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膀胱疼痛综合征中膀胱内注射硫酸软骨素及透明质酸/硫酸软骨素联合治疗对女性性功能的影响

Outcomes of intravesical chondroitin-sulfate and combined hyaluronic-acid/chondroitin-sulfate therapy on female sexual function in bladder pain syndrome.

作者信息

Arslan Burak, Gönültaş Serkan, Gökmen Ersin, Özman Oktay, Avci Mustafa Asım, Özdemir Enver

机构信息

Department of Urology, Istanbul Gaziosmanpasa Taksim Training and Research Hospital, Karayolları Str. No:621 Gaziosmanpaşa, Istanbul, Turkey.

出版信息

Int Urogynecol J. 2019 Nov;30(11):1857-1862. doi: 10.1007/s00192-019-04036-2. Epub 2019 Jun 28.

Abstract

INTRODUCTION AND HYPOTHESIS

Our aim was to determine the efficacy of intravesical chondroitin sulfate (CS) and combined hyaluronic acid/chondroitin sufate (HA/CS) treatment and their effects on sexual function of females with interstitial cystitis/bladder pain syndrome (IC/BPS).

METHODS

A total of 68 female patients with IC/BPS between 2012 and 2018 were reviewed. Thirty-three patients were treated with combined HA/CS and 28 patients were treated with CS. Instillations were performed weekly for the first month, biweekly for the second month, and monthly in the third and fourth months. Before and after the sixth month of the treatment, all patients were evaluated with the Female Sexual Function Index (FSFI), visual analog pain scale (VAS), interstitial cystitis symptom index (ICSI), interstitial cystitis problem index (ICPI), and voiding diary, and changes were recorded.

RESULTS

A statistically significant improvement was determined for FSFI, VAS, ICSI, and ICPI scores after treatment in both groups. Among baseline characteristics, a weak but significant negative correlation was determined only between the ICSI score improvement and age (rho: -0.38; p = 0.03) on statistical analysis. Compared with CS, combined HA/CS treatment was superior in terms of ICSI, ICPI, and daytime and nighttime frequency improvement (0.042, 0.038, 0.039, and 0.045; respectively). All domains of the sexual function index were significantly improved at the sixth month of intravesical therapy in both groups. A statistical difference was not found between the two groups.

CONCLUSIONS

Although it seems that intravesical HA/CS combination is superior to CS alone in terms of symptom reduction, both of them have beneficial effects on sexual function.

摘要

引言与假设

我们的目的是确定膀胱内注射硫酸软骨素(CS)以及透明质酸/硫酸软骨素联合制剂(HA/CS)治疗间质性膀胱炎/膀胱疼痛综合征(IC/BPS)女性患者的疗效及其对性功能的影响。

方法

回顾性分析了2012年至2018年间68例IC/BPS女性患者。33例患者接受HA/CS联合治疗,28例患者接受CS治疗。第一个月每周进行一次灌注,第二个月每两周进行一次灌注,第三和第四个月每月进行一次灌注。治疗第六个月前后,所有患者均采用女性性功能指数(FSFI)、视觉模拟疼痛量表(VAS)、间质性膀胱炎症状指数(ICSI)、间质性膀胱炎问题指数(ICPI)及排尿日记进行评估,并记录变化情况。

结果

两组治疗后FSFI、VAS、ICSI和ICPI评分均有统计学意义的改善。在基线特征中,经统计学分析,仅ICSI评分改善与年龄之间存在微弱但显著的负相关(rho:-0.38;p = 0.03)。与CS相比,HA/CS联合治疗在ICSI、ICPI以及白天和夜间排尿频率改善方面更具优势(分别为0.042、0.038、0.039和0.045)。两组膀胱内治疗第六个月时性功能指数的所有领域均有显著改善。两组之间未发现统计学差异。

结论

虽然膀胱内注射HA/CS联合制剂在减轻症状方面似乎优于单独使用CS,但两者对性功能均有有益影响。

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