Department of Pediatric Urology, Sri Ramachandra Medical College and Research Institute, Porur, Chennai, Tamil Nadu, 600116, India.
Pediatr Surg Int. 2022 Mar;38(3):493-498. doi: 10.1007/s00383-021-05040-8. Epub 2021 Dec 2.
This pilot study aims to assess the short-term efficacy and safety of mirabegron in valve bladder, an important cause of persistent hydronephrosis after successful treatment of posterior urethral valves (PUV).
Twenty-two patients with early valve bladder (no residual PUV; persistent hydronephrosis, wetting and urodynamic evidence of detrusor overactivity) were included. Three subjective parameters: frequency, wetting episodes; patient perception of bladder condition score (PPBC) and four objective parameters: uroflow index (UI = Qave/Qmax), voided volume (VV = voided volume/ expected bladder capacity), maximum filling pressure (P det-max) and society of fetal urology (SFU) hydronephrosis grading were analysed pre- and post-3-month treatment with mirabegron (0.5-1 mg/kg/day). All patients were observed for heart rate, BP, ECG changes during therapy.
There was significant reduction (p = 0.001) in mean frequency (pre 15; post 10), wetting episodes (pre 5; post 2) and PPBC (pre 4; post 3). There was significant improvement (p = 0.01) in mean UI (pre 0.3; post 0.5), VV (pre 0.54; post 0.72), Pdet-max (pre 42; post 25) and hydronephrosis grade (pre 3.5; post 2.2). There were no significant side effects.
This pilot study establishes short-term efficacy and safety of mirabegron in valve bladder with overactivity. Further larger long-term studies are warranted.
本初步研究旨在评估米拉贝隆治疗后尿道瓣膜(PUV)成功治疗后持续性肾积水的重要原因——瓣膜性膀胱的短期疗效和安全性。
纳入 22 例早期瓣膜性膀胱(无残余 PUV;持续性肾积水、湿尿和尿动力学证据表明逼尿肌过度活动)患者。分析了 3 项主观参数:频率、湿尿发作次数;膀胱状况评分(PPBC)和 4 项客观参数:尿流率指数(UI=Qave/Qmax)、排空量(VV=排空量/预期膀胱容量)、最大充盈压(Pdet-max)和胎儿泌尿外科学会(SFU)肾积水分级,在米拉贝隆(0.5-1mg/kg/天)治疗前和治疗 3 个月后。所有患者在治疗过程中均观察心率、血压、心电图变化。
平均频率(治疗前 15;治疗后 10)、湿尿发作次数(治疗前 5;治疗后 2)和 PPBC(治疗前 4;治疗后 3)均有显著降低(p=0.001)。平均 UI(治疗前 0.3;治疗后 0.5)、VV(治疗前 0.54;治疗后 0.72)、Pdet-max(治疗前 42;治疗后 25)和肾积水分级(治疗前 3.5;治疗后 2.2)均有显著改善(p=0.01)。无明显副作用。
本初步研究确立了米拉贝隆治疗瓣膜性膀胱过度活动的短期疗效和安全性。需要进一步开展更大规模的长期研究。