健康养生：美国医师学院（ACP）推荐压力型尿失禁者进行凯格尔练习（Kegel exercises）

来源: Nonsurgical Management of Urinary Incontinence in Women: A Clinical Practice Guideline From the American College of Physicians--- 16 September 2014

Recommendation 1: ACP recommends first-line treatment with pelvic floor muscle training in women with stress UI. (Grade: strong recommendation, high-quality evidence)

Recommendation 2: ACP recommends bladder training in women with urgency UI. (Grade: weak recommendation, low-quality evidence)

Recommendation 3: ACP recommends pelvic floor muscle training with bladder training in women with mixed UI. (Grade: strong recommendation, high-quality evidence)

Recommendation 4: ACP recommends against treatment with systemic pharmacologic therapy for stress UI. (Grade: strong recommendation, low-quality evidence)

Recommendation 5: ACP recommends pharmacologic treatment in women with urgency UI if bladder training was unsuccessful. Clinicians should base the choice of pharmacologic agents on tolerability, adverse effect profile, ease of use, and cost of medication. (Grade: strong recommendation, high-quality evidence)

Recommendation 6: ACP recommends weight loss and exercise for obese women with UI. (Grade: strong recommendation, moderate-quality evidence)

尿失禁类型:

1. 压力性尿失禁（Stress Urinary Incontinence）: 主要是由于盆底肌肉強度不足，在笑、咳嗽或打喷嚏时尿失禁。

2. 急迫性尿失禁（Urge Urinary Incontinence）: 就是一有尿意就必须立即排尿，憋不住，没到厕所就尿了。

3. 溢出性尿失禁（Overflow Urinary Incontinence）: 因膀胱肌肉強度弱或尿道堵塞（如前列腺肥大或其它梗阻），有少量尿从充盈的膀胱中不自主地流出。

4. 功能性尿失禁（Functional Urinary Incontinence）: 因行动不便或精神状态不良（老年失智症）或尿路感染或药物副作用等导致来不及到厕所而漏尿。


ACP推荐压力性尿失禁（Stress Urinary Incontinence）者进行凯格尔练习（Kegel exercises）。如果是急迫型（Urge Urinary Incontinence）的，凯格尔练习就不管用了，要做膀胱训练，或者定时排尿。凯格尔练习可以增强盆底肌和支持膀胱、子宫、阴道和直肠的肌肉。根据资料，做这种练习与不做相比，效果达到五倍。ACP不建议压力型尿失禁吃药，因为对它无效:

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