The prevalence,associated factors,and impact of urinary incontinence in pregnant and postpartum women in Nanjing,China:A cross-sectional study

Objective:Urinary incontinence(UI)is highly prevalent in antenatal and postnatal women while the prevalence of UI varied largely from 3.84%to 38.65%.This study was to assess the prevalence of UI,the associated factors,and the impact of UI on daily life in pregnant and postpartum women in Nanjing,China.Methods:The prevalence of UI and the impact of UI on life were assessed by the validated Chinese version of International Consultation on Incontinence Questionnaire-urinary incontinence-short form and the validated Chinese version of urinary incontinence quality of life.The associated factors were estimated by using logistic regression analysis.Results:UI affected 37.80%of pregnant women and 16.41%of postpartum women of the study population.Among the pregnant participants,the prevalence rates of stress UI,urge UI,and mixed UI were 25.77%,4.47%,and 7.10%,respectively.Among the postpartum women,the prevalence rates of stress UI,urge UI,and mixed UI were 11.15%,1.92%,and 2.69%,respectively.In both pregnant women and postpartum women,vaginal delivery had significantly increased the odds of reporting UI(p=0.007,p=0.003,respectively).The impact of UI on daily life was significantly greater in postpartum women compared to pregnant women especially in social embarrassment(p=0.000).Conclusion:The prevalence rates of UI were high in pregnant women in Nanjing,China.Vaginal delivery significantly increased odds of reporting UI.UI has a great impact on pregnant and postpartum women’s life,especially in social embarrassment.

Prevalence and Risk Factors of Stress Urinary Incontinence Among Perimenopausal Women and Its Influence on Daily Life in Women with Sexual Desire Problem

The prevalence of,and related factors to,stress urinary incontinence (SUI) among perimenopausal Chinese women and its impact on daily life among those women with sexual desire problem in Hubei province were investigated.In this study,1519 perimenopausal women aged 40 to 65 years were selected from three urban communities in the Wuhan area,and two impoverished,mountainous communities in Hubei province,and followed from April to October 2014.Detailed information about demographic characteristics,menstruation,pregnancy,sexual life and chronic diseases was collected.A cross-sectional survey was carried out following information collection by Chi-square test and multiple logistic regression analysis.Univariate and multivariate logistic regression analysis demonstrated that the potential factors associated with developing SUI were old age (OR=3.4,95% CI:1.92-6.04),vaginal delivery (OR=0.623,95% CI:0.45-0.87),low income (OR=0.063,95% CI:0.40-0.92),atrophic vaginitis (OR=1.4,95% CI:1.03-1.80),pelvic organ prolapse (OR=2.81,95% CI:1.36-5.80),chronic pelvic pain (OR=2.17,95% CI:1.90-4.03),constipation (OR=1.44,95% CI:1.07-1.93) and incontinence of feces (OR=3.32,95% CI:2.03-5.43).Moreover,the ratio of SUI (33.2%) was higher than the ratio of urgency urinary incontinence (24.1 %) or the ratio of mixed urinary incontinence (17.4%),and SUI had a greater impact on daily life among women with decreased sexual desire.In conclusion,SUI is a common disorder affecting over one third of the women surveyed,and has a severe impact on the daily life of perimenopausal women with declined sexual desire.Age,mode of delivery,and monthly income are major risk factors involved in the development of SUI.

A Review of Risk Factors for Predicting Urinary Incontinence after Benign Prostatic Hyperplasia

Benign prostatic hyperplasia (BPH) is one of the common diseases in middle-aged and elderly men, and its clinical symptoms include storage symptoms, voiding symptoms and post-urination symptoms. Surgery is an important treatment method for benign prostatic hyperplasia. It is suitable for BPH patients with moderate to severe LUTS (Lower Urinary Tract Symptoms) and has significantly affected the quality of life. The surgical methods include transurethral resection of the prostate and transurethral holmium laser enucleation of the prostate. While offering a high chance of cure, it also brings some complications, including postoperative urinary incontinence. This article mainly reviews the urinary incontinence after transurethral prostate surgery in recent years and analyzes its risk factors, and summarizes the experience for further prediction and reduction of the incidence of urinary incontinence.

