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经皮温度控制射频治疗绝经后阴道/泌尿生殖系统症状

Transcutaneous Temperature Controlled Radiofrequency (TTCRF) for the Treatment of Menopausal Vaginal/Genitourinary Symptoms.

作者信息

Leibaschoff Gustavo, Izasa Pablo Gonzalez, Cardona Jose Luis, Miklos John R, Moore Robert D

机构信息

ynecology and Obstetrics Department, University of Buenos Aires School of Medicine, Buenos Aires, Argentina.

Gynecology and Obstetrics Department, Military University of Colombia,Urogynecology Department, Hospital Universitario San Jorge, Pereira, Colombia.

出版信息

Surg Technol Int. 2016 Oct 26;29:149-159.

Abstract

OBJECTIVE

The aim of this study was to evaluate the effects of non-ablative, monopolar transcutaneous temperature controlled radiofrequency (TTCRF) technology in the treatment of postmenopausal women suffering from genuine stress urinary incontinence (SUI) related to menopause and to evaluate histological changes vaginally associated with the treatment.

MATERIALS AND METHODS

Subjective and objective symptoms of SUI were assessed in study subjects before and after TTCRF, (1 treatment every 30 days, for 3 months; n=10) and compared with the effects of a placebo treatment on a control group of demographically similar women (n =10). SUI was subjectively evaluated with subjective Urogenital Distress Inventory (UDI-6) and with the International Consultation on Incontinence Questionnaire-Urinary Incontinence Short Form (ICIQ-UI SF) before and after TTCRF treatments and objectively with cough stress test. Vaginal health was evaluated with the Vaginal Health Index (VHI) score and visual analogue score (VAS) for dyspareunia and dryness. Punch biopsies were obtained at the urethra-vesical junction in the anterior compartment, before and at the end of the treatment protocol. Basic and histochemical staining methods were used.

RESULTS

In subjects suffering SUI, TTCRF treatment was associated with a significant (p<0.01) improvement of ICIQ-SF and UDI-6 scores. Seven of 10 patients (70%) had a negative cough stress test after the treatment protocol. Improvements were maintained up to the 12th week of follow-up. The results were supported by the positive histologic changes seen vaginally in women suffering from postmenopausal vaginal atrophy. TTCRF was well tolerated with no complications reported in study patients.

CONCLUSION

TTCRF treatment in postmenopausal women suffering from SUI showed significant improvement in both objective and subjective symptoms. Vaginal health scores also improved as did VAS for dryness and dyspareunia. We feel these improvements were related to histological changes related to improvement in vaginal atrophy that were not observed in placebo patients.

摘要

目的

本研究旨在评估非消融性单极经皮温度控制射频(TTCRF)技术治疗绝经后妇女真性压力性尿失禁(SUI)的效果,并评估与该治疗相关的阴道组织学变化。

材料与方法

在TTCRF治疗前后对研究对象的SUI主观和客观症状进行评估(每30天治疗1次,共3个月;n = 10),并与安慰剂治疗对人口统计学特征相似的对照组女性(n = 10)的效果进行比较。在TTCRF治疗前后,通过主观泌尿生殖系统困扰量表(UDI - 6)和国际尿失禁咨询问卷 - 尿失禁简表(ICIQ - UI SF)对SUI进行主观评估,并通过咳嗽压力试验进行客观评估。通过阴道健康指数(VHI)评分以及性交困难和阴道干燥的视觉模拟评分(VAS)评估阴道健康状况。在治疗方案开始前和结束时,从前庭的尿道膀胱交界处获取组织块活检样本,采用基础和组织化学染色方法。

结果

在患有SUI的受试者中,TTCRF治疗使ICIQ - SF和UDI - 6评分显著改善(p < 0.01)。10名患者中有7名(70%)在治疗方案结束后咳嗽压力试验结果为阴性。这些改善在随访的第12周时仍持续存在。绝经后阴道萎缩女性阴道内出现的阳性组织学变化支持了该结果。TTCRF耐受性良好,研究患者未报告并发症。

结论

TTCRF治疗绝经后SUI患者在主观和客观症状方面均有显著改善。阴道健康评分以及阴道干燥和性交困难的VAS评分也有所改善。我们认为这些改善与安慰剂组患者未观察到的阴道萎缩改善相关的组织学变化有关。

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