Funaro Michael G, King Alexandra N, Stern Joel N H, Moldwin Robert M, Bahlani Sonia
Zucker School of Medicine at Hofstra/Northwell, Hempstead, NY.
Zucker School of Medicine at Hofstra/Northwell, Hempstead, NY.
Urology. 2018 Aug;118:25-29. doi: 10.1016/j.urology.2018.03.037. Epub 2018 May 18.
To investigate the efficacy of low dose triamcinolone injection for effectiveness and durability in patients with interstitial cystitis/bladder pain syndrome (IC/BPS) with Hunner lesions (HL).
Clinical data from patients with HL who underwent endoscopic submucosal injection of triamcinolone were reviewed. Demographics, pre- and postoperative pain and nocturia scores, and long-term clinical outcomes were assessed. Duration of response was estimated by time to repeat procedure. Kaplan-Meier estimator was used to evaluate time to repeat procedure.
A total of 36 patients who received injections of triamcinolone between 2011 and 2015 were included. Median age ± standard deviation of patients was 61.5 ± 12.0 years; 28 (77.8%) were female patients and 8 (22.2%) were male patients. Twenty six patients (72.2%) received only 1 set of injections, 8 (22.2%) received 2 sets of injections, and 2 (5.56%) received 3 or more sets of injections. Average time between injections in those receiving more than 1 set of injections was 344.9 days (median: 313.5, range: 77-714). Preprocedural pain scores were 8.3 ± 1.2 (mean ± standard deviation) on Likert pain scale (0-10), and mean postprocedural pain scores at approximately 1 month were 3.8 ± 2.2, P <.001. Mean preprocedural nocturia bother scores was 7.5 ± 2.0 and mean postprocedural nocturia bother scores was 5.1 ± 2.5, P <.001.
Endoscopic submucosal injection of low dose triamcinolone in patients with IC/BPS with HL is an effective and durable adjunct to existing treatment modalities. This approach is associated with low morbidity and can be performed on an outpatient basis.
探讨低剂量曲安奈德注射治疗间质性膀胱炎/膀胱疼痛综合征（IC/BPS）合并Hunner溃疡（HL）患者的有效性和持久性。
回顾接受曲安奈德内镜下黏膜下注射的HL患者的临床资料。评估人口统计学特征、术前和术后疼痛及夜尿评分，以及长期临床结局。通过重复治疗的时间来估计反应持续时间。采用Kaplan-Meier估计量来评估重复治疗的时间。
纳入2011年至2015年间接受曲安奈德注射的36例患者。患者的中位年龄±标准差为61.5±12.0岁；28例（77.8%）为女性患者，8例（22.2%）为男性患者。26例（72.2%）仅接受1次注射，8例（22.2%）接受2次注射，2例（5.56%）接受3次或更多次注射。接受多次注射的患者两次注射之间的平均时间为344.9天（中位数：313.5，范围：77-714）。术前疼痛评分为Likert疼痛量表（0-10）上的8.3±1.2（平均值±标准差），术后约1个月时的平均疼痛评分为3.8±2.2，P<0.001。术前夜尿困扰平均评分为7.5±2.0，术后夜尿困扰平均评分为5.1±2.5，P<0.001。
对IC/BPS合并HL患者进行低剂量曲安奈德内镜下黏膜下注射是现有治疗方式的一种有效且持久的辅助治疗方法。该方法发病率低，可在门诊进行。
