Moss Nani P, Chill Henry H, Sand Peter K, Chang Cecilia, Goldberg Roger P, Gafni-Kane Adam
Division of Urogynecology, NorthShore University HealthSystem, University of Chicago Pritzker School of Medicine, Skokie, Illinois, USA.
NorthShore University HealthSystem Research Institute, Evanston, Illinois, USA.
Neurourol Urodyn. 2023 Mar;42(3):615-622. doi: 10.1002/nau.25142. Epub 2023 Feb 6.
The primary aim of this study was to compare the effect of bladder instillations using dimethyl sulfoxide (DMSO) with triamcinolone versus bupivacaine, triamcinolone, and heparin (BTH) in women with newly diagnosed interstitial cystitis/painful bladder syndrome. The primary outcome was improvement in symptoms measured using the O'Leary-Sant Interstitial Cystitis Symptoms Index (ICSI) score. Secondary comparisons included changes in urinary frequency, nocturia, and bladder capacity.
This was a prospective, randomized study. Patients with a recent diagnosis of interstitial cystitis/painful bladder syndrome (IC/PBS) were randomized 1:1 to treatment with either 6 weekly bladder instillations of DMSO with triamcinolone or BTH. During follow-up visits, patients completed the ICSI questionnaire, and bladder capacity was determined through the retrograde filling of the bladder. The χ test or Student's t test were used for data analysis.
A total of 83 patients were randomized, and final analysis included 70 participants who completed the 6 weekly instillations (42 DMSO, 28 BTH). The groups were similar in baseline demographics and clinical characteristics, except for cystometric maximum capacity (DMSO 338.62± 139.44 mL, BTH 447.43 ± 180.38 mL, p = 0.01). In the DMSO group, 63% of patients had a greater than 29.5% reduction in total ICSI score versus 43% in the BTH group (p = 0.15). Nocturia and pain were significantly reduced in the DMSO group. There was a significant increase from baseline in bladder capacity for both groups.
In women with newly diagnosed IC/PBS, bladder instillations with DMSO and triamcinolone provide greater improvement in pain and nocturia compared to BTH.
本研究的主要目的是比较在新诊断的间质性膀胱炎/膀胱疼痛综合征女性患者中，使用二甲亚砜（DMSO）联合曲安奈德进行膀胱灌注与使用布比卡因、曲安奈德和肝素（BTH）进行膀胱灌注的效果。主要结局指标是使用奥利里 - 桑特间质性膀胱炎症状指数（ICSI）评分来衡量症状的改善情况。次要比较包括尿频、夜尿和膀胱容量的变化。
这是一项前瞻性随机研究。近期诊断为间质性膀胱炎/膀胱疼痛综合征（IC/PBS）的患者按1:1随机分为两组，分别接受为期6周的每周一次膀胱灌注DMSO联合曲安奈德或BTH治疗。在随访期间，患者完成ICSI问卷，并通过膀胱逆行充盈测定膀胱容量。数据分析采用χ检验或学生t检验。
共有83例患者被随机分组，最终分析纳入了70例完成6周灌注的参与者（42例接受DMSO治疗，28例接受BTH治疗）。除膀胱测压最大容量外，两组在基线人口统计学和临床特征方面相似（DMSO组为338.62±139.44 mL，BTH组为447.43±180.38 mL，p = 0.01）。在DMSO组中，63%的患者ICSI总分降低超过29.5%，而BTH组为43%（p = 0.15）。DMSO组的夜尿和疼痛明显减轻。两组的膀胱容量均较基线有显著增加。
在新诊断的IC/PBS女性患者中，与BTH相比，使用DMSO联合曲安奈德进行膀胱灌注能更有效地改善疼痛和夜尿症状。
