct validity and criterion-related validity. The final sample consisted of 102 patients (92·7%) in the data analysis. The results indicated that one factor was identified that accounted for 60·28% of the explained variance. The Cronbach's alpha coefficient was 0·90. Two-week test–retest reliability (ICC = 0·56; 95% CI = 0·26–0·72) was provided. Criterion-related validity was supported by correlation with the University of California, Los Angeles Prostate Cancer Index urinary function subscale (r = 0·74, p < 0·001) and a criterion variable measuring a 1-h pad test (r = 0·58, p < 0·001. The UISRP displays satisfactory reliability and validity for radical prostatectomy patients. The UISRP is a valuable research measure and can identify priority areas for nursing interventions designed to improve prostatectomy patients' outcomes.  相似文献   

7.
目的:应用生物反馈电刺激仪可以指导患者进行正确自主的盆底肌肉训练,观察其对腹腔镜前列腺癌根治术后控尿功能恢复的作用.方法:选择2005-07/2007-06中山大学附属第三医院泌尿外科收治腹腔镜前列腺癌根治术后尿失禁患者41例,轻度12例,中度23例,重度6例.采用加拿大Laborie公司生产的UROSTIM型盆腔生物反馈电刺激治疗仪电刺激联合盆底肌肉训练,生物反馈电刺激每日1次.5次为1个疗程,根据患者尿失禁程度分别治疗一两个疗程.疗效判定标准:治愈,自觉尿失禁症状消失、小便能自控,排尿正常,尿垫试验阴性;有效,自觉尿失禁次数明显减少、尿垫试验连续3次以上阴性;无效,尿失禁症状无明显改善,尿垫试验阳性.治疗结束后4周评价其治疗效果,追踪观察随访3~12个月.结果:41例术后不同程度尿失禁患者,治愈23例(56.1%),有效11例(26.9%),无效7例(17.0%),总有效率为83%.轻度尿失禁患者,治愈11例,有效1例;中度尿失禁患者,治愈11例,有效8例,无效3例;重度尿失禁患者,治愈1例,有效2例,无效3例.结论:应用生物反馈电刺激仪可促进前列腺癌根治术后患者控尿功能的恢复.  相似文献   

8.
Nurses use several conservative methods for treating urinary incontinence after radical prostatectomy. Functional electrical stimulation (FES) has a recognized role, while extracorporeal magnetic innervation (ExMI) is still under evaluation in the international guidelines. Few data are available in literature, regarding comparisons between these two treatments. The aim of the study is to compare electrical stimulation and magnetic innervation for treating urinary incontinence after radical prostatectomy. Twenty‐two patients treated with ExMI and 18 treated with FES were enrolled in a retrospective study. ExMI was available for 6 weeks; the number of times ExMI was required by the patients to reduce their leakages to 10 g/d or less was compared. The groups had comparable age and body mass index. Initial leakages showed clinically relevant differences (median = 80 g/d in the ExMI patients and 150 g/d in the FES group). After 6 weeks, 71·9% of ExMI patients and 29·2% of FES patients had completed rehabilitation. The difference was statistically significant even after adjusting the analyses for initial leakages (p = 0·008). Six patients treated with ExMI had already undergone FES, with no clinically relevant results after five sessions (leakages reduction <50 g/d). The difference remained even after removing the data of these patients from the analysis (p = 0·004). Both FES and ExMI produce muscle strengthening, which is just one step of rehabilitation. Our findings suggest the possibility of using ExMI instead of FES to reduce the times required to improve muscular performance. Pelvic muscle exercises remain essential to develop the ability to automatically perform the contractions needed to avoid leakages.  相似文献   

