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选择性膀胱去神经支配治疗难治性膀胱过度活动症女性患者的一年疗效。

One-year results with selective bladder denervation in women with refractory overactive bladder.

机构信息

Department of Urology, Medical University of South Carolina, Charleston, South Carolina.

Department of Obstetrics, Gynecology, and Reproductive Sciences, Rutgers University, New Brunswick, New Jersey.

出版信息

Neurourol Urodyn. 2019 Nov;38(8):2178-2184. doi: 10.1002/nau.24110. Epub 2019 Jul 29.

Abstract

AIMS

To report 1-year results with selective bladder denervation (SBD) of the trigone in women with refractory overactive bladder (OAB).

METHODS

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.

RESULTS

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.

CONCLUSIONS

A single treatment with selective bladder denervation is durable for 1-year in a significant proportion of women with refractory overactive bladder.

摘要

目的

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。

方法

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。

结果

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。

结论

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。

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