Werner Matthias, Schmid Daniel Max, Schüssler Bernhard
Department of Obstetrics and Gynecology, Cantonal Hospital Lucerne, Switzerland.
Am J Obstet Gynecol. 2005 May;192(5):1735-40. doi: 10.1016/j.ajog.2004.11.052.
This study was undertaken to investigate the efficacy and safety of botulinum-A toxin (BTX-A) treatment for non-neurogenic detrusor overactivity incontinence.
This prospective nonrandomized ongoing study was performed in a tertiary referral urogynecology department. In 26 women with urge incontinence and urodynamically demonstrated detrusor overactivity incontinence resistant to conventional treatment 100 units of BTX-A were injected into the detrusor muscle at 30 sites. Clinical and urodynamic evaluations and a quality of life assessment were performed at baseline and 4, 12, and 36 weeks after BTX-A treatment.
Of 26 women, 14 were dry after 4 weeks, 13 of 20 women after 12 weeks, and 3 of 5 women after 36 weeks. Two women failed to respond. Two women were on self-catheterization temporarily. There were no other complications besides 9 urinary tract infections within the 51 follow-up visits.
BTX-A treatment seems to be a safe and efficacious new treatment option for patients with detrusor overactivity incontinence.
本研究旨在探讨A型肉毒毒素（BTX-A）治疗非神经源性逼尿肌过度活动症所致尿失禁的疗效和安全性。
本前瞻性非随机对照研究在一家三级转诊泌尿妇科进行。对26例伴有急迫性尿失禁且经尿动力学检查证实为逼尿肌过度活动症所致尿失禁且常规治疗无效的女性患者，在膀胱逼尿肌30个部位注射100单位BTX-A。在基线期以及BTX-A治疗后4周、12周和36周进行临床和尿动力学评估以及生活质量评估。
26例女性患者中，14例在4周后无尿失禁，20例中的13例在12周后无尿失禁，5例中的3例在36周后无尿失禁。2例女性患者治疗无效。2例女性患者暂时需要自行导尿。在51次随访中，除9例泌尿系统感染外，无其他并发症。
对于逼尿肌过度活动症所致尿失禁患者，BTX-A治疗似乎是一种安全有效的新治疗选择。