9.
Total prostate-specific antigen (PSA) and complexed PSA were determined in venous blood from 12 patients with prostate cancer before and after radical prostatectomy by using Immuno 1 PSA assays. The elimination kinetics of complexed PSA were compared with that of total PSA. Nearly constant concentrations of complexed PSA were found during the first six hours after surgery, in contrast to the rapid elimination of free PSA and the significant decrease of total PSA. From day one to ten there was a continuous and nearly identical decrease of complexed PSA compared to total PSA. Our findings suggest that the initial rapid decrease of free PSA immediately after operation could be caused by formation of new PSA-complex.  相似文献   

10.
Urinary incontinence (UI) is a major complication among patients after radical prostatectomy (RP). Although previous research supports the efficacy of pelvic floor exercises for male UI, there are both positive and no significant effects. The purpose of this study was to examine the effect of pelvic floor exercises on UI after RP. This was a quasi‐experimental, randomized, mixed‐method study design. All participants were older than 45 years and had undergone an RP. Outcome measurements included a 1‐h pad test, personal demographics, and disease‐related data. After catheter removal, participants were distributed into either an exercise group (n = 39) or a non‐exercise group (n = 28). Patients in the exercise group took part in a pelvic floor exercise during their regular daily activities. The non‐exercise group did not perform the prescribed exercise. We examined urinary function at 1, 3 and 6 months after catheter removal. Following a mixed‐model anova test for differences, the results of the pad test revealed significant differences for the main effect of time (F = 75·30,P < 0·001), indicating that the amount of urine leakage decreased over time regardless of the group. Results for the main effect of group were statistically significant (F = 8·85,p < 0·01), indicating that urine leakage also decreased over time in both groups, but that urinary control in the exercise group was better than in the non‐exercise group. Although improvements in surgical technique have significantly improved the outcome of prostate surgery, we believe that patient education regarding pelvic floor exercises by a nurse prior to and after surgery has a significant impact on the early recovery of urinary continence. We believe these exercises would certainly have a positive impact on our patients undergoing RP by improving the quality of life after major urological surgery.  相似文献   

11.
目的调查分析腹腔镜下前列腺癌根治术(ELRP)后并发尿路感染危险因素,并探讨护理干预对策。方法选取2017年1月—2020年10月在医院行ELRP患者200例,将其中并发尿路感染的53例患者作为病例组,未并发尿路感染的147例作为对照组。采用单因素和多因素Logistic回归分析并发尿路感染的影响因素。结果经过单因分析素筛选,多因素Logistics回归分析发现,年龄、BMI、术前肾功能不全、ASA等级、D-二聚体是并发尿路感染的影响因素(P <0.05)。结论年龄≥60岁、BMI≥30、术前肾功能不全、CCI评分≥2分、ASA等级Ⅲ~Ⅳ、D-二聚体1.5μg/ml是并发尿路感染的独立危险因素,护理人员需加强围术期预防性护理干预,降低并发尿路感染风险,促进患者早日康复。  相似文献   

12.
OBJECTIVE: To assess the risk of local recurrence, systemic progression, and death from cancer among patients who experience biochemical relapse after radical retropubic prostatectomy and to stratify those patients by prostate-specific antigen (PSA) doubling time (DT). PATIENTS AND METHODS: We identified patients who experienced biochemical recurrence (defined as a PSA level < or =0.4 ng/mL) after radical prostatectomy from January 1, 1990, to December 31, 1999, for prostate adenocarcinoma. The PSA-DT was calculated by log linear regression using all PSA values within 2 years of biochemical recurrence. Local recurrence- and systemic progression- free survival and cancer-specific survival were estimated using the Kaplan-Meier method and analyzed by the log-rank test and Cox models. RESULTS: Biochemical recurrence was noted in 1521 (27%) of 5533 men during the follow-up period. Of the 1064 patients with a calculable PSA-DT, 322 (30%) had a PSA-DT of less than 1 year, 357 (34%) had a PSA-DT of 1 to 9.9 years, and 385 (36%) had a PSA-DT of 10 years or more. Patients with a PSA-DT of 10 years or more were less likely to have a higher preoperative PSA level, Gleason score, advanced pathologic stage, and seminal vesicle invasion. Patients with a PSA-DT of 10 years or more were at low risk of local recurrence (hazard ratio [HR], 0.09; 95% confidence interval [CI], 0.06-0.14; compared with patients with a PSA-DT of <1 year), systemic progression (HR, 0.05; 95% CI, 0.02-0.13), or death from cancer (HR, 0.15; 95% CI, 0.05-0.43). CONCLUSIONS: Prostate-specific antigen DT is an independent predictor of clinical disease recurrence and mortality after surgical biochemical failure. Risk stratification into high-, intermediate-, and low-risk categories based on the PSA-DT provides helpful clinical information and assists in the development of salvage therapy trials.  相似文献   

