Hung Man-Jung, Chen Yi-Ting, Shen Pao-Sheng, Hsu Shih-Tien, Chen Gin-Den, Ho Esther Shih-Chu
Department of Obstetrics and Gynecology, Taichung Veterans General Hospital, No. 160, Section 3, Taichung Harbor Road, Taichung 40705, Taiwan.
Int Urogynecol J. 2012 Nov;23(11):1533-9. doi: 10.1007/s00192-012-1699-x. Epub 2012 Mar 17.
Dimethyl sulfoxide (DMSO) bladder instillation is a standard therapy for interstitial cystitis (IC); however, there are varying degrees of success. We hypothesize that first-line intravesical therapy with a DMSO cocktail will optimize treatment outcome.
Ninety women with newly diagnosed IC were enrolled consecutively for the treatment. The IC symptom and problem index was used as an outcome measure.
Six (6.7%) patients dropped out of the treatment due to intolerable bladder irritation. Fifty-five (65.5%) of the remaining 84 patients, who completed the treatment, experienced ≧50% symptomatic improvement. After a regression analysis, three clinical variables were found to affect treatment adversely, i.e., the presence of advanced cystoscopic glomerulations, microscopic hematuria, and urodynamic detrusor underactivity, respectively.
Our results suggest bladder instillation with a DMSO cocktail may well be considered as first-line therapy for IC patients. However, there exists a subgroup of nonresponders who may have severe disease.
二甲基亚砜（DMSO）膀胱灌注是间质性膀胱炎（IC）的标准治疗方法；然而，治疗成功率各不相同。我们假设使用DMSO混合液进行一线膀胱内治疗将优化治疗效果。
连续纳入90例新诊断为IC的女性进行治疗。使用IC症状和问题指数作为疗效指标。
6例（6.7%）患者因无法耐受的膀胱刺激而退出治疗。其余84例完成治疗的患者中，55例（65.5%）症状改善≥50%。经过回归分析，发现三个临床变量分别对治疗产生不利影响，即存在晚期膀胱镜下肾小球样改变、镜下血尿和尿动力学逼尿肌活动不足。
我们的结果表明，对于IC患者，DMSO混合液膀胱灌注很可能被视为一线治疗方法。然而，存在一个可能患有严重疾病的无反应亚组。
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