Analysis of coping styles of elderly women patients with stress urinary incontinence

Objective:The aim of this study was to survey the coping style and related factors of elderly women with stress urinary incontinence(SUI)and provide a strong theoretical basis for promoting a positive coping style to improve quality of life in these patients.Methods:Cross-sectional surveys addressing SUI cognition and coping techniques of 520 elderly women patients with SUI were administered between July 2013 and February 2014.Results:Elderly women with SUI had significantly higher avoidance and acceptanceresignation scores than the normal population(p<0.05).Age,marital status,education level and stress urinary incontinence cognitive level all influenced the medical coping style of these patients.Conclusions:Elderly female patients with SUI differ in the factors that influence their coping styles;therefore,clinical and community medical staff should include a comprehensive analysis that takes these factors into consideration when working with patients with SUI to guide them in adopting a positive coping style.

Prevalence and risk factors of urinary incontinence in Fuzhou Chinese women

Background We randomly sampled a healthy community to evaluate the prevalence and associated risk factors of urinary incontinence. Methods The survey was performed in Fuzhou, China. Of women over twenty years of age in the city, 3.0% were randomly selected and 4684 evaluated by Bristol Female Urinary Tract Symptoms Questionnaire. Results Of the women in Fuzhou, 19.0% had urinary incontinence. The prevalence of stress incontinence, urge incontinence and mixed incontinence was 16.6% (n=777), 10.0% (n=468), 7.7% (n=360) respectively. The prevalence of the three types of urinary incontinence increased significantly with age (P<0.01). In multiple logistic models, age (OR, 1.3, 95%CI, 1.1-1.4), vaginal delivery (3.0, 1.9-4.7), parity >2 (2.1, 1.5-2.9), hypertension (2.7, 1.4-5.6), constipation (2.6, 1.8-3.8), alcohol consumption (4.7, 1.1-20.2), episiotomy (1.7, 1.4-2.0), higher body mass index (BMI, 1.8, 1.5-2.2) and unskilled worker (0.7, 0.5-0.8) were potential risk factors for stress incontinence. Urge incontinence was associated with age (OR, 1.3, 95%CI, 0.9-1.3), menopause (1.6, 1.1-2.4), Caesarean delivery (0.2, 0.1-0.5), parity >2 (2.6, 1.8-3.8), constipation (2.3, 1.4-3.7), foetal birthweight (1.7, 1.1-2.4), episiotomy (1.4, 1.1-1.8), higher BMI (1.5, 1.2-2.0) and unskilled worker (0.7, 0.5-0.9). Conclusions The prevalence of urinary incontinence and its subtypes in Chinese women is lower than that of occidental women. In China, age, vaginal delivery, parity, hypertension, constipation, alcohol consumption, episiotomy, higher BMI are potential risk factors for stress incontinence. Urge incontinence is associated with age, menopause, Caesarean delivery, parity, constipation, foetal birthweight, episiotomy, higher body mass index.

Female urinary incontinence in China after 15 years’efforts:Resultsfrom large-scale nationwide surveys

Urinary incontinence(UI)is a disease that quietly yet seriously impacts women's health and represents a global health burden that is often neglected.This study aims to systematically assess the prevalence and dynamics of female UI in China,and can inform further policies and have international implications.This study used three nationwide investigations:A national cross-sectional survey in 2021;another nationwide cross-sectional survey in 2006;and data regarding the institutions and physicians providing pelvic floor rehabilitation services from 2005 to 2019.The weighted prevalence of female UI and its subtypes,including stress UI(SUI),urgency UI(UUI),and mixed UI(MUI),were estimated as primary outcomes.Knowledge,attitude and care-seeking behaviors of UI were evaluated.It was found that the weighted prevalence of female UI was 16.0%(95%CI,13.3%–19.1%)with SUI remaining the predominant subtype(7.0%)in 2021,followed by MUI(6.5%)and UUI(1.9%).The estimated absolute number of Chinese adult women with UI was 85.8 million in 2021.52.7%(95%CI,45.9%–59.4%)of women were aware that UI was a medical condition,and only 10.1%of women with UI sought health care.After 15 years of development,there were 8400 pelvic floor rehabilitation institutions and nearly 10,000 relevant physicians in ChinaDthey were found to be associated with UI prevalence.The UI prevalence in China was significantly lower in 2021 compared to that in 2006.Despite the achievement,UI remains a public health problem,especially given China's fast aging and three-child policy.More innovations,especially those that can facilitate care seeking,are needed to address this prevalent yet treatable condition.

