Abulseoud Amr, Moussa Ahmed, Abdelfattah Gaber, Ibrahim Ibrahim, Saba Emmanuel, Hassouna Mohamed
Department of Urology, Alexandria University Hospital, Alexandria, Egypt.
Department of Physical Medicine, Rheumatology, and Rehabilitation, Alexandria University Hospital, Alexandria, Egypt.
Neurourol Urodyn. 2018 Feb;37(2):842-848. doi: 10.1002/nau.23361. Epub 2017 Aug 9.
To evaluate the effect of adding low dose trospium chloride with transcutaneous posterior tibial nerve stimulation (TPTNS) in the treatment of overactive bladder (OAB) in females after failure of behavioral therapy.
We randomized 30 women with OAB, in two groups: G I received 30 min TPTNS, three times a week; GII received TPTNS plus 20 mg trospium chloride daily. OAB Symptom Score questionnaire (OABSS), Incontinence Impact Questionnaire-short form 7 (IIQ-7), 3 day voiding diary and urodynamics at weeks 0 and 8 were evaluated.
The groups were similar before treatment. Eight weeks after treatment, the mean OABSS decreased significantly to 8.53 ± 1.30 for group II vs 10.0 ± 2.0 for GI (P < 0.024). The mean IIQ-7 score decreased significantly to 51.86 ± 17.26 in group I vs 31.99 ± 9.26 in group II (P < 0.001). Before treatment, 11 (73.3%) and 4 (26.7%) patients in each group had moderate and poor quality of life (QoL), respectively. After treatment, 6 (40%) and 14 (93.3%) had good QoL, 7 (46.7%) and 1 (6.7%) had moderate QoL in GI and GII, respectively. Two (13.3%) patients in GI had poor QoL. The mean frequency was reduced to 8.60 ± 0.83 vs 10.60 ± 2.32 for GII and GI respectively (P = 0.006). The cystometric capacity increased from 263.40 ± 50.45 to 377.80 ± 112.92 mL (P = 0.001) for GII vs 250.13 ± 56.24 to 296.40 ± 99.0 mL (P = 0.026) for GI.
TPTNS combined with low dose trospium chloride proved to be more effective than TPTNS alone in the treatment of OAB in females.
评估在行为疗法失败后，添加低剂量氯化托特罗定与经皮胫后神经刺激（TPTNS）联合治疗女性膀胱过度活动症（OAB）的效果。
我们将30例OAB女性患者随机分为两组：第一组（G I）每周接受3次、每次30分钟的TPTNS治疗；第二组（GII）接受TPTNS治疗并每日加用20mg氯化托特罗定。评估0周和8周时的OAB症状评分问卷（OABSS）、尿失禁影响问卷简表7（IIQ-7）、3天排尿日记及尿动力学。
治疗前两组相似。治疗8周后，第二组的平均OABSS显著降至8.53±1.30，而第一组为10.0±2.0（P<0.024）。第一组的平均IIQ-7评分显著降至51.86±17.26，第二组为31.99±9.26（P<0.001）。治疗前，每组分别有11例（73.3%）和4例（26.7%）患者生活质量（QoL）为中度和较差。治疗后，第一组和第二组分别有6例（40%）和14例（93.3%）患者QoL良好，7例（46.7%）和1例（6.7%）患者QoL为中度。第一组有2例（13.3%）患者QoL较差。第二组和第一组的平均排尿频率分别降至8.60±0.83和10.60±2.32（P=0.006）。第二组膀胱容量从263.40±50.45增加至377.80±112.92mL（P=0.001），第一组从250.13±56.24增加至296.40±99.0mL（P=0.026）。
在治疗女性OAB方面，TPTNS联合低剂量氯化托特罗定被证明比单独使用TPTNS更有效。