13.
目的:探讨尿动力学检查在女性压力性尿失禁(stress urinary incontinence,SUI)诊断中的作用.方法:对77例SUI行系统的尿动力学检查,21例同时行半卧位和站立位腹压漏尿点压(abdominal leak point pressure,ALPP)测定.结果:77例中不稳定膀胱者7例(9.1%).61例(79.2 %)ALPP测定见有漏尿:其中56例半卧位测定有35例(62.5%)见有漏尿;42例站立位测定有36例(85.7%)见有漏尿;半卧位无漏尿,改为站立位见漏尿的有8例.最大尿流率为(31.4±11.3)(16.3 ~ 70.1) mL/s、最大尿流率时的逼尿肌压为(16±8)(2 ~ 37) cmH2O.33例手术,随访21例,16例无尿失禁复发,5例改善.结论:尿动力学检查有助于SUI的诊断和鉴别诊断,对手术有指导意义,站立位ALPP测定能提高检查准确性.  相似文献   

14.
AIM: To assess the 6-mo and 12-mo functional outcomes after retropubic, laparoscopic and robot-assisted laparoscopic radical prostatectomy retropubic radical prostatectomy(RRP) laparoscopic radical prostatectomy(LRP); robot-assisted laparoscopic prostatectomy(RARP). METHODS: A literature search was conducted using the Pub Med, EMBASE, The Cochrane Library and the Web of Knowledge databases updated to March, 2014 for relevant published studies. After data extraction and quality assessment via the Newcastle-Ottawa Scale or the Cochrane collaboration's tool for assessing risk ofbias, meta-analysis was performed using Rev Man 5.1. Either a random-effects model or a fixed-effects model was used. Potential publication bias was assessed using visual inspection of the funnel plots, and verified by the Egger linear regression test. RESULTS: Thirty-seven studies were identified in total: 14 articles comparing LRP with RRP, 12 articles comparing RARP with RRP, and 11 articles comparing RARP with LRP. For urinary continence, a statistically significant advantage was observed in RARP compared with LRP or RRP both at 6 mo [odds ratio(OR) = 1.93; P 0.01, OR = 2.23; P 0.05, respectively] and 12 mo(OR = 1.47; P 0.01, OR = 2.93; P 0.01, respectively) postoperatively. The continence recovery rates after LRP and RRP, with obvious heterogeneity(6-mo: I2 = 74%; 12-mo: I2 = 75%), were equivalent(6-mo: P = 0.52; 12-mo: P = 0.75). In terms of potency recovery, for the first time, we ranked the three surgical approaches into a superiority level: RARP LRP RRP, with a statistically significant difference at 12 mo [RARP vs LRP(OR = 1.99; P 0.01); RARP vs RRP(OR = 2.66; P 0.01); LRP vs RRP(OR = 1.34; P 0.05)], respectively. Meta-regression and subgroup analyses according to adjustment of the age, body mass index, prostate volume, Gleason score or prostate-specific antigen did not vary significantly. CONCLUSION: Current evidence suggests that minimally invasive approaches(RARP or LRP) are effective procedures for functional recovery. However, more high-quality randomized control trials investigating the long-term functional outcomes are needed.  相似文献   