Incidence and Risk Factors of De novo Stress Urinary Incontinence after Pelvic Floor Reconstruction： A Nested Case-control Study

Background： Some patients with pelvic organ prolapse may suffer from incontinence （SUI） named de novo SUI alter pelvic floor reconstruction of de novo SUI. ower urinary tract symptoms （LUTS）, especially stress urinary This study aimed to investigate the incidence and risk factors Methods： This is a nested case-control study of 533 patients who underwent pelvic floor reconstruction due to pelvic organ prolapse （POP） at the Department of Gynecology in Peking University People＇s Hospital from January 2011 to March 2013. According to the inclusion and exclusion criteria, 401 patients were enrolled in the study with the follow-up rate of 74.8% （101 patients lost to follow-up）. There were 75 patients with de novo SUI postoperatively. According to the ratio of 1：3, we ensured the number of control group （n = 225）. The preoperative urinary dynamics, POP-quantification scores, and LUTS were compared between the two groups by univariate and multivariate logistic regression analyses to investigate the risk factors of de novo SUI. Results： The incidence of de novo SUI was 25% （75/300）. Univariate analysis showed that the ratio of lower urinary tract obstruction （LUTO） before surgery in de novo SUI group was significantly higher than the control group （odds ratio [OR] = 2.1, 95% confidence interval [（7] [1.1-4.0], P = 0.022）. The interaction test of LUTO and other factors displayed that Aa value was an interaction factor. With the increasing score of Aa, the incidence of de novo SUI become higher （OR = 2.1, 95% CI [1.0-3.7], P = 0.045）. After multivariable adjustment, multiple regression analysis showed that LUTO was independently associated with a greater risk of de novo SUI after pelvic floor surgery （OR = 2.3, 95% CI [1.2-4.6], P = 0.013）. Conclusions： Preoperative LUTO in patients with POP is a high-risk factor of de novo SUI, and high score of Aa-point is related to the occurrence of de novo SUI, which might be due to the outlet obstruction caused by bladder prolapse.

Gender differences of lower urinary tract symptoms in older Chinese Americans

Objective To describe whether or not there are gender differences in lower urinary tract symptoms(LUTS)prevalence and risk factors in community-dwelling older Chinese Americans.Methods We performed a secondary analysis of a prospective cross-sectional population-based survey of Chinese Americans aged 60 years and older between January 2011 and December 2013 in English,Mandarin,Cantonese,Taishanese,or Teochew.A clinical review of systems was used to assess LUTS,which included urinary frequency,urgency,burning and/or pain,blood in urine,and urinary incontinence.Results Of the total 3157 people queried,42%were men and 58%were women.More men reported LUTS compared to women(32.9%vs.28.6%,p=0.01).In a multivariable analysis,female gender(adjusted odds ratio[aOR]0.60,95%confidence interval[CI]0.49-0.73),being married(aOR 0.79,95%CI 0.65-0.97),and smoking(aOR 0.66,95%CI 0.49-0.88)were found to be protective,while traditional Chinese medicine use(aOR 1.51,95%CI 1.28-1.78),heart disease(aOR 1.54,95%CI 1.24-1.91),and anxiety(aOR 1.69,95%CI 1.25-2.28)were most strongly associated with increased odds of LUTS.When examining genders separately,being married was found to be protective only in women.Meanwhile,unique factors found in men were hypertension,heart disease,and practice of Tai Chi.Conclusion In this large population-based study,LUTS were more prevalent in older Chinese American men than women.We also found gender-specific factors that influenced the odds of reporting LUTS;however,traditional Chinese medicine use was the only factor that was shared by both genders.Future longitudinal investigations are needed to elucidate these underlying mechanisms to provide evidence-based and culture-specific guidelines for this rapidly growing population.

