Yang Xue-Song, Chen Zheng, Duan Jian-Li, Pan Bin, Qin Xiao-Ping, Lei Bin, Lu Yang-Bai, Li Yu-Tong, Luo Yun, Xu Xiao-Long, Lai Cai-Yong, Zhuo Yu-Min
Department of Urology, The First Affiliated Hospital of Jinan University, Guangzhou 510632, China.
Department of Urology, Affiliated Hospital of North Sichuan Medical College, Nanchong 637000, China.
Transl Androl Urol. 2020 Jun;9(3):1244-1251. doi: 10.21037/tau.2020.04.01.
The treatment of ketamine-induced bladder contractures remains poorly studied. We therefore evaluated the efficacy of cystectasia with a sodium hyaluronate balanced solution in this kind of bladder contracture.
Eighteen patients presenting with ketamine-induced bladder contracture between July 2010 and February 2018 were selected and analysed. Ketamine was discontinued in all patients, who were then treated with weekly cystectasia (0.09% sodium hyaluronate balanced solution) 3 times. The volume of the first perfusion was twice the preoperatively measured bladder capacity, and the volume of the subsequent two perfusions was increased by 100 mL each time. The Pelvic Pain and Urgency/Frequency (PUF) symptom score, O'Leary-Sant Interstitial Cystitis (IC) Symptom Index (ICSI), IC Problem Index (ICPI), Quality of Life (QOL) score, and bladder capacity were recorded before surgery and 3 and 12 months after the 3 expansion.
No significant complications were observed during the 3 expansions. Fourteen patients completed the full follow-up schedule. Preoperatively and at the 3- and 12-month follow-up evaluations performed after the 3 expansion, the PUF symptom scores were 20.4±3.6, 11.5±3.1, and 13.2±3.3, respectively; the mean ICSI was 13.6±2.8, 7.7±2.3, and 8.2±2.5, respectively; the mean ICPI was 10.6±2.6, 7.3±2.1, and 7.7±2.5, respectively; and the mean QOL scores were 6.0±0, 2.1±0.5, and 2.7±0.8, respectively; and the mean bladder catheter volume was 83±27, 234±56, and 228±52 mL, respectively. There were significant differences between all preoperative and postoperative values.
Cystectasia with a sodium hyaluronate balanced solution is an effective treatment modality for ketamine-induced bladder contracture.
氯胺酮所致膀胱挛缩的治疗仍研究不足。因此，我们评估了用透明质酸钠平衡液进行膀胱扩张术治疗此类膀胱挛缩的疗效。
选取2010年7月至2018年2月间18例氯胺酮所致膀胱挛缩患者进行分析。所有患者均停用氯胺酮，随后每周进行1次膀胱扩张术（0.09%透明质酸钠平衡液），共3次。首次灌注量为术前测量膀胱容量的2倍，随后两次灌注量每次增加100 mL。记录手术前、3次扩张后3个月和12个月时的盆腔疼痛及尿急/尿频（PUF）症状评分、奥利里 - 桑特间质性膀胱炎（IC）症状指数（ICSI）、IC问题指数（ICPI）、生活质量（QOL）评分以及膀胱容量。
3次扩张过程中未观察到明显并发症。14例患者完成了完整的随访计划。术前以及3次扩张后进行的3个月和12个月随访评估时，PUF症状评分分别为20.4±3.6、11.5±3.1和13.2±3.3；平均ICSI分别为13.6±2.8、7.7±2.3和8.2±2.5；平均ICPI分别为10.6±2.6、7.3±2.1和7.7±2.5；平均QOL评分分别为6.0±0、2.1±0.5和2.7±0.8；平均膀胱导尿量分别为83±27、234±56和228±52 mL。术前和术后所有值之间均存在显著差异。
用透明质酸钠平衡液进行膀胱扩张术是治疗氯胺酮所致膀胱挛缩的一种有效治疗方式。
