Department of Urology, Vanderbilt University Medical Center, A1302 Medical Center North, Nashville, Tennessee, USA.
J Spinal Cord Med. 2022 Jul;45(4):489-497. doi: 10.1080/10790268.2020.1829415. Epub 2020 Oct 15.
Detrusor underactivity (DUA) in women can result in urinary retention and the need for chronic bladder drainage management. Without a cure for urinary retention due to DUA, treatment options are focused on effective bladder drainage most often by intermittent or continuous catheter drainage. The inFlow intraurethral valve pump was FDA approved for use in women with this condition in 2014. Using a literature search, this clinical review sought to explore the epidemiology and commonly used treatment options for women with DUA and critically examine all available studies of the inFlow urinary prosthesis. Due to a lack of effective treatments to improve detrusor function, DUA is generally considered incurable and there are limited treatment options which mostly focus on effective bladder drainage. The inFlow urinary prosthesis is a unique technology which utilizes a nonsurgically inserted urethral device for females to assist with bladder drainage due to DUA. The inFlow urinary prosthesis has been used in Europe and elsewhere for 20 years and is the subject of seven peer-reviewed clinical studies. For those that tolerate the device (about half), the inFlow urinary prosthesis has a low infection rate and side effect profile, is easy to use, and can normalize urination by returning autonomy to patients and thus improve their quality of life. There is no cure for women with DUA. Bladder drainage can be managed by intermittent or continuous catheterization. Appropriately selected women interested in an alternative to catheterization may be offered an on-device trial of the inFlow urinary prosthesis.
女性逼尿肌活动不足(DUA)可导致尿潴留和需要长期进行膀胱引流管理。由于逼尿肌活动不足导致的尿潴留没有治愈方法,因此治疗方案主要集中在通过间歇性或持续性导尿管引流来有效排空膀胱。inFlow 尿道内阀泵于 2014 年获得美国食品和药物管理局批准用于治疗此类女性患者。本临床综述通过文献检索,旨在探讨女性逼尿肌活动不足的流行病学和常用治疗方法,并对 inFlow 尿失禁假体的所有现有研究进行批判性评估。由于缺乏改善逼尿肌功能的有效治疗方法,DUA 通常被认为是无法治愈的,并且治疗选择有限,主要集中在有效排空膀胱。inFlow 尿失禁假体是一种独特的技术,它利用一种非手术插入的尿道装置来帮助因 DUA 而导致膀胱排空的女性。inFlow 尿失禁假体已在欧洲和其他地区使用了 20 年,并且是 7 项同行评议的临床研究的主题。对于大约一半能够耐受该设备的患者,inFlow 尿失禁假体具有较低的感染率和副作用,使用方便,并通过恢复患者的自主排尿能力使排尿正常化,从而提高生活质量。对于逼尿肌活动不足的女性,没有治愈方法。膀胱引流可以通过间歇性或持续性导尿管来管理。对导管替代治疗感兴趣的适当选择的女性可能会被提供 inFlow 尿失禁假体的设备试用。