基于“互联网+护理”延续性护理平台的产后压力性尿失禁风险因素分析及预测模型构建

目的:构建产后压力性尿失禁的风险预测模型并进行效果评价。方法:从福建中医药大学附属人民医院盆底医学中心压力性尿失禁延续性护理平台提取2021年4月—2023年4月就诊的526例产后尿失禁病人的资料进行回顾性分析。根据《女性压力性尿失禁诊断和治疗指南(2017)》标准,将符合压力性尿失禁诊断的产后病人列为尿失禁组(n=172),无压力性尿失禁症状的病人列为非尿失禁组(n=354),使用国际尿失禁咨询委员会尿失禁问卷简表(ICI-Q-SF)对有压力性尿失禁症状的病人进行严重程度评分。结合病人一般情况、孕产史、会阴损伤、便秘、产前尿失禁等变量进行单因素及Logistic回归分析。结果:Logistic回归分析结果显示,年龄、体质指数、便秘、产前尿失禁是产后压力性尿失禁的独立危险因素(P<0.05)。根据筛选出的独立危险因素构建预测模型,通过统计软件绘制受试者工作特征曲线(ROC),计算出ROC曲线下面积(AUC)为0.804(P<0.001),提示该模型有较好的预测价值。结论:本研究构建的压力性尿失禁风险预测模型预测准确度较高,可为临床早期筛查并定位产后压力性尿失禁高风险病人,及时制订干预措施提供参考。

肌源干细胞通过TGF-β1/CTGF信号通路减轻压力性尿失禁大鼠的排尿障碍和尿道损伤

目的基于转化生长因子β1/结缔组织生长因子(TGF-β1/CTGF)信号通路探究肌源干细胞(MDSCs)对压力性尿失禁(SUI)大鼠排尿功能和尿道损伤的影响。方法分离、培养MDSCs,免疫细胞化学法检测MDSCs标志物Desmin和Sca-1表达。40只SD雌性大鼠按照随机数字表法分为4组:NC组(不作任何处理)、SUI组(SUI模型)、MDSCs组(SUI模型+MDSCs治疗)、MDSCs+SB431542组(SUI模型+MDSCs治疗+通路抑制剂SB431542处理),每组10只。比较4组大鼠喷嚏阳性率、尿动力学指标[膀胱最大容积(MBC)、漏尿点压(LPP)、腹压漏尿点压(ALPP)、排尿量、残余尿量、排尿效率];HE染色观察4组尿道组织病理学变化;蛋白免疫印迹法检测4组尿道组织中TGF-β1、CTGF蛋白表达。结果成功获得Desmin和Sca-1均呈阳性表达的MDSCs。与NC组比较,SUI组喷嚏阳性率、MBC、LPP、ALPP、排尿量、残余尿量均增加,排尿效率、TGF-β1和CTGF蛋白表达均降低(P<0.05),伴有严重尿道损伤;与SUI组比较,MDSCs组喷嚏阳性率、MBC、LPP、ALPP、排尿量、残余尿量均降低,排尿效率、TGF-β1和CTGF蛋白表达均增加(P<0.05),尿道损伤减轻;与MDSCs组比较,MDSCs+SB431542组喷嚏阳性率、MBC、LPP、ALPP、排尿量、残余尿量均增加,排尿效率、TGF-β1和CTGF蛋白表达均降低(P<0.05),尿道损伤加重。结论MDSCs可改善SUI大鼠的排尿功能,减轻尿道损伤,其可能是通过调控TGF-β1/CTGF信号通路发挥作用。

