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经尿道内注射自体碎化骨骼肌:治疗压力性尿失禁的一种简单手术方法。

Intraurethral injection of autologous minced skeletal muscle: a simple surgical treatment for stress urinary incontinence.

机构信息

Department of Obstetrics and Gynecology, Copenhagen University Hospital Herlev, Herlev, Denmark.

Department of Obstetrics and Gynecology, Copenhagen University Hospital Herlev, Herlev, Denmark.

出版信息

J Urol. 2014 Sep;192(3):850-5. doi: 10.1016/j.juro.2014.04.005. Epub 2014 Apr 13.

DOI:10.1016/j.juro.2014.04.005
PMID:24735937
Abstract

PURPOSE

Intraurethral injection of in vitro expanded autologous skeletal muscle derived cells is a new regenerative therapy for stress urinary incontinence. We examined the efficacy and safety of a simpler alternative strategy using freshly harvested, minced autologous skeletal muscle tissue with its inherent content of regenerative cells.

MATERIALS AND METHODS

A total of 20 and 15 women with uncomplicated and complicated stress urinary incontinence, respectively, received intraurethral injections of minced autologous skeletal muscle tissue and were followed for 1 year. Efficacy was assessed by the number of leakages in a 3-day diary and by ICIQ-SF scores. We calculated the rates of cure, defined as zero leaks in 3 days plus an ICIQ-SF score of 5 or less, and improvement, defined as simultaneous decreases in each outcome measure.

RESULTS

Significant reductions were observed in each group in the mean number of leakages (p <0.01) and in ICIQ-SF scores (p <0.001). In the uncomplicated group cure and improvement were observed in 25% and 63% of patients, and in the complicated group they were noted in 7% and 57%, respectively. No voiding dysfunction developed and only minor adverse events were noted.

CONCLUSIONS

Intraurethral injection of minced autologous muscle tissue is a simple surgical procedure that appears safe and moderately effective in women with uncomplicated stress urinary incontinence. It compares well to a more complicated regenerative strategy using in vitro expanded muscle derived cells.

摘要

目的

经尿道注射体外扩增的自体骨骼肌衍生细胞是治疗压力性尿失禁的一种新的再生疗法。我们研究了使用新鲜收获的、切碎的自体骨骼肌组织及其固有再生细胞含量的更简单替代策略的疗效和安全性。

材料和方法

共有 20 名和 15 名分别患有单纯性和复杂性压力性尿失禁的女性接受了经尿道注射切碎的自体骨骼肌组织治疗,并随访了 1 年。疗效通过 3 天日记中的漏尿次数和 ICIQ-SF 评分来评估。我们计算了治愈率,定义为 3 天内无漏尿且 ICIQ-SF 评分<5,以及改善率,定义为每种结果测量同时下降。

结果

两组患者的平均漏尿次数(p<0.01)和 ICIQ-SF 评分(p<0.001)均显著降低。在单纯性组中,25%的患者治愈,63%的患者改善,在复杂性组中,分别有 7%和 57%的患者治愈和改善。无排尿功能障碍发生,仅出现轻微不良反应。

结论

经尿道注射切碎的自体肌肉组织是一种简单的手术程序,对于单纯性压力性尿失禁女性来说,安全且中度有效。与使用体外扩增的肌肉衍生细胞的更复杂的再生策略相比,它表现良好。

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