Department of Urology, Medical University of South Carolina, Charleston, South Carolina.
Department of Obstetrics, Gynecology, and Reproductive Sciences, Rutgers University, New Brunswick, New Jersey.
Neurourol Urodyn. 2019 Nov;38(8):2178-2184. doi: 10.1002/nau.24110. Epub 2019 Jul 29.
To report 1-year results with selective bladder denervation (SBD) of the trigone in women with refractory overactive bladder (OAB).
In this prospective, international, multicenter case series, women with refractory OAB underwent a single SBD treatment of the bladder subtrigone region using temperature-controlled radiofrequency. Patients were followed for 1 year and evaluated for changes in OAB symptoms and adverse events.
Among 35 women, 29 (83%) returned for 1-year follow up. Median symptom reductions based on 3-day bladder diaries were 68% for urgency urinary incontinence ( P < .001), 67% for urinary incontinence ( P < .001), 43% for urgency episodes ( P < .001), 5% for urinary frequency ( P = .19), and 33% for the total urgency and frequency score ( P < .001), with the majority of treatment benefit realized in the first month. Treatment benefit was reported in 72% of patients, the clinical success rate (≥50% reduction in urgency urinary incontinence) was 69%, and the dry rate was 10%. Statistically significant improvements occurred on Symptom Bother and Health-related Quality of Life scales on the Overactive Bladder questionnaire, and on 6 of 9 King's Health Questionnaire domains. Patients with less severe baseline symptoms had similar quality of life improvements as those with more severe baseline symptoms. Device- or procedure-related adverse events were reported in 6 (17%) patients.
A single treatment with selective bladder denervation is durable for 1-year in a significant proportion of women with refractory overactive bladder.
报告选择性三角区膀胱去神经支配(SBD)治疗难治性膀胱过度活动症(OAB)的 1 年结果。
在这项前瞻性、国际、多中心病例系列研究中,采用温度控制射频对难治性 OAB 女性的膀胱下三角区进行单次 SBD 治疗。患者随访 1 年,评估 OAB 症状和不良事件的变化。
在 35 名女性中,29 名(83%)完成了 1 年随访。基于 3 天膀胱日记的症状缓解中位数为:急迫性尿失禁 68%(P < .001)、尿失禁 67%(P < .001)、急迫性发作 43%(P < .001)、排尿频率 5%(P = .19)和急迫性和频率总评分 33%(P < .001),大多数治疗获益发生在第 1 个月。72%的患者报告有治疗获益,临床成功率(急迫性尿失禁减少≥50%)为 69%,干燥率为 10%。在膀胱过度活动症问卷的症状困扰和健康相关生活质量量表以及 King's 健康问卷的 9 个领域中的 6 个领域均有显著改善。基线症状较轻的患者与基线症状较重的患者有相似的生活质量改善。6 名(17%)患者报告有与设备或程序相关的不良事件。
在相当一部分难治性膀胱过度活动症女性中,单次选择性膀胱去神经支配治疗可持久 1 年。