Prevalence of urinary incontinence and association of vaginal pressure and urinary incontinence in japanese women

日本人女性の尿失禁の実態ならびに腟圧と尿失禁の関連,骨盤底筋訓練の認知度と実施状況などを明らかにすることを目的として成人女性を対象に調査を行った.平成22年3月~平成24年7月に無記名自記式質問紙調査と腟圧測定を行った.分析対象数は88名であった.その結果,尿失禁群13名(14.8%),尿失禁経験群33名(37.5%),尿失禁なし群42名(47.7%)であった.尿失禁群13名のうち｢治療中｣1名,｢過去に尿失禁の治療を受けたことがある｣2名,｢治療経験はない｣は10名であった.治療経験がない者の尿失禁開始時期は半数が7年以上前であったことから,長期間尿失禁を放置している女性が多いことが明らかになった.骨盤底筋訓練を知っている者が65.9%であったが,実施している者や実施経験者は少なかった.尿失禁と腟圧の関連を検討するため,尿失禁群,尿失禁経験群,尿失禁なし群の3群間で最大収縮圧,平均収縮圧,収縮持続時間を比較した.その結果,いずれも尿失禁なし群が最大であったが,有意な差は認められず,各群における腟圧のばらつきも大きかった.以上のことから,女性尿失禁の放置を防ぐため,治療に関する正しい知識の普及を図ることが急務である.また,女性の尿禁制には強い腟圧が必要なのではなく,腹圧上昇や尿意切迫感が起こる直前に意識的に骨盤底筋群を収縮させることが重要であると考えられる.

A survey of Japanese adult women was performed to clarify the status of urinary incontinence treatment, correlation between vaginal pressure and urinary incontinence, and awareness and implementation of pelvic floor muscle training exercises. Anonymous self-administered questionnaires together with vaginal pressure measurement were conducted from March 2010 to July 2012 for the 88 participants recruited from a hospital.Based on the survey results, 13 participants(14.8%)were classified as having urinary incontinence and another 33(37.5%)as having a history of urinary incontinence, and 42(47.7%)reported having no urinary incontinence. Among the 13 women reporting urinary incontinence, one was undergoing treatment, two had a treatment history, and 10 had no treatment history. Among those with no history of treatment for urinary incontinence, 50% had a mean onset period of >7 years, which indicated that many women had neglected urinary incontinence for a long time. Among the enrolled participants, 65.9% were aware of pelvic floor muscle training exercises, but only few were regularly performing or had performed these exercises. To examine the association between vaginal pressure and urinary incontinence, maximum contraction pressure, mean contraction pressure, and duration of contraction of the three groups were compared. The group with no urinary incontinence showed the highest values in all items, however, no significant differences were observed among the groups and vaginal pressure levels in all the groups varied widely.The above results highlight the importance of accurate knowledge of women’s urinary incontinence treatment to avoid negligence that could aggravate the condition. In addition, increasing vaginal pressure is not necessarily required for women’s urinary continence, but conscious contraction of the pelvic floor muscles at the time of increased abdominal pressure or just before having the urge to urinate is considered to be more important.

尿失禁

女性

腟圧

骨盤底筋訓練