Cao Mengya, Wu Xiaoxia, Xu Junmei
Department of Anesthesiology, The Second Xiangya Hospital, Central South University, Changsha, China.
Nursing Department, The Third Xiangya Hospital, Central South University, Changsha, China.
Transl Androl Urol. 2022 Feb;11(2):190-201. doi: 10.21037/tau-22-16.
The aim of this research is to analyze the efficacy of neostigmine in the treatment of postoperative urinary retention (POUR).
In this research, we screened multiple databases including PubMed, EMBASE, Web of Science, and Chinese National Knowledge Infrastructure (CNKI). After a systematic search process, data extraction was conducted. Review Manager 5.2 was adopted for meta-analysis, sensitivity analysis, and bias analysis.
After searching for articles, 20 eligible trials including 1,850 patients after surgery were extracted. Our results suggested that the neostigmine group had a higher effective rate for urinary retention than the Chinese traditional and physical therapy group (OR =7.47, 95% CI: 4.10-13.59, overall effect P<0.001). Further subgroup analysis showed that neostigmine acupoint injection was better than neostigmine intramuscular injection. Time to first voiding in the neostigmine acupoint injection group was shorter than that in the neostigmine intramuscular injection group (MD =-81.92, 95% CI: -130.13 to -33.70, overall P<0.001, I=99% with random effects model). Furthermore, neostigmine acupoint injection improved urine excretion (MD =243.40, 95% CI: 201.62-285.18, overall P<0.0001) and reduced the residual urine volume (MD =-41.31, 95% CI: -58.05 to -24.58, overall P<0.001, I=75% with random effects model). The results of the sensitivity analysis and publication bias showed that this research was robust and had little publication bias.
Our meta-analysis results suggest that neostigmine can effectively improve the symptoms of POUR and neostigmine acupoint injection may achieve a better therapeutic effect.
本研究旨在分析新斯的明治疗术后尿潴留（POUR）的疗效。
本研究筛选了多个数据库，包括PubMed、EMBASE、科学网和中国知网（CNKI）。经过系统检索过程后，进行了数据提取。采用Review Manager 5.2进行荟萃分析、敏感性分析和偏倚分析。
检索文章后，提取了20项符合条件的试验，包括1850例术后患者。我们的结果表明，新斯的明组尿潴留的有效率高于中医传统及物理治疗组（OR = 7.47，95%CI：4.10 - 13.59，总体效应P < 0.001）。进一步的亚组分析表明，新斯的明穴位注射优于新斯的明肌肉注射。新斯的明穴位注射组首次排尿时间短于新斯的明肌肉注射组（MD = - 81.92，95%CI： - 130.13至 - 33.70，总体P < 0.001，随机效应模型I = 99%）。此外，新斯的明穴位注射改善尿量（MD = 243.40，95%CI：201.62 - 285.18，总体P < 0.0001）并减少残余尿量（MD = - 41.31，95%CI： - 58.05至 - 24.58，总体P < 0.001，随机效应模型I = 75%）。敏感性分析和发表偏倚结果表明，本研究结果可靠，发表偏倚较小。
我们的荟萃分析结果表明，新斯的明可有效改善术后尿潴留症状，新斯的明穴位注射可能取得更好的治疗效果。
