“疏”“堵”并举, 系统治疗女性尿失禁

Systematic treatment of female urinary incontinence by dredging and blocking in combination

分析尿失禁的形成机制以及危险因素,为女性尿失禁防治提供理论研究方向。女性尿失禁的发生与盆底肌功能下降、尿路动力学改变相关。当基础腹内压与瞬间腹内压之和大于最大尿道闭合压时,就会发生尿失禁。通过降低基础腹内压来降低总腹内压,进而改善尿失禁,我们称之为“疏”。对患者采用“生活方式干预”“生活方式干预联合药物治疗”“生活方式干预联合手术治疗”的三阶梯治疗模式,可以降低手术率及术后并发症发生率,改善患者生活质量,降低医疗总费用。“疏堵理论”是对经典压力性尿失禁治疗方式的升华和完善,可以使女性尿失禁治疗手段更加系统化、个体化、精准化。

The formation mechanism and risk factors of urinary incontinence were analyzed so as to provide a direction of theretical researches for the prevention and treatment of the disease.It has been reported that female urinary incontinence is associated with decreased pelvic floor function and urodynamic changes.Urinary incontinence will occur when the value of basic intra-abdominal pressure plus instantaneous intra-abdominal pressure is above the maximum urethral closure pressure.Total intra-abdominal pressure will fundamentally reduce by decreasing basic intra-abdominal pressure and then urinary incontinence can be improved,which is called"dredging"in clinic.Three steps therapy model including"lifestyle intervention","lifestyle intervention combined with drug therapy"and"lifestyle intervention combined with surgical treatment"can better reduce the operation rate,and incidence of various complications after surgery,improve the quality of life,and reduce the total medical costs."Dredging and blocking theory"is the upgrading and improvement of the classical treatment of stress urinary incontinence,which makes the treatment of female urinary incontinence more systematic,individualized and accurate.