ISSN:0002-9629    

出版商:OVID    

年代:1997

数据来源: OVID

摘要:

Lower urinary tract symptoms and disorders are prevalent and bothersome in the rapidly growing aging population. Common symptoms include urinary frequency, nocturia, urgency, and incontinence. Among older men, symptoms of voiding difficulty, such as hesitancy, slow stream, and straining, are also common. A variety of aging changes, as well as age-associated disease, predispose older people to the development of lower urinary tract symptoms. Medications used to treat conditions outside the lower urinary tract also can contribute to these symptoms. Physicians and other health professionals should routinely ask specific questions about lower urinary tract symptoms in their older patients and evaluate them thoroughly when they are present.

ISSN:0002-9629    

出版商:OVID    

年代:1997

数据来源: OVID

摘要:

Lower urinary tract dysfunctions, such as urinary incontinence, detrusor instability, and benign prostatic hyperplasia, are prevalent in older adults. These conditions, which can occur alone or in combination, result in irritative or obstructive symptoms that can interfere with everyday functioning, leading to negative consequences on health-related quality of life. The nature and severity of these symptoms and the perception of their impact on daily activities can be quite variable. Until recently, relatively little was known about the effect of lower urinary tract dysfunctions on general health status and quality of life. An increasing research base is now available that shows the impact of different urologic dysfunctions in clinical and general populations.This article will provide a brief background on the definition and measurement of health-related quality of life and will summarize the literature about the quality of life of community-dwelling elderly patients with urinary incontinence or prostate conditions. Implications to guide clinical practice and future research will be derived.

ISSN:0002-9629    

出版商:OVID    

年代:1997

数据来源: OVID

摘要:

Menopause is associated with a marked reduction in endogenous estrogen production. Lower levels of circulating blood estrogen have various deleterious effects, including those on the lower urinary tract. The vaginal epithelium becomes atrophied and dry, which can cause vaginal discomfort, itching, and dyspareunia. The epithelium may become inflamed and contribute to urinary symptoms, including frequency, urgency, dysuria, and incontinence. Diminished estrogen effects on periurethral tissues can contribute to pelvic laxity and stress incontinence. Changes in vaginal pH and normal flora may predispose older women to urinary tract infection. Although estrogen replacement therapy can result in maturation of the vaginal epithelium, the optimal form of administration and the dosage regimen for improving symptoms and quality of life of the geriatric female population have not been well studied.

ISSN:0002-9629    

出版商:OVID    

年代:1997

数据来源: OVID

摘要:

Aging often disturbs the normal circadian rhythm of urine production. The nocturia commonly seen with aging may result from the loss of nighttime vasopressin production or release that develops by childhood. Restoring the nocturnal increase in vasopressin can have a dramatic clinical response: improved quality of life and less risk of nighttime falls in carefully selected and accurately diagnosed patients.

ISSN:0002-9629    

出版商:OVID    

年代:1997

数据来源: OVID

摘要:

Benign prostatic hyperplasia is a common and costly disease that effects older men. This article reviews the underlying histopathologic changes that cause benign prostatic hyperplasia. The symptoms and systematic evaluation of the patient are described, along with the current therapeutic options for treatment.

ISSN:0002-9629    

出版商:OVID    

年代:1997

数据来源: OVID

摘要:

Urinary tract infection (UTI) remains very common. As many as 50% of women report having had at least one UTI in their lifetimes. Urinary tract infection is the most common cause of infection in nursing home residents and the most common source of bacteremia in the elderly population. Urinary tract infection occurs in patients with structurally or functionally abnormal urinary tracts (complicated UTI) and in patients with anatomically normal urinary tracts (uncomplicated UTI).Escherichia coli (E coli)is the most common cause of uncomplicated UTI, whereas antibiotic-resistantEnterobacteriaceae, enterococci, andCandidaspecies often are the causes of complicated UTI. In this article we review current concepts of the epidemiology, microbiology, pathophysiology, clinical manifestations, diagnosis, and treatment of urinary tract infection.

ISSN:0002-9629    

出版商:OVID    

年代:1997

数据来源: OVID

摘要:

Urinary incontinence affects 15% to 30% of the population1and 50% of those living in nursing homes. Care for incontinence is difficult because this condition is underreported by patients and underdiagnosed by physicians. This article describes the medical and nursing diagnostic assessment of urinary incontinence of geriatric populations, and the criteria for referral. Comprehensive review of urinary incontinence, including treatment, is available elsewhere.2,3Although this article focuses on the assessment of urinary incontinence, the type of treatment being considered guides the scope of the evaluation, and therefore, treatment of incontinence is discussed.

ISSN:0002-9629    

出版商:OVID    

年代:1997

数据来源: OVID

摘要:

Behavioral intervention is a group of therapies used to modify stress, urge, or mixed urinary incontinence by changing patient bladder habits or by teaching new skills. Three broad categories of behavioral treatment are reviewed: pelvic muscle exercise, biofeedback, and bladder training. The literature concerning each of these methods indicates that the treatments are effective for most community-dwelling older adults. More research is needed to identify the best methods for implementing these treatments, to explore the role of various components of treatment packages, to examine issues of durability, and to improve adherence to behavioral protocols necessary for long-term effectiveness.

ISSN:0002-9629    

出版商:OVID    

年代:1997

数据来源: OVID

摘要:

Medications to treat lower urinary tract dysfunction in older adults are selected to alter specific physiologic parameters. Pharmacotherapy alone results in modest clinical improvement. Because of the high prevalence of adverse drug reactions and polypharmacy in the geriatric population, medication should be used for those conditions that do not respond sufficiently to behavioral therapy. For stress incontinence, medications withα-adrenergic agonist properties are the mainstay of pharmacotherapy because they increase outlet resistance. Pharmacotherapy of urinary frequency and urge incontinence aims to decrease detrusor irritability and increase bladder capacity by inhibiting cholinergic stimulation of the bladder. In addition to these medications, in postmenopausal women, estrogen seems to have an additive effect for both urge and stress incontinence. More randomized, placebo-controlled, double-blinded clinical trials are needed that compare various pharmacologic agents and combinations, as well as pharmacotherapy with other forms of treatment for lower urinary tract dysfunction.

ISSN:0002-9629    

出版商:OVID    

年代:1997

数据来源: OVID