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一种用于女性压力性尿失禁的新型无创一次性阴道装置:疗效与生活质量

A Novel Incisionless Disposable Vaginal Device for Female Stress Urinary Incontinence: Efficacy and Quality of Life.

作者信息

Lee Chung Lyul, Park Jong Mok, Lee Ji Yong, Yang Seung Woo, Na Hyun Seok, Lee Jaegeun, Jung Sunkyung, Shin Ju Hyun

机构信息

Department of Urology, Chungnam National University Hospital, Daejeon, Korea.

Department of Urology, Chungnam National University Sejong Hospital, Sejong, Korea.

出版信息

Int Neurourol J. 2023 May;27(Suppl 1):S40-48. doi: 10.5213/inj.2346092.046. Epub 2023 May 31.

Abstract

PURPOSE

This clinical study sought to evaluate the possible clinical effectiveness and practicality of URINO, an innovative, incisionless, and disposable intravaginal device, designed for patients suffering from stress urinary incontinence.

METHODS

A prospective, multicenter, single-arm clinical trial was carried out, involving women diagnosed with stress urinary incontinence who used a self-inserted, disposable intravaginal pessary device. Comparisons were made between the results of the 20-minute pad-weight gain (PWG) test at baseline and visit 3, where the device was applied. After 1 week of device usage, compliance, satisfaction, the sensation of a foreign body, and adverse events were assessed.

RESULTS

Out of 45 participants, 39 completed the trial and expressed satisfaction within the modified intention-to-treat group. The average 20-minute PWG of participants was 17.2±33.6 g at baseline and significantly dropped to 5.3±16.2 g at visit 3 with device application. A total of 87.2% of participants exhibited a reduction ratio of PWG by 50% or more, surpassing the clinical trial success benchmark of 76%. The mean compliance was recorded as 76.6%±26.6%, the average visual analogue scale score for patient satisfaction was 6.4±2.6, and the sensation of a foreign body, measured on a 5-point Likert scale, was 3.1±1.2 after 1 week of device use. No serious adverse events were reported; there was 1 instance of microscopic hematuria and 2 cases of pyuria, all of which recovered.

CONCLUSION

The investigated device demonstrated significant clinical effectiveness and safety for patients with stress urinary incontinence. It was easy to use, showing favorable patient compliance. We propose that these disposable intravaginal pessaries could potentially be an alternative treatment for patients with stress urinary incontinence who are seeking nonsurgical options or are unable to undergo surgery. Trial Registration: The study was registered as a clinical trial (KCT0008369).

摘要

目的

本临床研究旨在评估URINO(一种创新的、无创的一次性阴道内装置)对压力性尿失禁患者的潜在临床疗效和实用性。

方法

开展了一项前瞻性、多中心、单臂临床试验,纳入被诊断为压力性尿失禁且使用自行插入的一次性阴道子宫托装置的女性。对基线时和第3次访视(使用该装置时)的20分钟护垫增重(PWG)测试结果进行比较。在使用该装置1周后,评估依从性、满意度、异物感和不良事件。

结果

在45名参与者中,39名完成了试验,并在改良意向性治疗组中表示满意。参与者的平均20分钟PWG在基线时为17.2±33.6克,在第3次访视使用该装置时显著降至5.3±16.2克。共有87.2%的参与者PWG降低率达到50%或更高,超过了76%的临床试验成功基准。平均依从性记录为76.6%±26.6%,患者满意度的平均视觉模拟量表评分为6.4±2.6,在使用该装置1周后,用5点李克特量表测量的异物感为3.1±1.2。未报告严重不良事件;有1例镜下血尿和2例脓尿,均已康复。

结论

所研究的装置对压力性尿失禁患者显示出显著的临床疗效和安全性。它易于使用,患者依从性良好。我们建议,这些一次性阴道子宫托可能成为寻求非手术选择或无法接受手术的压力性尿失禁患者的替代治疗方法。试验注册:该研究已注册为临床试验(KCT0008369)。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/d064/10263161/4ce046634661/inj-2346092-046f1.jpg

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