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A型肉毒杆菌毒素100单位与200单位治疗难治性特发性膀胱过度活动症的疗效比较

Efficacy of botulinum toxin type A 100 Units versus 200 units for treatment of refractory idiopathic overactive bladder.

作者信息

Abdelwahab Osama, Sherif Hammouda, Soliman Tark, Elbarky Ihab, Eshazly Aly

机构信息

Urology department, Faculty of Medicine, Benha University, Egypt.

出版信息

Int Braz J Urol. 2015 Nov-Dec;41(6):1132-40. doi: 10.1590/S1677-5538.IBJU.2014.0221.

Abstract

OBJECTIVE

To evaluate the efficacy and safety of a single intra detrusor injection of BoNTA comparing two different doses (100 U or 200 U) in patients with idiopathic overactive bladder.

MATERIALS AND METHODS

A randomized prospective study evaluated the efficacy of BoNTA in management of refractory idiopathic overactive bladder and included 80 patients. All patients were assessed initially by taking a history, a physical examination, overactive bladder symptom score, urine analysis, routine laboratory investigations, KUB and pelviabdominal. OABSS was adjusted on all patients postoperative at 1,3,6,9 months also Urodynamic was done for all patients preoperative and postoperative at 3, 6, 9 months.

RESULTS

The mean age was 30.22±8.37 and 31.35±7.61 in group I and II respectively. There was no statistically difference between both groups in all parameters all over the study except at 9 months after treatment. Hematuria was observed 6 and 9 patients in group I and II respectively. Dysuria was observed in 6 and 15 patients in group I and II respectively. UTI was detected in 3 and 7 patients in group I and II respectively.

CONCLUSION

A single-injection procedure of 100 U or 200 U BoNTA is an effective and safe treatment for patients with IOAB who failed anticholinergic regimens. OABSS and QoL were improved for 6 months; 100 U injections seemed to have comparable results with 200 U. There was a significant difference at month 9 towards 200 U with more incidences of adverse events.

摘要

目的

评估在特发性膀胱过度活动症患者中单次膀胱逼尿肌注射两种不同剂量(100 U或200 U)肉毒杆菌毒素A(BoNTA)的疗效和安全性。

材料与方法

一项随机前瞻性研究评估了BoNTA治疗难治性特发性膀胱过度活动症的疗效,纳入80例患者。所有患者最初均通过病史采集、体格检查、膀胱过度活动症症状评分、尿液分析、常规实验室检查、腹部平片及盆腔腹部检查进行评估。所有患者在术后1、3、6、9个月时调整膀胱过度活动症症状评分,并且所有患者在术前及术后3、6、9个月时进行尿动力学检查。

结果

第一组和第二组的平均年龄分别为30.22±8.37和31.35±7.61。在整个研究过程中,除治疗后9个月外,两组在所有参数上均无统计学差异。第一组和第二组分别有6例和9例患者出现血尿。第一组和第二组分别有6例和15例患者出现排尿困难。第一组和第二组分别有3例和7例患者检测出尿路感染。

结论

对于抗胆碱能治疗方案失败的特发性膀胱过度活动症患者,单次注射100 U或200 U BoNTA是一种有效且安全的治疗方法。膀胱过度活动症症状评分和生活质量在6个月内得到改善;100 U注射似乎与200 U注射效果相当。在第9个月时,200 U注射组出现更多不良事件,差异有统计学意义。

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