臨床泌尿器科65巻10号

2011年09月発行

特集 頻尿・切迫性尿失禁

女性の過活動膀胱の治療

著者： 巴ひかる¹

所属機関： ¹東京女子医科大学東医療センター骨盤底機能再建診療部

ページ範囲：P.739 - P.746

要旨　わが国の女性の過活動膀胱罹患率は10.9％で，このうち63.9％が切迫性尿失禁を伴うOAB wetである。45歳以上でOAB wetが急増する理由は，骨盤底脆弱による尿道抵抗の低下と考えられる。女性のOAB wetでは排尿筋過活動の検出は59％と男性に比し低く，さまざまな理由が推測される。一部の混合性尿失禁の病態には尿道抵抗の低下が関連すると考えられ，腹圧性尿失禁が有意で症状が先行し排尿筋過活動がない混合性尿失禁では，手術により尿失禁のみならずしばしば尿意切迫感も消失する。骨盤臓器脱では過活動膀胱を20～50％に合併する。骨盤臓器脱に起因する過活動膀胱にも抗コリン薬は約60％で有効であるが，骨盤臓器脱の治療により過活動膀胱が消失する例も多い。

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