Department of Urology, China Medical University Hospital, Taichung 40447, Taiwan.
School of Medicine, China Medical University, Taichung 40402, Taiwan.
Toxins (Basel). 2020 Jun 2;12(6):365. doi: 10.3390/toxins12060365.
This study aimed to evaluate and compare the efficacy and safety of mid-urethral sling (MUS) with botulinum toxin A (BoNT-A) versus MUS only in women with mixed urinary incontinence. This was a comparative observational study, and total of 73 patients were enrolled. A total of 38 and 35 patients received MUS only and MUS with BoNT-A injection, respectively. The efficacy outcome included change in Urinary Incontinence Outcome Scores (UIOS), change in Overactive Bladder Symptom Score (OABSS), and use of antimuscarinic agent or beta-3 agonist. Safety assessments included adverse events including urinary retention, increased postvoid residual volumes, and urinary tract infection. MUS with BoNT-A injection was insignificantly better than MUS only in urinary incontinence outcome (88% vs. 71%, respectively, = 0.085) at week three. Among the 33 patients with detrusor overactivity (DO), patients who received BoNT-A had a higher cure rate of incontinence (88% vs. 41%, = 0.01) and less required antimuscarinic agent or beta-3 agonist (31% vs. 94%, < 0.001) compared to patients who did not receive BoNT-A injection. There was no significant difference in the incidences of adverse events between two groups. BoNT-A injection with MUS demonstrated efficacy and safety in the treatment of mixed urinary incontinence, specifically for women with DO.
本研究旨在评估和比较中尿道吊带（MUS）联合肉毒毒素 A（BoNT-A）与单独 MUS 在混合性尿失禁女性中的疗效和安全性。这是一项比较观察性研究，共纳入 73 例患者。共有 38 例和 35 例患者分别接受了单独的 MUS 和 MUS 联合 BoNT-A 注射治疗。疗效结局包括尿失禁结局评分（UIOS）的变化、膀胱过度活动症症状评分（OABSS）的变化以及抗毒蕈碱药物或 β3 激动剂的使用。安全性评估包括包括尿潴留、残余尿量增加和尿路感染等不良事件。在第 3 周时，MUS 联合 BoNT-A 注射在尿失禁结局方面略优于单独使用 MUS（分别为 88%和 71%， = 0.085）。在 33 例逼尿肌过度活动（DO）患者中，接受 BoNT-A 治疗的患者失禁治愈率更高（88%比 41%， = 0.01），需要抗毒蕈碱药物或 β3 激动剂的比例更低（31%比 94%， < 0.001），与未接受 BoNT-A 注射的患者相比。两组不良事件的发生率无显著差异。MUS 联合 BoNT-A 注射在治疗混合性尿失禁方面具有疗效和安全性，特别是对 DO 女性。
