压力 尿失禁 in 女性

迹象 & 症状

Symptoms include urine loss when performing activities such as coughing, 打喷嚏, 笑, 锻炼，甚至站起来.

诊断

如果你有尿失禁，保持 尿的日记 -每天的排尿记录, 尿意外和液体摄入-可以帮助我们做出正确的诊断和决定适当的治疗.

你第一次来加州大学旧金山分校的时候, 你的十大赌博平台排行榜会询问你的一般健康状况, 你的尿失禁史, 过去的手术, 你正在服用的疾病和药物. The provider will also perform a physical examination, including a pelvic exam. 此外，还将检测尿样. If your problem is complex, additional 测试s may be done at a later visit.

体格检查评估

这取决于你的病史, your doctor may proceed to any or all of the following physical evaluations.

• Neurologic examination to evaluate strength, sensation and reflexes in your legs.
• Pelvic exam to assess whether you have any pelvic relaxation or prolapse.
• 盆底评估, in which your provider will evaluate the strength of your pelvic floor muscles, particularly your ability to contract and relax the appropriate muscle group.
• 排尿后残留尿评估，测量在排尿后15分钟内膀胱内残留的尿量. 这 测试 offers an estimation of your 膀胱's ability to efficiently "empty the tank.“同样的尿液样本可能会被分析其他因素, 比如血, 糖, 结晶或感染迹象. 这样的评估可以通过办公室尿液试纸或十大赌博平台排行榜实验室的显微镜尿液分析来完成.
• Urine culture if a urine dipstick or urinalysis suggests signs of acute infection. 培养物被送到微生物实验室，然后, 大约24到48小时内, bacterial growth can be detected and the specific strain identified.
• 咳嗽压力试验, 膀胱里充满了水, 你被要求以同样的方式咳嗽或用力，这会导致你尿漏. 该测试可以在办公室进行，也可以合并到更复杂的尿动力学测试中.
• A 尿的日记 提供有关您的液体摄入量和尿量的详细信息, 哪些是做出正确诊断的关键. 因为这不是我们在日常生活中通常会注意到的信息, your provider will give you a 尿的日记 and a measuring receptacle. 你可能会被要求仔细记录你在一个完整的24小时内喝的液体和排尿的时间和数量. You may be asked to repeat this 24-hour diary for three to five days. 这 allows us to notice patterns that might be important to planning your treatment.

其他诊断测试

In some cases, the doctor may decide to pursue further diagnostic 测试ing. Below is a list of some scenarios that are more complex and merit further 测试ing:

• 膀胱疾病诊断不明确
• 无法制定成功的治疗计划
• 症状未改善或治疗失败
• 病人正在考虑手术
• 手术失败
• 存在其他情况，如血尿(尿中带血)无感染，复发 尿路感染, elevated postvoid residual urine volume, neurologic condition

尿动态研究

这些研究的目的是评估膀胱和尿道的解剖和功能, 重现你的症状.

• Cystometrogram. 在这 测试, 导管放置在膀胱、阴道或直肠, 你的膀胱通过导管充满了液体. The 测试 is used to determine your perception of water filling the 膀胱, 尿急, 膀胱不可控收缩, the volume at which your 膀胱 cannot comfortably hold any more, and the pressures within your 膀胱 during the fluid storage process.
• 压力测试. You may be asked to perform a number of maneuvers such as coughing, 改变位置, 或者带着导尿管在脚跟上跳来跳去试图重现任何失禁的症状.
• 尿道压力分布图. A catheter in your urethra is manipulated to measure urethral function.
• Uroflometry. 排尿时，a 特别设计的插座 will measure the varying rate of urine flow, as well as duration of urination.
• 压力空化研究. 这 测试 identifies abnormal voiding patterns or urine obstruction.

