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謝筱芸 成年女性夜間遺尿的盛行率與下泌尿道症狀的關聯性 2017/3/31 下午 06:59:49 0
原 文 題  目 Nocturnal enuresis: prevalence and associated LUTS in adult women attending a urogynaecology clinic
作  者 Patrick Campbell, Weiguang Li, John Money-Taylor, Joanna Davies, Thomas Gray, Stephen Radley
出  處 International Urogynecology Journal
出版日期 February 2017
評 論 夜間遺尿是指夜間睡夢中無法控制的漏尿。夜間遺尿又可分為初發型與次發型: 初發型是為五歲以上的孩童發生夜間遺尿,次發性則是兒童六個月以上或成人一年以上未發生夜間遺尿卻再發。

本文為英國一家婦女泌尿診所針對就診的成年女性,進行夜間遺尿的盛行率與下泌尿道症狀關聯性的世代研究。結果發現2012-2015年有2302名納入研究的女性,其中23%有夜間遺尿的情形,而且與下泌尿道症狀中的膀胱過動症、夜尿、應力性尿失禁皆有統計學上的顯著差異(p < 0.005)。接受研究的2302名女性中有84名接受經陰道尿失禁吊帶手術(TVT),41名女性(49%)術前有夜間遺尿的情形,術後這41名女性中,60%的女性夜間遺尿情況改善,與應力性尿失禁的改善與否有統計學上的顯著差異(p < 0.005),但與膀胱過動症(p = 0.335) 或夜尿(p = 0.141)的改善與否則沒有明顯關係。

夜間遺尿對成年女性的生活品質影響甚大,雖然此研究的盛行率明顯高於一般女性盛行率,但此研究提供可進一步探討應力性尿失禁與夜間遺尿的關聯性,亦可對於醫者提供患者在經陰道尿失禁吊帶手術後夜間遺尿改善與否的諮詢。
abstract

Introduction
The primary objective of this study was to investigate the prevalence of NE and its association with other lower urinary tract symptoms (LUTS).

Methods
A validated pelvic floor questionnaire [electronic Personal Assessment Questionnaire–Pelvic Floor (ePAQ-PF)] was completed by 2302 women attending a urogynaecology clinic over a 3-year period. Association between NE and overactive bladder (OAB), stress incontinence (SUI) and nocturia was assessed using logistic regression. Subgroup analysis was performed on women with NE undergoing transvaginal tape (TVT). Ethical approval was acquired from the University of Sheffield and statistical analysis performed using SPSS version 22.

Results
The overall prevalence of NE reported in the cohort was 23 % (536 women). The reporting of NE was significantly associated with OAB (p < 0.005), SUI (p < 0.005) and nocturia (p < 0.005). Of 84 women undergoing TVT, 49 % reported NE preoperatively. These women reported significantly more severe symptoms of SUI and OAB (p < 0.05). Sixty percent reported improvement or cure of NE postoperatively, and this was dependent on improvement or cure of SUI (p < 0.005). The presence of NE was a negative predictor for improvement in symptoms of SUI following TVT (p = 0.037).

Conclusion
This study provides insight into NE, a commonly reported symptom in women attending urogynaecology clinics. To our knowledge, this is the first study to implicate stress incontinence as an important aetiological factor in women with NE. Further studies are required to better understand the aetiology of NE in adult women and relate this to management and outcome.

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