膀胱癌病人接受治療導致下泌尿道症狀臨床評估及護理處置

Clinical Evaluation and Nursing Management of Lower Urinary Tract Symptoms in Bladder Cancer Patients

10.6386/CGN.202309_34(3).0003

黃盈芳(Ying-Fang Huang)；郭于綾(Yu-Ling Kou)；陳淑卿(Shu-Ching Chen)

膀胱癌 ； 膀胱灌注治療 ； 下泌尿道症狀 ； bladder cancer ； bladder instillation therapy ； lower urinary tract symptoms

長庚護理

34卷3期（2023 / 09 / 01）

27 - 35

繁體中文;英文

膀胱癌病人接受膀胱腫瘤刮除、切除、化學治療或免疫治療會引起下泌尿道症狀，下泌尿道症狀包括：膀胱周邊的疼痛、頻尿、急尿、排尿時疼痛或灼熱等，會影響病人的身體功能、角色功能、社會功能、情感功能及性功能等層面，進而干擾日常生活導致生活品質下降。本文主要目的為探討膀胱癌病人接受治療引起下泌尿道症狀之定義、病理機轉、導因、評估工具、醫療處置及護理照護。常見下泌尿道症狀評估工具，客觀評估為常見不良事件評價標準5.0版，主觀評估包括：國際攝護腺症狀評分表及核心下泌尿道症狀評分表，希望藉此能提升健康照護提供者評估膀胱癌病人下泌尿道症狀，改善病人生活品質。

Bladder cancer patients undergoing transurethral resection, intravesical chemotherapy, and immunochemotherapy may experience a range of lower urinary tract symptoms. These symptoms cause discomfort around the bladder area, increased frequency of urination, a sense of urgency, and pain or a burning sensation during urination. These symptoms significantly impact a patient's life, including physical well-being, role fulfillment, social interactions, emotional health, and even sexual function, leading to a decline in overall quality of life. The article includes defining the condition, understanding the underlying pathological mechanisms, exploring potential causes, assessing tools for evaluation, and outlining medical management and nursing care strategies. Key assessment tools include: 1. Objective Assessment: The Common Terminology Criteria for Adverse Events 5.0v (CTCAE), and 2. Subjective Assessments: These comprise the International Prostate Symptom Score Scale (IPSS) and the Core Lower Urinary Tract Symptom Score (CLSS). This article aims to enhance the ability of healthcare providers to assess lower urinary tract symptoms in bladder cancer patients to enhance the quality of life for these patients.