女性压力性尿失禁病人心理资本现况及影响因素分析

目的 调查女性压力性尿失禁病人心理资本现状及其影响因素。方法 2021年6—12月便利抽取郑州市王立砦社区、陇海社区、侯寨社区的528例女性压力性尿失禁病人,使用一般资料问卷、心理资本问卷(PCQ-24)、社会支持评定量表(SSRS)进行调查。结果 女性压力性尿失禁病人心理资本总分为(120.51±7.58)分,多元线性回归分析显示,年龄、学历、漏尿次数、疾病严重程度、社会支持程度、认为漏尿不需要就诊是影响女性压力性尿失禁病人心理资本水平的主要因素(P<0.05)。结论女性压力性尿失禁病人的心理资本问题亟待重视,医护人员应先评估病人的心理水平,重视失禁症状的健康宣教,为病人提供心理资本在各个维度上的针对性护理干预,提高其心理资本水平。

近10年中国成年女性压力性尿失禁患病率及影响因素的Meta分析

目的对近10年中国成年女性压力性尿失禁(stress urinary incontinence,SUI)的患病率及影响因素进行Meta分析,以期为SUI的预防提供参考依据。方法计算机检索数据库包括中国知网、万方、维普、中国生物医学文献数据库、PubMed、Web of Science、The Cochrane Library、Embase,检索时间段为2013-01-01—2023-08-01,收集近10年国内关于女性SUI的横断面研究,由2名经专业培训的研究者对文献进行严格筛选、资料提取以及质量评价后,采用StataMP 17.0进行Meta分析。结果共纳入20篇文献,包括13209名SUI患者。Meta分析结果显示,近10年我国成年女性SUI总发患率为23.2%[95%CI(19.6,26.8)]。亚组分析结果显示,2010—2015年和2016—2020年我国女性SUI患病率分别为19.9%[95%CI(16.7,23.2)]、28.1%[95%CI(20.1,36.0)];城镇、农村女性SUI患病率分别为21.5%[95%CI(17.3,25.8)]、30.5%[95%CI(18.9,42.1)];南方、北方女性SUI患病率分别为20.6%[95%CI(16.1,25.1)]、27.1%[95%CI(23.1,31.0)];SUI患病率随年龄增高而增加,在50~59岁达到高峰值34.7%[95%CI(28.2,41.2)]。影响因素效应量合并值如下:体力劳动[OR=1.63,95%CI(1.28,2.06)]、便秘[OR=1.45,95%CI(1.31,1.61)]、高血压[OR=1.63,95%CI(1.08,2.46)]、糖尿病[OR=1.48,95%CI(0.48,4.57)]、绝经[OR=1.67,95%CI(1.31,2.11)]、有分娩史[OR=2.17,95%CI(1.68,2.81)]、产次≥2次[OR=1.17,95%CI(1.06,1.29)]、经阴道分娩[OR=1.90,95%CI(1.22,2.87)]、尿路感染史[OR=1.49,95%CI(1.34,1.64)]、盆腔手术史[OR=1.54,95%CI(0.87,2.73)]、吸烟[OR=1.47,95%CI(0.90,2.38)]、饮酒[OR=1.04,95%CI(0.83,1.30)]。结论我国成年女性SUI患病率较高,不同人群患病率存在差异,受多种因素影响,需引起重视。

