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在间质性膀胱炎/膀胱疼痛综合征患者管理中应用低强度体外冲击波治疗:在一家三级医疗中心的三十例病例研究。

Use of low-intensity extracorporeal shock wave therapy in the management of interstitial cystitis/bladder pain syndrome patients: A thirty case study in a tertiary medical center.

机构信息

Department of Obstetrics and Gynecology, Chang Gung Memorial Hospital, Linkou Medical Center, Taoyuan, Taiwan.

College of Medicine, Chang Gung University, Taoyuan, Taiwan.

出版信息

Neurourol Urodyn. 2023 Jan;42(1):65-72. doi: 10.1002/nau.25027. Epub 2022 Sep 30.

DOI:10.1002/nau.25027
PMID:36177673
Abstract

INTRODUCTION

Low-energy extracorporeal shock wave therapy (LiESWT) is a new potential treatment for intractable interstitial cystitis/bladder pain syndrome (IC/BPS), and this paper will evaluate its therapeutic effects on IC/BPS.

MATERIALS AND METHODS

This prospective clinical trial enrolled 30 women who have been diagnosed with IC/PBS to receive LiESWT treatment at an intensity of 0.25 mJ/mm and a frequency of 3 pulses/second, for a total of 3000 pulses within 8 weeks. And we assessed questionnaires (including O'Leary-Sant Interstitial Cystitis Symptom Index (ICSI)), 3-day voiding diary, and urodynamic study at the following intervals: 4 weeks of LiESWT (W4), 8 weeks of LiESWT (W8), 1-month follow-up (F1), 3-month follow-up (F3) after LiESWT, and 1 year follow-up (F12).

RESULTS

The primary outcome of questionnaires showed significant improvement of symptoms compared to baseline (W0), especially on ICSI(12.87 ± 3.44 before treatment and 7.87 ± 5.27 at F12, p < 0.05). 3-day voiding diary also revealed significant decrease in daytime voiding frequency (15.57 ± 5.22 times before treatment and 10.70 ± 4.21 times at F1, p < 0.05) and significant increase on average voiding volume (95.85 ± 35.30 mL before treatment and 161.27 ± 74.21 mL at F1, p < 0.05). However, there were no significant differences in all parameters of the urodynamic study.

CONCLUSION

LiESWT can mitigate pain and lower urinary tract symptoms and improve the quality of life in IC/PBS patients, but does not increase the maximal cystometric capacity.

摘要

介绍

低能量体外冲击波疗法(LiESWT)是一种治疗难治性间质性膀胱炎/膀胱疼痛综合征(IC/BPS)的新方法,本文将评估其对 IC/BPS 的治疗效果。

材料与方法

本前瞻性临床试验纳入了 30 名被诊断为 IC/PBS 的女性患者,接受 LiESWT 治疗,强度为 0.25mJ/mm,频率为 3 脉冲/秒,共 3000 个脉冲,持续 8 周。我们在以下时间点评估问卷(包括 O'Leary-Sant 间质性膀胱炎症状指数(ICSI))、3 天排尿日记和尿动力学研究:LiESWT 治疗 4 周(W4)、LiESWT 治疗 8 周(W8)、LiESWT 后 1 个月随访(F1)、3 个月随访(F3)和 1 年随访(F12)。

结果

问卷的主要结果显示,与基线相比,症状有显著改善(W0),尤其是 ICSI(治疗前为 12.87±3.44,治疗后第 12 个月为 7.87±5.27,p<0.05)。3 天排尿日记也显示,白天排尿频率显著减少(治疗前为 15.57±5.22 次,治疗后第 1 个月为 10.70±4.21 次,p<0.05),平均排尿量显著增加(治疗前为 95.85±35.30ml,治疗后第 1 个月为 161.27±74.21ml,p<0.05)。然而,尿动力学研究的所有参数均无显著差异。

结论

LiESWT 可减轻 IC/PBS 患者的疼痛和下尿路症状,提高生活质量,但不会增加最大膀胱容量。

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