15.
ObjectivesThis systematic review and metaanalysis compared the effects of biofeedback-assisted pelvic floor muscle training with those of pelvic floor muscle training alone in patients with urinary incontinence after radical prostetactomy.DesignA review and metaanalysis study design.Data sourcesThe metaanalysis was conducted in accordance with the Preferred Reporting Items for Systematic Reviews and MetaAnalyses guidelines. A systematic search of PubMed/Medline OVID, the Cumulative Index to Nursing and Allied Health Literature, Cochrane Library, BioMed Central, Web of Science, Chinese Electronic Periodical Services, Chinese Journal and Thesis Database, and China National Knowledge Infrastructure was performed for retrieving records.Review methodsFor determining the effects of training type on urinary incontinence, randomized controlled trials on biofeedback-assisted pelvic floor muscle training with or without electrical stimulation were compared with those on pelvic floor muscle training with or without electrical stimulation, respectively, in the metaanalysis. The Cochrane Collaboration tool in the Cochrane Handbook for Systematic Review of Interventions 5.1.0 was used to assess the methodological quality of the included trials. Subjective and objective measurement of urinary incontinence improvement and the quality of life were the primary and secondary outcome measures, respectively. Data were analyzed using Comprehensive Meta-Analysis software 2.0. In addition, subgroup analyses and metaregression were performed to explore the possible sources of heterogeneity.ResultsThirteen randomized controlled trials involving 1108 patients with prostatectomy incontinence were included. The immediate-, intermediate-, and long-term effects of objectively measured biofeedback-assisted pelvic floor muscle training on urinary incontinence were significant (mean effect size = −0.316, −0.335, and −0.294; 95% CI: −0.589 to −0.043, −0.552 to −0.118 and −0.535 to −0.053; p = 0.023, 0.002, and 0.017, respectively) when compared with those of pelvic floor muscle training alone. However, when urinary incontinence was measured subjectively, only the intermediate and long-term effects of biofeedback were found (p = 0.034 and 0.005, respectively). Small-to-moderate immediate- and intermediate-term effects on the quality of life were observed when biofeedback-assisted pelvic floor muscle training was compared with pelvic floor muscle training alone. No publication bias was observed among studies.ConclusionsBiofeedback can be an adjunct treatment to pelvic floor muscle training for reducing urinary incontinence in patients who have undergone radical prostatectomy.  相似文献   

16.
目的: 探讨初产妇足月阴道分娩后尿失禁发生的高危因素。方法: 收集2017年1月至2017年4月在国际和平妇幼保健院产后6~8周复诊的经阴道足月分娩的初产妇1211例。同时行尿失禁问卷调查,根据结果分为产后尿失禁组(178例)和非尿失禁组(1033例,对照组),用单因素和多因素Logistic回归分析各种产科因素与产后早期尿失禁发生的相关性。结果:在1211例阴道分娩的初产妇中,孕期尿失禁的发生率为25.76%(312/1211),产后尿失禁的发生率为14.70% (178/1211);产后尿失禁组的年龄、第二产程时长显著大于对照组,两组比较差异有统计学意义(P=0.000,0.020);而比较两组产妇分娩孕周、孕前体重指数(BMI)、孕期体重增加量、产时BMI、新生儿出生体重、会阴裂伤率、会阴侧切率以及产钳助产率,两组差异均无统计学意义(P=0.890,0.052,0.592,0.107,0.097,0.916,0.491,0.887)。多因素Logistic回归分析显示,产妇年龄大于35岁(OR=2.219,95%CI:1.124~4.382,P=0.022)以及第二产程大于2小时(OR= 1.660,95%CI:1.018~2.706,P=0.042)是产后UI发生的独立高危因素。结论: 初产妇阴道分娩产后尿失禁的发生与年龄及第二产程有关。产后尿失禁发生率高,应加强产妇盆底疾病的预防及重视产后康复训练,尤其是具有高危因素的产妇。  相似文献   

