Dr. Jones: 作为一个成年人，总觉得自己要尿裤子的问题是，这很尴尬，而且这是一个两岁的孩子会做的事情. This is Dr. Kirtly Jones from Obstetrics and Gynecology at University of Utah Health. And this is "The Seven Domains Of Women's Health" on The Scope.
Announcer: 涵盖妇女健康的各个方面，这是“妇女健康的七个领域”. Kirtly Jones on The Scope.
Dr. Jones: 回到两年前的问题，尿裤子或者害怕尿裤子. This is a very common problem for older adults men and women, 但你可能不知道这很常见，因为你的朋友和家人不会谈论它. Many of us quietly have urgency. But what can we do about it? Today we're going to talk about this as grown-ups. Here in The Scope studio is Dr. Sara Lenherr. 她是犹他大学的泌尿科医生对成人的尿失禁特别感兴趣, meaning not peeing your pants. Thanks for joining us, Dr. Lenherr. Well, how common is this problem? Is it more common for older people or men or for women or? Tell me about your patients.
How Common is an Overactive Blader?
Dr. Lenherr: 所以膀胱过动症（OAB）确实影响了美国数百万的女性和男性. And many patients are tried on medications, 但是要停止服用，因为它们无效或会引起麻烦的副作用. There are other treatments that are not without side effects, 但适当的咨询可以非常有效地改善他们的症状和生活质量.
Dr. Jones: How common is this problem? Is it more common for older people or for men or for women? Tell me about who comes to see you.
Dr. Lenherr: 有不同年龄的人来找我，因为他们总是想尿尿. They're men, they're women, 有的人一辈子都有这种病，有的人老了才有. We treat so many different people that have to go to the bathroom urgently, frequently, they either lose their urine with incontinence, or they don't have any incontinence. All these different types of people come in for evaluation.
What is an Overactive Bladder?
Dr. Jones: Okay. You've used the word overactive bladder, 我真的很喜欢这个词，因为它听起来很医学，而不是尿裤子之类的. 所以膀胱过度活动这是你专门研究的各种问题的总称?
Dr. Lenherr: 所以这基本上意味着当你突然想去小便的时候，你不能拖延去小便的冲动. 而且大多数人都需要经常上厕所. 所以他们必须每20分钟或每一个小时排尿一次，而不是在合理的时间内排尿, like four or five hours.
Am I Drinking Too Much Water?
Dr. Jones: Right. So tell me a story, the common kinds of things. You mentioned that sometimes people try to treat this by not drinking, but sometimes people maybe drink so much.
Dr. Lenherr: 有些人喝的水比他们意识到自己身体真正需要或真正能承受的要多得多. 他们有时也会喝一些会刺激膀胱的液体, like a lot of coffee, tea, things with artificial sweeteners, sodas with caffeine. All those things can irritate the bladder, and they just don't realize that it's impacting their bladder health.
Dr. Jones: Right. The Big Gulp is the big pee. Right?
Dr. Lenherr: Exactly.
Dr. Jones: Oh, yeah, yeah. So how do people come to you? 他们已经有几年的麻烦了或者他们曾经有过一次或者他们必须由他们的医生介绍?
Dr. Lenherr: 很多人觉得他们已经受够了，他们来找一个评估 urologist right off the bat. 但有些人一生都在与之斗争，他们只是没有时间自己解决这个问题，或者他们的初级保健医生还没有成功地大发娱乐他们.
Dr. Jones: Yeah, yeah. Well, what kinds of things begin? 我只是想重新训练我的大脑和膀胱就像我训练我两岁的孩子一样. So I just like to say, "Stop. I want to start over." Because I train my 2-year . . . well, actually, it was my mother-in-law trained my 2-year-old in a weekend. I want to retrain my bladder to behave. So what kinds of things can be done?
Evaluating an Overactive Bladder
Dr. Lenherr: So, first, 我总是先评估一个人患膀胱过度活动的风险因素或原因. 是因为他们的液体摄入量还是他们喝的液体种类, 或者他们推迟排尿，他们只是没有意识到他们应该在一段时间前就去，然后他们被突然的急迫感所困扰，他们需要去?
另一种会导致膀胱过度活动或者你需要更频繁地小便的感觉是慢性便秘, so having difficulties with bowel movements, and it basically becomes a space issue in the pelvis. And so if your pelvis is full of poop, 你不一定有足够的空间来储存膀胱里的尿液.
Dr. Jones: Right. And then for women, 有时他们有肌瘤或靠在膀胱上的大子宫, or for men, they might have a big prostate.
Dr. Lenherr: Exactly.
Age as a Factor
Dr. Jones: So people don't know that there are many kinds of things. So the evaluation process is for each person. 这不是所有的初级保健医生甚至一些泌尿科医生都能做到的. 所以我很担心，因为大发娱乐知道2岁的孩子在憋尿方面有问题，大发娱乐试图训练他们解决这个问题. But we also know that 80 and 90-year-olds as they kind of get demented, their brain isn't as good at calling it quits and say, "I'm holding this for another half an hour." So, as you get older, is your brain just not so good?
Dr. Lenherr: 通常情况下，你需要离开的感觉和意识在老年人中更不清楚. 所以有时他们只是需要提示，提醒他们定期去洗手间.
Dr. Jones: Right.
Dr. Lenherr: 另一件在老年人中很常见的事情是便秘，没有人发现. So, again, it just makes the bladder always feel like it's partially full.
Dr. Jones: Right. Well, I think that this is common.
Dr. Lenherr: Very common.
Dr. Jones: In fact, if you bring it up and I won't say you, I brought it up to my family, 我姐姐和我发现她和我妈妈一样也在挣扎, that I had struggled with it, 然后我和我的朋友们聊了聊，大发娱乐偶尔都在为此挣扎. 所以这是一个常见的问题，有些人设法解决并做得很好, 但对于那些生活受到干扰的人来说，他们必须知道从大发娱乐到你的小屋之间的每一家商店里的每一个厕所和每一个休息站, that can get old.
Bladder Issues & Quality of Life
Dr. Lenherr: It's very exhausting. It definitely impacts quality of life. And that's one of the main things that I assess with my patients is, how much is this really running their lives? 如果他们没有那么烦恼，他们可以在周末左右安排时间, then they're okay. But sometimes people have special events that they want to go to, 所以大发娱乐想出了一个量身定制的计划来大发娱乐他们，当他们想去参加婚礼或者他们想和朋友一起进行公路旅行时，他们一直避免做这些活动，因为他们害怕他们不得不一直去小便.
Dr. Jones: Well, it's great that (a) you can talk like a grown-up to a grown-up, we can talk grown-up to grown-up about this kid's issue. 大发娱乐的结论是膀胱过度活动有很多原因也有很多治疗方法, not just medication that you might see on the TV, and we're grateful to have Dr. Lenherr to help us hold it. And thanks for joining us on The Scope.
Dr. Lenherr: Thank you for having me.
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