经尿道完全切除术联合治疗性水扩张治疗溃疡性间质性膀胱炎的长期疗效。
Long-term outcomes of ulcerative interstitial cystitis after complete transurethral resection with therapeutic hydrodistention.
机构信息
Department of Urology, Soonchunhyang University Bucheon Hospital, Soonchunhyang University College of Medicine, Jomaru-ro 170, Wonmi-gu, Bucheon, 23268, Republic of Korea.
Department of Urology, Soonchunhyang University Seoul Hospital, Soonchunhyang University College of Medicine, Seoul, Republic of Korea.
出版信息
Int Urol Nephrol. 2021 Feb;53(2):219-227. doi: 10.1007/s11255-020-02637-1. Epub 2020 Sep 14.
PURPOSE
We analyzed the long-term efficacy of simultaneous transurethral resection (TUR) and therapeutic hydrodistention in patients with ulcerative interstitial cystitis (IC) who did not experience recurrence on long-term follow-up.
METHODS
We studied 132 female patients (mean age = 56.45 ± 11.56 years) who underwent TUR followed by hydrodistention to treat ulcerative IC between January 2010 and January 2017, and who were available for follow-up, for more than 36 months (mean = 52.3 ± 10.51 months). Of the 132 patients, those who did not suffer recurrence within 36 months after surgery were allocated to group I and those who had a recurrence within the same period were assigned to group II. Preoperative factors, including age, were compared between the groups. In group I, improvements in pain and voiding symptoms were recorded using a 10-point visual analog pain scale (VAS) and a 3-day micturition chart. A global response assessment (GRA) was used to evaluate patient satisfaction.
RESULTS
In group II, the maximum functional bladder capacity (FBC) was smaller, and voiding frequency was higher, than in group I. Follow-up of patients in group I for more than 3 years showed that pain decreased after surgery. The 10-point VAS scores were 9.68 before surgery, and 1.54, 0.93, 0.55, and 0.46 at 1, 6, 12, and 36 months after surgery (p < 0.001), respectively. Maximum FBCs were 174.82 mL before surgery and 237.14, 250.71, and 254.46 mL at 1, 12, and 36 months after surgery (p < 0.001), respectively; thus, FBC increased after surgery. Urination frequency decreased significantly after surgery; the number of daily urinations was 12.77 before surgery, and 9.88, 9.21, and 9.25 at 1, 12, and 36 months after surgery (p < 0.001), respectively. Overall patient satisfaction improved after surgery; the GRA scores were 2.39, 2.71, and 2.8 points at 1, 12, and 36 months after surgery (p < 0.001), respectively.
CONCLUSION
Upon simultaneous performance of TUR and therapeutic hydrodistention in patients with ulcerative IC, 49.2% showed favorable outcomes for 3 years.
目的
我们分析了在长期随访中未复发的溃疡性间质性膀胱炎（IC）患者中，同时进行经尿道电切术（TUR）和治疗性水扩张术的长期疗效。
方法
我们研究了 132 名女性患者（平均年龄=56.45±11.56 岁），她们于 2010 年 1 月至 2017 年 1 月期间接受 TUR 联合水扩张治疗溃疡性 IC，并可进行超过 36 个月（平均=52.3±10.51 个月）的随访。在 132 名患者中，术后 36 个月内无复发的患者被分为 I 组，在同一时期内有复发的患者被分为 II 组。比较两组患者的术前因素，包括年龄。在 I 组中，使用 10 分视觉模拟疼痛量表（VAS）和 3 天排尿图记录疼痛和排尿症状的改善情况。采用总体反应评估（GRA）评估患者满意度。
结果
在 II 组中，最大膀胱容量（FBC）较小，排尿频率较高。I 组患者的随访时间超过 3 年，显示术后疼痛减轻。术前 10 分 VAS 评分为 9.68，术后 1、6、12 和 36 个月分别为 1.54、0.93、0.55 和 0.46（p<0.001）。术前最大 FBC 为 174.82ml，术后 1、12 和 36 个月分别为 237.14、250.71 和 254.46ml（p<0.001），因此 FBC 术后增加。术后排尿频率明显减少，每日排尿次数由术前的 12.77 次减少至术后 1、12 和 36 个月的 9.88、9.21 和 9.25 次（p<0.001）。术后患者总体满意度提高，术后 1、12 和 36 个月的 GRA 评分分别为 2.39、2.71 和 2.8 分（p<0.001）。
结论
在同时进行 TUR 和治疗性水扩张治疗溃疡性 IC 患者中，49.2%的患者在 3 年内获得良好的效果。
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