17.
目的探讨尿流动力学在女性压力性尿失禁TVT-O手术治疗中的临床价值。方法采用TVT-O手术治疗26例女性压力性尿失禁患者。检测患者术前术后尿流动力学结果,并进行对比。根据患者主诉,排尿正常、完全自控、无尿失禁为治愈,尿失禁减少〉50%为改善。结果 26例患者手术后主观症状均明显改善。其中主观治愈24例,主观改善2例。尿流动力学检测指标中,最大尿流率在治疗前后无明显改变(P〉0.05),最大尿道压和腹压漏尿点压力在治疗前后有明显改变(P〈0.05),最大尿道闭合压(MUCP)在术前均为负值,术后均为正值。结论尿流动力学对于女性压力性尿失禁患者选择恰当的治疗方案,以及对TVT-O手术治疗效果的评估有着重要临床价值。  相似文献   

18.
目的 了解中老年前列腺癌根治术后患者社会疏离现状,探讨其影响因素.方法 采用一般情况调查表、一般疏离感量表、简易应对方式量表、社会支持评定量表对210例中老年前列腺癌根治术患者进行横断面的调查.采用多重线性回归分析探讨影响中老年前列腺癌根治术后患者社会疏离的因素.结果 中老年前列腺癌根治术后患者社会疏离得分为(44.4...  相似文献   

19.
Urinary incontinence (UI) and sexual dysfunction are common complications among patients after radical prostatectomy (RP). Although a nerve‐sparing procedure has been recommended to reduce these two complications, the benefits of this procedure still need to be examined in Taiwan. The purposes of this study were to describe and compare the changes over time in the urinary and sexual function of prostate cancer patients treated with or without nerve‐sparing RP. In this study, a longitudinal pre‐test and four post‐test study designs were employed. In all, 62 prostate cancer patients who had undergone an RP were recruited from two hospitals in southern Taiwan. Structure questionnaires and one‐hour pad tests were administered to the patients upon their first visit to the urological clinic (as baseline data) and at follow‐up visits at the clinic 3, 6, 9 and 12 months after RP. All of the patients experienced UI and sexual dysfunction from the first month after undergoing an RP to 12 months. A two‐way multivariate analysis of variance with repeated measurements indicated that the nerve‐sparing procedure (F = 4·41, p < 0·01) and time (F = 12·47, p < 0·001) significantly affected the combined dependent of UI and sexual function. The results of a univariate analysis of variance indicated that the International Index of Erectile Function (IIEF) scores were significantly different for patients who underwent the nerve‐sparing procedure (F = 7·72, p = 0·001), but pad weights were not altered by the effects of the nerve‐sparing procedure. Regarding the effects of time, the results demonstrated that both pad weights and IIEF scores changed significantly over time (F = 12·47, p < 0·001). This study demonstrates that nerve‐sparing positively affects sexual dysfunction, but that it exhibits limited benefit for UI in RP patients. These results can assist health care providers in providing patients with pre‐operation information.  相似文献   

20.
目的 探讨前列腺增生患者前列腺电切除术后盆底肌康复训练方案的构建。方法 通过文献检索、定性访谈和专家组会议讨论,初步构建前列腺增生术后患者盆底肌康复训练方案。采用德尔菲法进行两轮专家函询,根据专家意见和建议对方案进行修改。结果 最终构建的前列腺增生术后患者盆底肌康复训练方案包括3个一级指标(康复训练评估、康复训练时间及内容、康复训练形式),12个二级指标,以及53个三级指标。结论 构建的前列腺增生术后患者盆底肌康复训练方案科学、安全、可行,可为前列腺增生术后患者盆底肌康复训练临床护理实践提供指导。  相似文献   

设为首页 | 免责声明 | 关于勤云 | 加入收藏

Copyright©北京勤云科技发展有限公司  京ICP备09084417号