基于Logistic多因素分析的高龄产妇产后早期压力性尿失禁的影响因素分析

目的 分析高龄产妇产后早期压力性尿失禁(stress urinary incontinence, SUI)的影响因素,为预防和治疗该病提供依据。方法 选择2019年6月至2022年6月间在安徽医科大学附属宿州医院妇产科进行盆底筛查的83例高龄产妇为研究对象,其中43例为病例组(诊断为SUI),40例为对照组(无SUI)。使用一般资料调查表收集受试者基本情况与分娩资料,并进行单因素分析和二元Logistic多因素回归模型的多因素分析,评价模型的拟合优度。结果 单因素分析结果显示,病例组、对照组之间的分娩次数、分娩方式、胎儿是否足月、婴儿出生体重、孕前BMI、孕期体重增加、第二产程时长、是否进行盆底功能锻炼、妊娠合并症情况均存在统计学差异(P<0.05)。多因素分析结果显示,分娩次数、胎儿是否足月、孕期体重增加、第二产程时长、是否进行盆底功能锻炼、妊娠合并症均是影响高龄产妇产后早期SUI发生的独立影响因素(P<0.05)。模型系数的Omnibus检验结果表明,该模型总体有统计学意义(χ^(2)=78.846,P<0.001),内戈尔科R方=0.818(接近1),说明回归模型的拟合度较好。霍斯默-莱梅肖检验结果显示,P=0.682>0.05,说明模型拟合优度较高。结论 分娩次数、胎儿是否足月、孕期体重增加、第二产程时长、是否进行盆底功能锻炼、妊娠合并症均是影响高龄产妇产后早期SUI发生的独立影响因素,应该在临床中予以重视和处理。

压力性尿失禁患者经阴道无张力尿道中段悬吊术后排尿功能恢复情况及其相关影响因素

目的探讨压力性尿失禁(SUI)患者经阴道无张力尿道中段悬吊术后排尿功能恢复情况及其相关影响因素。方法选择2018年10月至2023年10月于首都医科大学附属北京康复医院接受经阴道无张力尿道中段悬吊术的112例SUI患者为研究对象。记录患者术后排尿功能恢复情况,依据术后排尿功能恢复时间将术后恢复至正常排尿时间≤3 d的患者纳入快速恢复组,术后恢复至正常排尿时间>3 d的患者纳入非快速恢复组。比较2组患者的年龄、体质量指数、是否绝经、经阴道分娩史、分娩次数、疾病严重程度、合并高血压、合并糖尿病、盆腔器官脱垂史、最大尿流率、术后尿潴留、术前膀胱残余尿量、膀胱最大容量、血红蛋白(Hb)水平、白细胞(WBC)计数、红细胞(RBC)计数及血小板(PLT)计数等临床资料,应用多因素logistic回归分析SUI患者术后排尿功能恢复的影响因素。结果112例SUI患者术后排尿功能恢复时间为1~15(4.10±0.78)d,其中64例(57.14%)术后排尿功能恢复时间≤3 d,48例(42.86%)术后排尿功能恢复时间>3 d。非快速恢复组绝经、有经阴道分娩史、有盆腔器官脱垂史、术后尿潴留患者占比均显著高于快速恢复组,最大尿流率显著低于快速恢复组(P<0.01);2组患者的年龄、体质量指数、分娩次数、术前膀胱残余尿量、膀胱最大容量、Hb水平、WBC计数、RBC计数、PLT计数、疾病严重程度、合并高血压占比、合并糖尿病占比比较差异无统计学意义(P>0.05)。多因素logistic回归分析显示,绝经、有经阴道分娩史、盆腔器官脱垂史、术后尿潴留及最大尿流率是SUI患者术后排尿功能恢复的影响因素(P<0.05)。结论SUI患者经阴道无张力尿道中段悬吊术后排尿功能恢复情况并不理想,绝经、有经阴道分娩史、盆腔器官脱垂史、术后尿潴留及最大尿流率是SUI患者术后排尿功能恢复的影响因素。

