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CNEWS匯流新聞網記者陳鈞凱／台北報導

台中一名熱愛運動的42歲女性，在當了二寶媽之後，跳舞或跑步時總會憋不住尿，抱怨「褲底經常溼一片」，只好整天在家看電視，導致體重暴增，十分苦惱，就醫檢查之後，確診為「應力性尿失禁」，由於不想動手術，經醫師建議採用尿道填充注射療法，這才大幅改善漏尿情形，更有自信出門曬嬰。

收治病人的亞洲大學附屬醫院婦女泌尿科主任蕭子玄指出，應力性尿失禁是指當大笑、搬重物、咳嗽或打噴嚏時，腹部壓力突然增加，連帶造成膀胱內壓力也上升，萬一患者的尿道阻力太低，就會導致尿液漏出，好發於多次生產、胎兒體重較重、停經後及肥胖的患者。

臨床治療視症狀而定，若只有在用力咳嗽或跳躍才會漏出一點點尿，平時不需護墊或衛生棉保護，這一類患者適合較保守的治療；反之，如果一起身或走動就會漏尿，平時需使用護墊才不會弄溼褲子，則屬於嚴重等級，治療應較積極。

蕭子玄指出，治療應力性尿失禁的患者，必須考量其年齡、運動量、生活習慣及與伴侶的關係，並根據骨盆肌肉肌膜層對排尿器官的支撐力量及漏尿嚴重度，再規劃個人化的治療計劃，通常會先透過提肛訓練等保守性治療觀察恢復情形，若改善幅度有限，會進一步建議接受中段尿道懸吊微創手術治療。

許多怕痛的女性期待能有「比微創更微創」的治療方式。蕭子玄強調，這時多會建議採用經由膀胱內視鏡填充物注射在尿道，藉此增加尿道的阻力，改善應力性尿失禁，優點是介於藥物與手術之間的折衷選擇，對於不適合或不想手術的患者，提供不一樣的選項。

蕭子玄提醒，許多女性長期為應力性尿失禁所苦，卻因羞於啟齒不敢就醫，影響生活品質，其實應力性尿失禁治療方式相當多元，醫師完整評估後會提供個人化的治療方式，所以積極的就醫態度是擺脫尿失禁的第一步。

照片來源：亞大醫院提供

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