其他测试

In 膀胱镜检查, 一个细长的照相机通过尿道插入膀胱, 使十大赌博平台排行榜能够非常详细地查看膀胱和尿道的内部解剖结构. 它通常是针对以下症状或情况进行的门诊手术:

• 尿液中有血或脓，没有细菌
• 膀胱感染异常难以治疗
• 新发作的排尿刺激
• 新发膀胱痛
• 膀胱内有疑似异物
• 尿动力学测试无法重现尿失禁症状

Radiologic 测试s identify upper or lower urinary tract structural abnormalities:

• 静脉肾盂造影(IVP). 这 测试 包括静脉注射(IV)染料到你的血液中，并在肾脏处理注射的染料时对整个尿路进行x光检查. 如果您对静脉造影剂过敏或肾功能异常，则不能进行此测试.
• CT扫描. A CT扫描 可以进行腹部和骨盆的切除, in which an X-ray machine takes a rapid sequence of two-dimensional, 人体感兴趣区域的薄横截面. 这 exam can be performed with or without contrast dye; mostly, 这取决于你的十大赌博平台排行榜在寻找什么. The X-rays pictures provide great anatomic detail of most of the internal organs.
• 超声波. 与前两次测试不同的是 超声波 不涉及x射线. 它利用皮肤探针引导声波从人体内部器官反射, 生成解剖图像. It can be a very useful screening tool for a number of the above indications.

治疗

行为治疗, 阴道插入, 电刺激和手术是女性压力性尿失禁的三种治疗选择. 目的是通过建立支持膀胱的肌肉的力量和功能来恢复骨盆底, 尿道和其他器官包含在骨盆区域内.

行为治疗

行为治疗很简单, 自主, have no side effects and are often used in conjunction with other treatment options. 它们已被证明对许多女性有效，对某些类型的尿失禁也很有效. 它们包括:

• 盆腔肌锻炼. 盆腔肌锻炼, 也被称为凯格尔, are an essential part of improving incontinence and preventing it from worsening. 它们还可以帮助你抑制小便的冲动. The exercises strengthen and tone the muscles that support the pelvic organs. 这些肌肉在你的命令下收缩和放松来控制膀胱的打开和关闭. 要想取得成果，需要有决心和规律的锻炼. 正确的技术也很重要.
• 生物反馈. 生物反馈 已被证明有效的大量研究治疗尿失禁. It can help you learn to control and strengthen your pelvic floor muscles, 哪些在膀胱控制中起重要作用. 因为你看不到盆底肌肉, 你可能会发现很难找到它们，也很难确定你是否在正确地做盆腔肌肉锻炼. 生物反馈疗法使用计算机图形和声音来显示你正在锻炼的肌肉. 它还允许治疗师测量你的肌肉力量和个性化的锻炼计划.
• 的诀窍. 正常情况下, the pelvic floor muscles contract automatically when pressure hits the 膀胱, 保持尿道密封. 但如果你的肌肉收缩不够快或不够有力，你可能会漏尿. 防止尿漏的关键是及时使用盆腔肌肉挤压尿道. 这种适时的肌肉使用被称为“诀窍”.“学习在正确的时间使用骨盆肌肉是一种技能，就像学习任何其他新的肌肉活动一样. At first it might be hard, but with practice many can learn how to remain dry.

阴道插入

阴道插入物 子宫托 are frequently used to treat 膀胱 and pelvic support problems. These devices are placed into the vagina to provide support for the uterus, 膀胱, 尿道和直肠. A number of types are available, and the inserts are fit to meet your needs and anatomy.

电刺激

盆底电刺激使用低强度的电流刺激虚弱或不活动的盆腔肌肉收缩. 将一个类似卫生棉条的传感器插入阴道，该传感器连接到手持可调节设备. The patient then increases the current to the level of a comfortable tingle. 定期的电刺激可以补充或增强你的骨盆肌肉锻炼制度. Units are available for home use and may be covered by Medicare or insurers.

手术

手术 is performed to restore the normal position of the 膀胱 neck and urethra. 有两种主要类型的手术失禁:膀胱颈部悬吊手术和吊带手术. 在医学界, the comparative effectiveness of these procedures is still being debated. 如果你考虑做手术, it is important that the decision be based on your individual circumstances.

药物

目前市场上还没有专门用于治疗压力性尿失禁的药物. However, there are several experimental medications in development. 药物 for this condition should be available in the near future.

服用避孕药或皮肤贴片形式的雌激素替代疗法尚未被证明是女性尿失禁的有效治疗方法. Vaginal estrogen (creams, vaginal rings or vaginal pellets) have helped reduce recurrent 尿路感染 in postmenopausal women, but their effectiveness for incontinence is unknown.