高齢女性における失禁症
Patricia S Goode1, Kathryn L Burgio, Holly E Richter
1Birmingham/Atlanta Geriatric Research, Education, and Clinical Center, and Department of Medicine, University of Alabama at Birmingham, Birmingham, AL 35233, USA. pgoode@uab.edu
JAMA
|June 3, 2010
まとめ
尿失禁は多くの高齢女性に影響を与え,生活の質に影響を与えます. 早期診断とエビデンスに基づく治療は,運動と薬を含む,患者の満足度と幸福度を大幅に改善します.
科学分野:
- ゲリアトリクス ゲリアトリクス
- 泌尿器科 泌尿器科とは
背景:
- 尿失禁は,高齢女性の3分の1以上に影響を与える一般的な高齢症候群です.
- これは,社会的孤立,転倒,制度化などの悪影響と関連しています.
- しばしば報告が不足しているため,高齢の女性では定期的なスクリーニングが必要になります.
研究 の 目的:
- 高齢女性における尿失禁の評価と治療に関する証拠をレビューする.
- 効果的な管理のための正確な診断 (ストレス,緊急性,混合) の重要性を強調する.
- 認知症の患者に対する様々な治療法と特別な考慮事項について議論する.
主な方法:
- 高齢者の尿失禁の診断と治療戦略のエビデンスベースのレビュー.
- ケースイラストは,慢性性と管理アプローチを強調します.
- 認知障害の患者に対する特別な考慮事項を含める.
主要な成果:
- 保守的 (運動,流体管理) や医療/外科的オプションを含む様々な治療法があります.
- 具体的治療法: 骨盤床運動,ストレス/衝動抑制戦略,薬,ペサリ,ボツリヌム毒素,神経刺激,手術.
- 治療は高い患者満足度と生活の質の向上を示しています.
結論:
- 正確な診断は,尿失禁の高齢女性の治療結果を最適化するために不可欠です.
- 総合的でエビデンスに基づいた管理戦略は,生活の質と患者の満足度を大幅に高めることができます.
- 尿失禁のスクリーニングと迅速な治療は,高齢者の介護の重要な構成要素です.
関連する概念動画
01:21Nursing Assessment of the Genitourinary System I: Health History
The genitourinary system is critical to maintaining fluid balance, waste elimination, and reproductive function. Nurses play a vital role in assessing this system, beginning with a thorough health history. This process involves gathering patient information, identifying risk factors, and recognizing symptoms of genitourinary disorders. Early detection is vital for timely interventions and management.1. Gathering Patient InformationA complete health history includes the patient’s personal,...
01:28Menopause
Menopause, a natural biological process marking the end of a woman's fertility, typically occurs between the fifth and sixth decade of life. This phase is characterized by the exhaustion of the ovarian follicle pool, leading to less responsive ovaries despite the high levels of Follicle Stimulating Hormone (FSH) and Luteinizing Hormone (LH). The consequential decrease in estrogen production results in symptoms like hot flashes, heavy sweating, headaches, hair loss, muscle pains, vaginal...
01:18Pharmacokinetics in Geriatric Patients: Effect of Age on Drug Excretion
In geriatric patients, renal physiology undergoes significant changes, including diminished renal blood flow and a lower glomerular filtration rate (GFR), leading to alterations in medication clearance. Drugs such as aminoglycoside antibiotics, lithium, and digoxin, which rely on glomerular filtration for removal from the body, particularly impact pharmacokinetics. These drugs tend to have slower clearance rates in older adults, necessitating careful dosage considerations.Evaluation of renal...
01:22Pharmacokinetics in Geriatric Patients: Effect of Age on Drug Absorption
As individuals age, their body's physiology evolves, affecting drug pharmacokinetics. The most apparent changes occur in the gastrointestinal tract, where an increase in gastric pH, a delay in gastric emptying, and a reduction in gastrointestinal motility are observed. Remarkably, these changes do not substantially modify the absorption of orally administered drugs, particularly those absorbed via passive diffusion.Transdermal drug delivery emerges as a highly viable method for older adults due...
01:17Urinary Tract Infection IV: Nursing Management
In managing urinary tract infections (UTIs) in nursing, a comprehensive assessment is essential. Begin by gathering subjective data, such as the patient’s complaints of dysuria (painful urination), urinary frequency, urgency, suprapubic pain, and any lower abdominal discomfort. This information can be complemented by questions regarding previous UTIs, sexual activity, and personal hygiene practices, which can provide insight into risk factors. Objective assessment should focus on signs like...
01:23Urinary Bladder
The urinary bladder is a hollow, muscular sac that temporarily stores urine before it is expelled from the body. It can hold approximately 600 mL of urine prior to micturition. The bladder is retroperitoneal and located behind the pubic symphysis in the pelvic floor.
In males, the bladder is situated in front of the rectum, while in females, it is positioned anterior to the vagina and uterus. The bladder floor contains an inverted triangular area called the trigone, defined by the two ureteric...
In males, the bladder is situated in front of the rectum, while in females, it is positioned anterior to the vagina and uterus. The bladder floor contains an inverted triangular area called the trigone, defined by the two ureteric...