Department of Urology, Hualien Tzu Chi Hospital, Buddhist Tzu Chi Medical Foundation and Tzu Chi University, Hualien, Taiwan, ROC.
Sci Rep. 2021 Mar 8;11(1):5371. doi: 10.1038/s41598-021-84923-1.
Platelet-rich plasma (PRP) is the most innovative blood-derived product used in regenerative medicine. We aimed to investigate the therapeutic efficacy of PRP urethral sphincter injection for the management of postprostatectomy incontinence (PPI). In total, 28 PPI patients with a mean age of 71.8 ± 8.9 years were prospectively enrolled. They received four PRP urethral sphincter injections each month. The clinical outcomes were assessed 3 months after the fourth injection as posttreatment Global Response Assessment (GRA) score, the newly designed visual analogue scale of stress urinary incontinence (VAS of SUI), and in urodynamic parameters. After injections, the posttreatment median GRA with quartiles was 2.0 (1.0, 2.0). Overall, six (21.4%) patients achieved complete continence and pad-free status, 20 (71.4%) achieved successful outcome (GRA score ≥ 2), and 26 (92.9%) showed clinical improvement (GRA score ≥ 1). The VAS of SUI significantly improved from 6.5 (5.0, 8.0) to 3.5 (2.0-5.8) (p < 0.001) as well as abdominal leak point pressure, from 57.5 (50.0, 115.0) to 126.0 (68.3, 150.0), (p = 0.004). After repeated PRP urethral sphincter injections, the SUI severity reduced significantly with high success rates. There was no major adverse event, except three patients with mild hematuria and micturition pain. In conclusion, PRP urethral sphincter injection is safe and effective as a novel management of PPI.
富血小板血浆 (PRP) 是再生医学中最具创新性的血液衍生产品。我们旨在研究 PRP 尿道括约肌注射治疗前列腺切除术后尿失禁 (PPI) 的疗效。共纳入 28 例 PPI 患者，平均年龄 71.8±8.9 岁，前瞻性纳入。他们每月接受 4 次 PRP 尿道括约肌注射。第四次注射后 3 个月评估临床疗效，采用治疗后总体反应评估 (GRA) 评分、新设计的压力性尿失禁视觉模拟量表 (VAS of SUI) 和尿动力学参数评估。注射后，治疗后中位数 GRA 四分位数为 2.0(1.0, 2.0)。总体而言，6 例（21.4%）患者达到完全控尿和无尿垫状态，20 例（71.4%）获得成功结果（GRA 评分≥2），26 例（92.9%）显示临床改善（GRA 评分≥1）。SUI 的 VAS 显著改善，从 6.5（5.0, 8.0）改善至 3.5（2.0-5.8）（p<0.001），腹压漏点压力也从 57.5（50.0, 115.0）改善至 126.0（68.3, 150.0）（p=0.004）。经多次 PRP 尿道括约肌注射后，SUI 严重程度显著降低，成功率较高。除 3 例患者出现轻度血尿和排尿疼痛外，无其他严重不良事件。总之，PRP 尿道括约肌注射是治疗 PPI 的一种安全有效的新方法。
