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| 發表人 | 討論主題 | 發表時間 | 討論數 |
| 張尚仁 | Incidence and Remission of Lower Urinary Tract Symptoms During 12 Years After the First Delivery: A Cohort Study | 2008/11/28 下午 06:43:47 | 0 |
| 原 文 | 題 目 | Incidence and Remission of Lower Urinary Tract Symptoms During 12 Years After the First Delivery: A Cohort Study |
| 作 者 | Lars Viktrup, and Gunnar Lose | |
| 出 處 | Journal of Urology | |
| 出版日期 | 2008年九月 | |
| 評 論 |
在討論婦女尿失禁的議題時，尿失禁與分娩及女性賀爾蒙變化的關聯性是被廣泛接受的概念。分娩過程與造成後續排尿症狀的危險因子也曾被加以討論。此篇文章的有趣之處，在於其觀察婦女第一次分娩後的下尿路症狀長達十二年的時間，提供我們了解分娩前後女性之應力性尿失禁、急迫性尿失禁、頻尿和夜尿這些症狀時序上的變化。或可作為參考，我們亦可統計台灣本土的資料。 本研究收集兩百四十二位初次分娩的丹麥女性，於分娩後三到五天、三個月、五年及十二年後，以國際尿失禁醫學會之問卷評估其下尿路症狀，以尿失禁、頻尿和夜尿為主。以應力性尿失禁來說，懷孕期間至分娩後三到五天，有此症狀的病人達到36.2%，三個月後下降至0%，但五年及十二年後又達到26.3%及25.2%。以夜尿來說，懷孕期間有30.5%婦女有此症狀，三個月後完全緩解，但十二年後上升至5.9%。其他症狀亦有隨時間起伏的情形，但其共同點是，女性的下尿路症狀會隨年紀的增長而逐漸上升。 這篇文章顯示出女性懷孕中的下尿路症狀會於分娩後數月內有顯著的改善，但長期的影響仍無法忽略，或許我們日後可進一步分析不曾懷孕的婦女和多次分娩的婦女其下尿路症狀在時序上的變化。作為預防、診斷和治療婦女尿失禁的參考。 |
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| abstract |
Purpose: We estimated the incidence and remission of lower urinary tract symptoms during the 12 years following the first pregnancy and delivery. Materials and Methods: In a cohort study 242 primiparae were questioned about lower urinary tract symptoms 3 months, 5 years and 12 years after the first delivery. Results: From 3 months to 5 years after first delivery the incidence of stress urinary incontinence, urge urinary incontinence, urgency, diurnal frequency and nocturia was 56 of 213 cases (26.3%), 33 of 219 (15.1%), 33 of 206 (16.0%), 49 of 219 (22.4%), and 6 of 225 (2.7%), respectively. Remission of stress urinary incontinence, urge urinary incontinence, urgency, diurnal frequency and nocturia during the same period occurred in 1 of 11 cases (9.1%), 2 of 5 (40%), 2 of 5 (40%), 4 of 7 (57.1%) and 1 of 1 (100%), respectively. From 5 to 12 years after the first delivery the incidence of stress urinary incontinence, urge urinary incontinence, urgency, diurnal frequency and nocturia was 40 of 158 cases (25.3%), 25 of 188 (13.3%), 24 of 175 (13.7%), 40 of 174 (23.0%) and 13 of 220 (5.9%), respectively. Remission of stress urinary incontinence, urge urinary incontinence, urgency, diurnal frequency and nocturia during the same period occurred in 14 of 66 cases (21.2%), 13 of 36 (36.1%), 22 of 36(61.1%), 14 of 52 (26.9%) and 4 of 6 (66.7%), respectively. Of 62 women with pure stress urinary incontinence during the first pregnancy and puerperium 20 (32.2%) had pure stress urinary incontinence, 3 (4.8%) had pure urge urinary incontinence and 15 (24.2%) had mixed urinary incontinence 12 years later. Of 13 women with pure urge urinary incontinence during the first pregnancy and puerperium 3 (23.1%) had pure urge urinary incontinence, 2 (15.4%) had pure stress urinary incontinence and 3 (23.1%) had mixed urinary incontinence 12 years later. The overall prevalence of lower urinary tract symptoms 12 years after the first delivery increased significantly. Conclusions: The incidence and remission of lower urinary tract symptoms after the first pregnancy and delivery fluctuate and the types of urinary incontinence may interchange, while the overall prevalence of lower urinary tract symptoms increases in the long term. |
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