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Könnun á algengi þvagleka meðal kvenna og árangri einfaldrar meðferðar í héraði

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Authors
Sigurður Halldórsson
Guðrún G. Eggertsdóttir
Sigríður Kjartansdóttir
Issue Date
1995-04-01

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Other Titles
Prevalence of female urinary incontinence and the effect of simple treatment measures at a health centre
Citation
Læknablaðið 1995, 81(4):309-11, 314-7
Abstract
The purpose of this study was to find out the prevalence of female urinary incontinence outside institutions, its effects on daily life and to see if effective treatment was possible with relatively simple diagnostic and treatment measures at the local health centre. A questionnaire was sent to all women (131) over the age of 20 living in private homes in Öxarfjörður, a small rural community in Iceland. The results showed a 56% overall prevalence of self-reported incontinence, thereof 29% with moderate or severe symptoms. About 70% of the women with incontinence had typical stress incontinence, 14% urgency incontinence and 16% mixed symptoms. There was a statistically significant relationship between incontinence and number of childbirths but not regarding age. The incontinence had some adverse effects on daily life for 39% of women with incontinence or 20% of the whole sample. Some treatment for incontinence had been given earlier to 26 women with variable results. Only four women had a registered incontinence diagnosis at the health centre. All women with incontinence were invited to participate in pelvic floor exercise groups or offered written instructions of pelvic floor exercises. Those with moderate or severe symptoms were offered a more extensive evaluation and examination at the health centre, resulting in a number of cases in other treatment like antibiotics or oestrogen's. A new questionnaire 10 months later showed that 61% of the women had improved. The improvement was statistically significant for the group with stress incontinence and for those attending the treatment groups. Pelvic floor exercises were helpful even when symptoms were severe and though they were only performed once or twice a week. We recommend an active diagnostic approach and a trial of systematic pelvic floor exercises and post- menopausal hormone treatment before resorting to surgical treatment for urinary incontinence.
Tilgangur þessarar rannsóknar var að kanna algengi þvagleka hjá konum sem dveljast utan stofnana, áhrif hans á daglegt lif og hvort hægt væri að bæta úr með einföldum aðferðum á heilsugæslustöð. Sendur var spurningalisti til allra kvenna 21 árs og eldri í Öxarfjarðarhéraði, sem bjuggu heima, alls 131 konu. Reyndust 63 (56%) hafa þvagleka, þar af 32 (29%) talsverðan eða mikinn. Af 63 konum með þvagleka höfðu 70% áreynsluþvagleka, 14% bráðaþvagleka og 16% blönduð einkenni. Marktækt samband var við fjölda fæðinga, en ekki við aldur. Þvaglekinn hafði heftandi áhrif á daglegt líf hjá 39% kvenna með þvagleka eða 20% af heildinni. Áður höfðu 26 konur fengið einhverja meðferð við þvagleka með misjöfnum árangri. Aðeins fjórar voru með þessa sjúkdómsgreiningu á heilsugæslustöðinni. Öllum með þvagleka var boðin æfingameðferð í hópum eða skriflegar leiðbeiningar um grindarbotnsæfingar. Tilboð um nánara mat og skoðun á heilsugæslustöð fengu allar með talsverð eða mikil einkenni og nokkrar síðan meðferð svo sem sýkla- eða hormónalyf. Nýr spurningalisti 10 mánuðum síðar sýndi að 61% kvennanna sögðust betri. Marktækt bestur var árangur þeirra sem höfðu haft áreynslueinkenni og komu í æfingahópa. Æfingar komu að gagni jafnvel við mikil einkenni og þótt þær væru aðeins gerðar einu sinni til tvisvar í viku. Mælt er með að greining verði virkari og konum með þvagleka boðið upp á skipulega æfingameðferð og hormónameðferð eftir tíðahvörf áður en gripið er til skurðaðgerðar.
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