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富血小板血浆和二氧化碳激光治疗压力性尿失禁的显著效果

Promising impact of platelet rich plasma and carbon dioxide laser for stress urinary incontinence.

作者信息

Behnia-Willison Fariba, Nguyen Tran T T, Norbury Aidan J, Mohamadi Behrang, Salvatore Stefano, Lam Alan

机构信息

Department of Obstetrics & Gynaecology, Flinders Medical Centre, Adelaide, Australia.

Flinders University, Adelaide, Australia.

出版信息

Eur J Obstet Gynecol Reprod Biol X. 2019 Oct 22;5:100099. doi: 10.1016/j.eurox.2019.100099. eCollection 2020 Jan.

Abstract

OBJECTIVES

To evaluate the safety, feasibility and efficacy of trans-vaginal fractional micro-ablative CO laser therapy in combination with platelet rich plasma (PRP) for the treatment of stress urinary incontinence (SUI) in women.

STUDY DESIGN

Participants with SUI underwent three sessions of transvaginal CO laser and PRP treatment, administered at 4-6-week intervals. Outcomes were assessed using the bladder function section of the Australian Pelvic Floor Questionnaire (APFQ). The primary outcome was changes in the participants' symptoms of SUI. Secondary outcomes were related to general bladder function. Outcome differences from baseline (T1) to 3 months (T2) and 12 months (T3) were analysed using Wilcoxon signed-rank tests. Subjective verbal scales were used to assess the degree of pain associated with PRP injections and laser treatment.

RESULTS

Sixty-two women with SUI were enrolled into this study. There were 66% (41/62) of participants who reported improved SUI symptoms from T1 to T2 (p < 0.001) and at T3, 62% (23/37) of patients reported improved SUI symptoms (p < 0.001). From T1 to T2, all bladder function variables were improved significantly (p < 0.002). At T3, significant improvements (p < 0.03) were maintained for all bladder function variables, except pad usage (p = 0.073).

CONCLUSIONS

Combining transvaginal fractional CO laser with PRP might be a beneficial treatment for SUI. It may have the potential to be a minimally-invasive and low-risk alternative to surgery, with reduced recovery time.

摘要

目的

评估经阴道分次微消融二氧化碳激光疗法联合富血小板血浆(PRP)治疗女性压力性尿失禁(SUI)的安全性、可行性和疗效。

研究设计

患有SUI的参与者接受了3次经阴道二氧化碳激光和PRP治疗,治疗间隔为4 - 6周。使用澳大利亚盆底问卷(APFQ)的膀胱功能部分评估结果。主要结果是参与者SUI症状的变化。次要结果与一般膀胱功能有关。使用Wilcoxon符号秩检验分析从基线(T1)到3个月(T2)和12个月(T3)的结果差异。使用主观言语量表评估与PRP注射和激光治疗相关的疼痛程度。

结果

62名患有SUI的女性被纳入本研究。从T1到T2,66%(41/62)的参与者报告SUI症状有所改善(p < 0.001),在T3时,62%(23/37)的患者报告SUI症状有所改善(p < 0.001)。从T1到T2,所有膀胱功能变量均有显著改善(p < 0.002)。在T3时,除了护垫使用情况(p = 0.073)外,所有膀胱功能变量均保持显著改善(p <  0.03)。

结论

经阴道分次二氧化碳激光联合PRP可能是治疗SUI的一种有益方法。它有可能成为一种微创、低风险的手术替代方法,且恢复时间更短。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/21ab/6994399/3a6ef2f33595/gr1.jpg

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