1. Abdelmoteleb, H.,Jefferies, E. R.,Drake, M. J.(2016).Assessment and management of male lower urinary tract symptoms (LUTS).International Journal of Surgery,25,164-171.
2. Abrams, P.,Cardozo, L.,Fall, M.,Griffiths, D.,Rosier, P.,Ulmsten, U.,van Kerrebroeck, P.,Victor, A.,Wein, A.,Standardisation Subcommittee of the International Continence Society(2002).The standardisation of terminology of lower urinary tract function: report from the Standardisation Sub-committee of the International Continence Society.Neurourology and Urodynamics,21(2),167-178.
3. Akinaga, J.,García-Sáinz, J. A.,S Pupo, A.(2019).Updates in the function and. regulation of α1-adrenoceptors.British Journal of Pharmacology,176(14),2343-2357.
4. Barry, M. J.,Fowler, F. J., Jr.,O'Leary, M. P.,Bruskewitz, R. C.,Holtgrewe, H. L.,Mebust, W. K.,Cockett, A. T.(1992).The American Urological Association symptom index for benign prostatic hyperplasia. The Measurement Committee of the American Urological Association.The Journal of Urology,148(5),1549-1564.
5. Bright, E.,Cotterill, N.,Drake, M.,Abrams, P.(2014).Developing and validating the International Consultation on Incontinence Questionnaire bladder diary.European Urology,66(2),294-300.
6. D'Ancona, C.,Haylen, B.,Oelke, M.,Abranches Monteiro, L.,Arnold, E.,Goldman, H.,Hamid, R.,Homma, Y.,Marcelissen, T.,Rademakers, K.,Schizas, A.,Singla, A.,Soto, I.,Tse, V.,de Wachter, S.,Herschorn, S.,Standardisation Steering Committee ICS,the ICS Working Group on Terminology for Male Lower Urinary Tract & Pelvic Floor Symptoms and Dysfunction(2019).The International Continence Society (ICS) report on the terminology for adult male lower urinary tract and pelvic floor symptoms and dysfunction.Neurourology and Urodynamics,38(2),433-477.
7. de Groat, W. C.,Griffiths, D.,Yoshimura, N.(2015).Neural control of the lower urinary tract.Comprehensive Physiology,5(1),327-396.
8. Drobnis, E. Z.,Nangia, A. K.(2017).5α-Reductase Inhibitors (5ARIs) and Male Reproduction.Advances in Experimental Medicine and Biology,1034,59-61.
9. Elterman, D.,Aubé-Peterkin, M.,Evans, H.,Elmansy, H.,Meskawi, M.,Zorn, K. C.,Bhojani, N.(2022).UPDATE – 2022 Canadian Urological Association guideline on male lower urinary tract symptoms/benign prostatic hyperplasia (MLUTS/BPH).Canadian Urological Association Journal,16(8)
10. Gratzke, C.,Bachmann, A.,Descazeaud, A.,Drake, M. J.,Madersbacher, S.,Mamoulakis, C.,Oelke, M.,Tikkinen, K.,Gravas, S.(2015).EAU Guidelines on the assessment of non-neurogenic male lower urinary tract symptoms including benign prostatic obstruction.European Urology,67(6),1099-1109.
11. Griffiths, T. R.(2013).Current perspectives in bladder cancer management.International Journal of Clinical Practice,67(5),435-448.
12. Homma, Y.,Yoshida, M.,Yamanishi, T.,Gotoh, M.(2008).Core Lower Urinary Tract Symptom score (CLSS) questionnaire: a reliable tool in the overall assessment of lower urinary tract symptoms.International Journal of Urology,15(9),816-820.
13. International Continence Society. (2015). ICS fact sheets: a background to urinary and faecal incontinence. Retrieved from https://www.ics.org/Documents/Documents.aspx?DocumentID=3102
14. Joshua, J. M.,Vijayan, M.,Pooleri, G. K.(2019).A retrospective analysis of patients treated with intravesical BCG for high-risk nonmuscle invasive bladder cancer.Therapeutic Advances in Urology,11,1756287219833056.
15. Maharajh, S.,Abdel Goad, E. H.,Ramklass, S. S.,Conradie, M. C.(2015).Lower urinary tract symptoms (LUTS) in males: A review of pathophysiology.South African Family Practice,57(2),88-92.
16. Mogensen, K.,Christensen, K. B.,Vrang, M. L.,Hermann, G. G.(2016).Hospitalization for transurethral bladder resection reduces quality of life in Danish patients with non-muscleinvasive bladder tumour.Scandinavian Journal of Urology,50(3),170-174.
17. National Cancer Institute (2017) Common Terminology Criteria for Adverse Events (CTCAE), Version 4.0. Available from: https://ctep.cancer.gov/protocoldevelopment/electronic_applications/docs/ctcae_v5_quick_reference_5x7.pdf
18. Nickel, J. C.,Aaron, L.,Barkin, J.,Elterman, D.,Nachabé, M.,Zorn, K. C.(2018).Canadian Urological Association guideline on male lower urinary tract symptoms/benign prostatic hyperplasia (MLUTS/BPH): 2018 update.Canadian Urological Association Journal,12(10),303-312.
19. Okamura, K.,Kimura, K.,Mizuno, H.,Okamoto, N.,Aota, Y.(2014).Core lower urinary tract symptom score questionnaire: A psychometric analysis.International Journal of Urology,21(11),1151-1154.
20. Okamura, K.,Nojiri, Y.,Osuga, Y.,Tange, C.(2009).Psychometric analysis of international prostate symptom score for female lower urinary tract symptoms.Urology,73(6),1199-1202.
21. Pell, B.,Thomas-Jones, E.,Bray, A.,Agarwal, R.,Ahmed, H.,Allen, A. J.,Clarke, S.,Deeks, J. J.,Drake, M.,Drinnan, M.,Dyer, C.,Hood, K.,Joseph-Williams, N.,Marsh, L.,Milosevic, S.,Pickard, R.,Schatzberger, T.,Takwoingi, Y.,Harding, C.,Edwards, A.(2020).Primary care management of lower urinary tract symptoms in men: protocol for development and validation of a diagnostic and clinical decision support tool (the PriMUS study).BMJ Open,10(6),e037634.
22. Russo, G. I.,Urzì, D.,Cimino, S.(2018).Epidemiology of LUTS and BPH.Lower urinary tract symptoms and benign prostatic hyperplasia
23. Rutherford, C.,Patel, M. I.,Tait, M. A.,Smith, D. P.,Costa, D.,Sengupta, S.,King, M. T.(2021).Patient-reported outcomes in nonmuscle invasive bladder cancer: A mixed methods systematic review.Quality of Life Research,30(2),345-366.
24. Siegel, R.L.,Miller, K.D.,Fuchs, H.E.,Jemal, A.(2022).Cancer statistics, 2022.CA: A Cancer Journal for Clinicians,72(1),7-33.
25. Soler, R.,Andersson, K. E.,Chancellor, M. B.,Chapple, C. R.,de Groat, W. C.,Drake, M. J.,Gratzke, C.,Lee, R.,Cruz, F.(2013).Future direction in pharmacotherapy for non-neurogenic male lower urinary tract symptoms.European Urology,64(4),610-621.
26. Sung, H.,Ferlay, J.,Siegel, R. L.,Laversanne, M.,Soerjomataram, I.,Jemal, A.,Bray, F.(2021).Global cancer statistics 2020: GLOBOCAN estimates of incidence and mortality worldwide for 36 cancers in 185 countries.CA: A Cancer Journal for Clinicians,71(3),209-249.
27. Yoshimura, N.,Ogawa, T.,Miyazato, M.,Kitta, T.,Furuta, A.,Chancellor, M. B.,Tyagi, P.(2014).Neural mechanisms underlying lower urinary tract dysfunction.Korean Journal of Urology,55(2),81-90.
28. 台灣尿失禁防治協會(2013，1 0月2 4日)‧核心下泌尿道症狀中文化問卷 。http://www.tcs.org.tw/tcs_old/ask_coupon/ac_info.asp?Page=1&titleid=43[Taiwanese Continence Society (October 24, 2013). Core lower urinary tract symptom score (CLSS) questionnaire. http://www.tcs.org.tw/tcs_old/ask_coupon/ac_info.asp?Page=1&titleid=43]
29. 衛生福利部國民健康署 (2021，03月22日)‧107年癌症登記報告 。https://www.hpa.gov.tw/Pages/Detail.aspx?nodeid=269&pid=13498[Promotion Administration Ministry of Health and Welfare Taiwan (March 22, 2021). Cancer registry annual report, 2018 Taiwan. https://www.hpa.gov.tw/Pages/Detail.aspx?nodeid=269&pid=13498]