基于全孕周期数据的产后压力性尿失禁危险因素分析

目的了解产妇产后压力性尿失禁(SUI)的发病率,探索导致产后SUI发生的危险因素。方法纳入2021年1月至2021年12月在杭州市妇产科医院产检、分娩、并于产后6~8周回院随访的1627名产妇作为研究对象,根据其有无SUI分为SUI组(n=276)和正常组(n=1351),采用调查问卷收集产妇一般临床资料、压力性尿失禁相关情况,分析导致产后SUI发病的危险因素。结果产后SUI的发病率为16.9%,单因素分析发现产妇年龄、基础体重、基础BMI、新生儿出生体重、孕中期体重、孕中期BMI、孕中期腹围、孕中期高密度脂蛋白胆固醇水平、分娩方式与产后SUI相关(t/χ^(2)值为3.000、2.974、2.894、2.143、2.883、3.096、2.905、3.096和11.399,P<0.05)。多因素分析发现孕中期腹围(OR=1.027,95%CI:1.005~1.051)、分娩年龄(OR=1.050,95%CI:1.008~1.091)、孕中期高密度脂蛋白胆固醇(OR=0.660,95%CI:0.450~0.971)与产后SUI相关,其中孕中期腹围及分娩年龄为产后SUI发病的危险因素。结论产妇分娩年龄、孕中期腹围是产后SUI的危险因素,孕中期高密度脂蛋白是产后SUI的保护因素。适龄妊娠分娩、定期进行盆底肌肉训练、控制孕期体重增加等可以降低SUI的发生率。

成年女性尿失禁的危险因素研究进展

尿失禁(urinary incontinence,UI)是成年女性常见的健康问题,可导致患者泌尿道感染、抑郁症、睡眠障碍等,已成为一个影响全球成年女性的医疗问题,其患病率始终处于较高水平。虽然对UI的研究不断深入,但其病因至今仍不明确。因此,研究成年女性UI的患病率及相关危险因素,对于防治UI和改善UI患者的生活质量有着非常重大的意义。本文通过对近年来国内外有关成年女性UI的文献报道进行综述,总结成年女性UI的危险因素,以期为进一步的研究提供相关依据。

基于倾向性评分匹配分析盆腔脏器脱垂患者发生压力性尿失禁的影响因素

目的:探讨盆腔脏器脱垂(POP)患者发生压力性尿失禁(SUI)的相关影响因素。方法:对2021年1月至2022年12月山西医科大学第三医院收治的129例POP合并SUI患者(观察组)与169例单纯POP患者(对照组)相关变量进行倾向性评分匹配,最终成功匹配101对。单因素和logistic多因素回归分析POP发生SUI的影响因素。结果:观察组和对照组的孕产次、初产年龄、会阴裂伤、劳动强度、体质量指数(BMI)、甘油三酯(TG)以及代谢综合征(MS)比较,差异均有统计学意义(P<0.05)。多因素分析结果显示,孕产次≥2次、初产年龄<20岁、会阴裂伤和MS是POP患者发生SUI的独立危险因素,患SUI的风险分别增加了1.079倍、3.918倍、1.451倍和2.539倍。结论:POP发生SUI的影响因素较多,如妊娠、分娩、腹压增加及基础疾病等,应强调适龄妊娠的重要性,重视健康管理,加强妇女产后盆底修复训练的意识,充分控制和预防MS,避免或减少POP妇女发生SUI,提高患者生活质量。

绝经期压力性尿失禁合并膀胱过度活动综合征的危险因素研究

目的探讨绝经期压力性尿失禁(SUI)合并膀胱过度活动综合征(OAB)的危险因素。方法选取2019年10月—2022年10月收治的136例女性绝经期SUI为研究对象,依据膀胱过度活动综合征评分(OABSS)分为OAB(尿急评分≥2分,且总分≥3分)组25例和无OAB组111例。比较2组相关临床资料、OABSS、焦虑自评量表(SAS)和抑郁自评量表(SDS)评分。采用单因素、多因素Logistic回归分析影响绝经期SUI患者合并OAB的相关因素。结果OAB组OABSS、SAS和SDS评分均高于无OAB组(P<0.01)。OAB组与无OAB组在体质量指数(BMI)、妊娠次数、盆腔手术史、合并糖尿病、便秘史、焦虑和憋尿习惯方面比较差异有统计学意义(P<0.05,P<0.01)。多因素Logistic回归分析显示,BMI>28 kg/m^(2)、妊娠次数≥2次、有盆腔手术史和有便秘史均为影响绝经期SUI合并OAB的独立危险因素(OR=2.208、2.307、2.651和2.686,P<0.05)。结论绝经期SUI患者合并OAB较为常见,临床需重点关注BMI>28 kg/m^(2)、妊娠次数≥2次、有盆腔手术史和有便秘史的患者。

