Usefulness of urodynamic examination in female urinary incontinence - Lessons from a population-based, randomized, controlled study of conservative treatment
Usefulness of urodynamic examination in female urinary incontinence - Lessons from a population-based, randomized, controlled study of conservative treatment
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DOI：
10.1080/003655900750016544
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发表时间：
2000-06-01
影响因子：
--
通讯作者：
Hunskaar, S
中科院分区：
文献类型：
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作者：
Holtedahl, K;Verelst, M;Hunskaar, S
目的：探讨尿动力学检查对女性尿失禁的诊断价值。材料和方法：作为全科医学中一项基于人群的随机对照治疗研究的一部分，对照组在入组研究后6个月开始延迟治疗之前和之后接受尿动力学检查，即在首次结局评价后将初始治疗组与对照组进行比较。干预组仅在12个月的最终结局评估后进行尿动力学检查。来自挪威三个城市的87名年龄在50-74岁之间的妇女参加了培训。结果：尿动力学检查与未检查的患者治疗效果无差异。11例患者（占42例对照患者的26%）在尿动力学检查后进行了诊断修订，其中10例随后改变了治疗。该组的结果与其他患者没有差异。作为一个亚组，11例患者比其他对照组患者有更严重的渗漏（p = 0.048）和更多的既往妇科手术（p = 0.038）。结论：我们的研究支持这样一种观点，即在一般的实践中，或在相当多的患者中，女性尿失禁可以在没有尿动力学检查的情况下进行分类和治疗。如果在最初的几个月内几乎没有改善或没有改善，应考虑转诊，对于严重失禁或既往妇科手术的患者，应比其他患者更早转诊。
Objective: To test the usefulness of urodynamic examination in female urinary incontinence. Material and Methods: As part of a population-based, randomized, controlled treatment study in general practice, the control group was offered urodynamic examination before and after delayed treatment starting 6 months after inclusion in the study, i.e. after the first outcome evaluation comparing the initially treated group with the control group. The intervention group was offered urodynamic examination only after the final outcome evaluation at 12 months. Eighty-seven women, aged 50-74, from three Norwegian municipalities participated. Results: There was no difference in treatment outcome whether the patients had urodynamic examination or not. Eleven patients (26% of 42 control patients) had their diagnosis revised after urodynamic examination, ten of them with a subsequent change in treatment. The outcome for this group was no different than for the other patients. As a subgroup, the 11 patients had more severe leakage (p = 0.048) and more previous gynecological operations (p = 0.038) than the other control group patients. Conclusions: Our study supports the idea that in general practice, or in rather unselected patients, women with urinary incontinence may be classified and treated without urodynamic examination. If there is little or no improvement during the first few months referral should be considered, and this should be done sooner for patients with severe incontinence or prior gynecological operations than for other patients.