女性尿失禁与盆底疾病症状的相关性研究

Study on the relationship between female urinary incontinence and pelvic floor disease symptoms

目的评价女性尿失禁与盆底疾病症状的相关性。方法选取2017年8月至2019年1月北京市通州区中西医结合医院诊治的下尿路症状女性患者460例为研究对象,采用国际尿失禁咨询委员会尿失禁问卷表简表(ICIQ-SF),评价尿失禁严重程度,采用盆底器官脱垂/尿失禁对性功能影响调查问卷(PISQ-IR)评价患者性功能,采用盆底功能障碍问卷(PFDI-20)评价盆底器官脱垂,采用盆腔器官脱垂定量分期法(POP-Q)对盆腔脏器脱垂情况进行分级。结果 345例患者诊断为尿失禁(UI),其中压力性尿失禁(SUI)72例,急迫性尿失禁(UUI)83例,混合型尿失禁(MUI)165例,其他类型UI 25例;非UI患者115例。UI患者性功能及盆腔器官脱垂症状评分低于非UI患者,且MUI患者性功能与盆腔器官脱垂症状评分低于SUI与UUI,差异均具有统计学意义(P<0.05);MUI患者POP-Q分期较其他类型UI及非UI患者高,差异均具有统计学意义(P<0.001)。多元线性回归分析结果显示UI分型与性功能、盆腔器官脱垂症状独立相关。结论混合型尿失禁的患者性功能较差,且盆腔脱垂症状也更为严重,临床在进行UI患者的诊治时,应同时关注患者性功能及盆腔脱垂症状,及时评估盆底功能,提前进行干预。

Objective To evaluate the relationship between female urinary incontinence(UI) and pelvic floor disease symptoms. Methods 460 cases with lower urinary tract symptoms in Beijing Tongzhou District Traditional Chinese and Western Medicine Hospital from August 2017 to January 2019 were included. International Consultation on Incontinence Questionnaire-Short Form(ICIQ-SF) was used for UI evaluation, Pelvic Organ Prolapse/Incontinence Sexual Questionnaire(PISQ-IR) was used for sexual function evaluation, Pelvic Floor Distress Inventory(PFDI-20) was used for pelvic organ prolapse evaluation, and Pelvic Organ Prolapse Quantitation(POP-Q) was used for quantitative grading of pelvic organ prolapse. Results 345 patients were diagnosed with UI, including 72 cases of stress urinary incontinence(SUI), 83 cases of urinary urgency incontinence(UUI), 165 cases of mixed urgency incontinence(MUI), and 25 cases of other types of UI;115 patients were not diagnosed with UI. The scores of sexual function and pelvic organ prolapse symptoms in UI patients were lower than those in non-UI patients(P<0.05), and the scores of sexual function and pelvic organ prolapse symptoms in MUI patients were lower than those in SUI and UUI(P<0.05). POP-Q staging of MUI was higher than other UI types and non-UI patients(P<0.001). Multiple linear regression analysis showed that UI classification was independently associated with sexual function and pelvic organ prolapse symptoms. Conclusions Patients with MUI have poor sexual function and more serious pelvic prolapse symptoms. Clinical attention should be paid to the patient′s sexual function and pelvic prolapse symptoms when performing diagnosis and treatment of UI patients.