个体化预测经尿道前列腺剜除术后压力性尿失禁发生风险的列线图模型构建

目的探讨经尿道前列腺剜除术(TUEP)术后压力性尿失禁(SUI)发生的影响因素,并构建个体化预测SUI发生的列线图模型。方法选取2019年3月至2022年6月沧州市人民医院收治的557例行TUEP的良性前列腺增生(BPH)患者作为研究对象,术后开展6个月随访。根据术后是否发生SUI分成SUI组和非SUI组。对两组收集资料的差异开展分析,将差异具有统计学意义的因素纳入Logistic回归分析,最终筛查出影响TUEP术后SUI发生的因素,并利用R软件中RMS包构建列线图模型。绘制受试者工作特征(ROC)曲线,根据曲线下面积(AUC)评价模型预测效果,并行H-L拟合优度检验。结果557例BPH患者TUEP术后发生SUI 51例(9.16%);SUI组年龄≥75岁患者比例、合并糖尿病患者比例、前列腺体积、手术时长、术中剜除组织重量与非SUI组比较,差异具有统计学意义(P<0.05);Logistic回归分析结果显示,BPH患者TUEP术后发生SUI的危险因素包括年龄≥75岁、伴有糖尿病、前列腺体积大、手术耗时长(P<0.05);将这4项因素引入R软件构建列线图模型,结果显示,AUC为0.834(95%CI:0.756~0.912),拟合优度H-L检验χ^(2)=7.108,P=0.527。结论基于年龄≥75岁、伴有糖尿病、前列腺体积大、手术耗时长4项预测变量构建的列线图模型可有效预测TUEP术后SUI的发生风险。

基于盆底超声参数及血清学指标建立的列线图模型预测初产妇压力性尿失禁的临床价值

目的基于盆底超声参数及血清学指标建立列线图模型,探讨其预测初产妇压力性尿失禁(SUI)的临床应用价值。方法选取我院148例初产妇,根据产后3个月是否发生SUI分为SUI组(37例)及非SUI组(111例),获取两组一般资料,包括分娩方式及妊娠期是否进行盆底肌锻炼、是否运动、是否存在SUI;均行盆底超声检查和实验室检查,获取尿道旋转角(URA)、尿道倾斜角(UTA)、膀胱颈移动度(BND)、膀胱尿道后角(PUA)、肛提肌裂孔面积(LHA)及血清基质金属蛋白酶-1(MMP-1)、骨桥蛋白(OPN)、结缔组织生长因子(CTGF),比较两组上述检查结果的差异。采用多因素Logistic回归分析筛选初产妇SUI的独立影响因素,并据此建立预测初产妇SUI的列线图模型。绘制受试者工作特征(ROC)曲线分析模型的区分度;采用Hosmer-Lemeshow检验并绘制校准曲线评估模型的校准度;绘制临床决策曲线分析模型的临床适用性。结果两组分娩方式及妊娠期是否进行盆底肌锻炼、是否运动、是否存在SUI,以及URA、UTA、BND、PUA、LHA和血清MMP-1、OPN、CTGF比较差异均有统计学意义(均P<0.05)。多因素Logistic回归分析显示,URA、UTA、BND、PUA、LHA和血清MMP-1、OPN、CTGF均为初产妇SUI的独立影响因素(均P<0.05);基于以上独立影响因素构建列线图模型。ROC曲线分析显示,列线图模型预测初产妇SUI的曲线下面积为0.841(95%可信区间:0.756~0.926);Hosmer-Lemeshow检验显示,列线图模型预测概率与实际概率比较差异无统计学意义(χ^(2)=82.349,P=0.642);校准曲线显示,预测曲线与校准曲线的校准度较高;临床决策曲线显示,列线图模型具有较好的临床适用性。结论基于盆底超声参数及血清学指标建立的列线图模型对初产妇SUI具有较高的预测价值,能为临床防治初产妇SUI提供参考依据。