环状子宫托与多成分行为疗法治疗膀胱过度活动症的回顾性比较
A retrospective comparison of ring pessary and multicomponent behavioral therapy in managing overactive bladder.
作者信息
Sze Eddie H M, Hobbs Gerry
机构信息
Division of Urogynecology and Reconstructive Pelvic Surgery, Department of Obstetrics and Gynecology, West Virginia University School of Medicine, Morgantown, WV, 26506-9186, USA,
出版信息
Int Urogynecol J. 2014 Nov;25(11):1583-8. doi: 10.1007/s00192-014-2397-7. Epub 2014 May 7.
INTRODUCTION AND HYPOTHESIS
Overactive bladder (OAB) is a physically, psychologically, and socially disabling condition that affects millions of women worldwide and is especially prevalent postmenopause. The objective of our study was to compare the cure rates of ring pessary with those of multicomponent behavioral therapy in managing overactive bladder.
METHODS
We performed a comparative retrospective parallel cohort study of all women whose overactive bladder was treated with multicomponent behavioral therapy or ring pessary over a 42-month period. At the end of the 6-month treatment period, cure was defined as the subjective (self-reported) absence of urinary urgency, frequency, nocturia, and urge incontinence in the preceding 30 days; the objective absence of these symptoms in a 7-day voiding diary; and a Patient Global Impression of Improvement response of "much better" or "very much better."
RESULTS
Ring pessary and multicomponent behavioral therapy had similar cure rates (29 out of 150 [19 %] vs 46 out of 231 [20 %] respectively, P = 0.889; OR of 1.04, 95 % confidence interval 0.618-1.742, P = 0.887). They also produced comparable cure rates in premenopausal (4 out of 31 [13 %] vs 14 out of 68 [21 %], P = 0.358) and postmenopausal subjects (25/ out of 19 [21 %] vs 32 out of 163 [20 %], P = 0.776), and in women who had undergone previous treatment (21 out of 108 [19 %] vs 31 out of 176 [18 %], P = 0.699) and those who had not (8 out of 42 [19 %] vs 15 out of 55 [27 %], P = 0.345). Logistic regression showed that neither treatment outcome is significantly associated with demographic characteristics; Pelvic Organ Prolapse Quantification at the anterior and posterior vaginal walls and at the vaginal cuff; previous treatment; overactive bladder symptoms; pad usage; or any combination thereof.
CONCLUSIONS
Ring pessary has a cure rate similar to that of multicomponent behavioral therapy in managing overactive bladder.
引言与假设
膀胱过度活动症（OAB）是一种在身体、心理和社会层面都会造成功能障碍的病症，影响着全球数百万女性，在绝经后尤为普遍。我们研究的目的是比较环形子宫托与多组分行为疗法在治疗膀胱过度活动症方面的治愈率。
方法
我们对在42个月期间接受多组分行为疗法或环形子宫托治疗膀胱过度活动症的所有女性进行了一项比较性回顾性平行队列研究。在6个月治疗期结束时，治愈的定义为：主观上（自我报告）在过去30天内无尿急、尿频、夜尿和急迫性尿失禁；在7天排尿日记中客观上无这些症状；以及患者整体改善印象反应为“好多了”或“非常好多了”。
结果
环形子宫托和多组分行为疗法的治愈率相似（分别为150例中的29例[19%]和231例中的46例[20%]，P = 0.889；OR为1.04，95%置信区间为0.618 - 1.742，P = 0.887）。在绝经前（31例中的4例[13%]比68例中的14例[21%]，P = 0.358）和绝经后受试者（119例中的25例[21%]比163例中的32例[20%]，P = 0.776），以及既往接受过治疗的女性（108例中的21例[19%]比176例中的31例[18%]，P = 0.699）和未接受过治疗的女性（42例中的8例[19%]比55例中的15例[27%]，P = 0.345）中，它们的治愈率也相当。逻辑回归显示，两种治疗结果均与人口统计学特征、阴道前壁和后壁以及阴道袖口的盆腔器官脱垂量化、既往治疗、膀胱过度活动症症状、护垫使用情况或它们的任何组合均无显著关联。
结论
在治疗膀胱过度活动症方面，环形子宫托与多组分行为疗法的治愈率相似。
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