您經常受尿頻、尿急、夜尿困擾嗎?
您有尿頻、夜尿、排尿困難等問題嗎?我們統稱這些問題為「下泌尿道症狀」 (LUTS)。根據香港中文大學一個電話訪問調查,受訪者中有七成多的40歲以上男女都曾患有「下泌尿道症狀」。1 不少人以為年紀大,這些問題無可避免,或因感到尷尬而遲遲未求醫。事實上,這些症狀不但影響患者日常生活,長遠更有機會造成心理壓力,甚至拒絕社交活動,2影響深遠。長者頻頻夜尿更可能增加跌傷和骨折的風險。3在香港,高達17%的50歲以上患者會於髖骨骨折一年內死亡。4
您長期受「下泌尿道症狀」困擾嗎?不用擔心,現時有不少藥物,能有效舒緩病情。因此及早了解和治療相當重要!
甚麼是「下泌尿道症狀」(LUTS)?
「下泌尿道症狀」 (LUTS) 指下泌尿道(包括膀胱、前列腺及尿道)問題的各類症狀,其中包括男女均有機會患上的「膀胱過度活躍症」(Overactive Bladder,OAB)和只有男性有機會患上的「良性前列腺增生」(Benign Prostatic Hyperplasia,BPH)。5
「膀胱過度活躍症」(OAB) :
膀胱儲存尿液功能出現問題。6膀胱未達到正常排尿容量時,便不正常地突然收縮,增加膀胱內的壓力,造成突發性尿急、尿頻。7患者或需立刻如廁,嚴重時更有機會尿失禁(漏尿)。8部份患者亦會出現尿頻、夜尿等症狀。6
「良性前列腺增生」(BPH) :9
指男性前列腺有增生的現象,以致排尿功能出現問題,如排尿時比較費力,尿流細弱或斷續。患者大多需等候一段時間,才能開始排尿,而且尿液快要排盡前,尿流會變成尿滴。年紀越大的男性,患「良性前列腺增生」症的機會就越高。
很多男性出現尿頻時,以為自己患上「良性前列腺增生」。事實上,他們有可能是患上了「膀胱過度活躍症」,甚至可能同時患上兩種泌尿系統疾病。10 根據一項歐美的研究,約每三個患有「下泌尿道症狀」的40歳或以上男性中,就有一個同時有儲存和排尿問題。10
近年已有不少新藥物,如Beta-3腎上腺素受體激動劑(β3-agonists)可放鬆膀胱肌肉,增加膀胱儲尿能力,改善尿頻、尿急、夜尿、尿失禁等症狀。11, 12, 13 相比過往採用的抗乙醯膽鹼劑,β3腎上腺素受體激動劑出現口乾等副作用的機會較低 。14此外,近年亦有研究顯示β3腎上腺素受體激動劑對於長者沒有出現認知能力的副作用。15
而對α-1a和α-1d受體選擇性比較高的α1-受體阻滯劑 (α1-Blocker) 除了可同時放鬆前列腺和膀胱頸的平滑肌,改善排尿因難等症狀外16,心血管及頭暈方面的副作用亦較低。17, 18
至少有1種儲存、排尿及排尿後症狀10
患有「膀胱過度活躍症」19
就有2個 有中度至重度
「良性前列腺增生」20
我有「下泌尿道症狀」嗎?
此測試由「膀胱過度活躍症」症狀問卷(OABSS)21和國際前列腺症狀評分表(IPSS)22組成,協助您作出初步評估。只需回答數條簡單選擇題(男士回答12條,女士回答5條),就可了解自己的情況。
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