Wayne State University School of Medicine, Detroit, Michigan, USA.
Karmanos Cancer Center, Detroit, Michigan, USA.
Can J Urol. 2023 Aug;30(4):11607-11612.
Chronic radiation cystitis (CRC) can develop between 6 months and 20 years after radiation therapy that presents with symptoms of urinary frequency, urgency, bladder pain, and nocturia. Amniotic membrane (AM) is known to contain pro-regenerative properties and could thereby be a potential therapeutic modality for radiation-induced tissue injury of the bladder.
CRC patients recalcitrant to previous treatments received amniotic bladder therapy (ABT) comprised of intra-detrusor injections of 100 mg micronized AM (Clarix Flo) diluted in 10 mL 0.9% preservative-free sodium chloride. Clinical evaluation and questionnaires (Interstitial Cystitis Symptom Index (ICSI), Interstitial Cystitis Problem Index (ICPI), Bladder Pain/ Interstitial Cystitis Symptom Score (BPIC-SS), Overactive Bladder (OAB) Assessment Tool, and SF-12 Health Survey) were repeated at preop and 2, 4, 8 and 12 weeks post-injection.
Five consecutive female patients aged 64.4 ± 20.1 years with a median CRC disease duration of 10 years were included. After ABT, BPIC-SS scores improved from baseline to 12 weeks (36.6 ± 1.1 to 12.6 ± 3.1) and this was associated with an improvement in ICSI, ICPI, OAB, and SF-12 scores. One patient had an acute urinary tract infection at 2 weeks but was successfully treated with oral antibiotics. No other adverse events related to micronized AM injections were observed. Uroflow assessments showed increases in voided volume for all five patients.
This data provides additional evidence for the potential benefit of ABT in patients with chronic inflammatory conditions of bladder such as CRC.
放射性膀胱炎（CRC）可在放射治疗后 6 个月至 20 年内发生，表现为尿频、尿急、膀胱疼痛和夜尿。羊膜（AM）已知具有促再生特性，因此可能是治疗膀胱放射性组织损伤的一种潜在治疗方法。
对以前治疗无效的 CRC 患者，采用羊膜膀胱治疗（ABT），即在膀胱内注射 100mg 微化 AM（Clarix Flo），溶于 10ml 0.9%无防腐剂氯化钠溶液中。在术前和注射后 2、4、8 和 12 周重复进行临床评估和问卷调查（间质性膀胱炎症状指数（ICSI）、间质性膀胱炎问题指数（ICPI）、膀胱疼痛/间质性膀胱炎症状评分（BPIC-SS）、膀胱过度活动症（OAB）评估工具和 SF-12 健康调查）。
纳入了 5 名连续的女性患者，年龄 64.4±20.1 岁，CRC 疾病平均病程为 10 年。ABT 后，BPIC-SS 评分从基线到 12 周改善（36.6±1.1 至 12.6±3.1），同时 ICSI、ICPI、OAB 和 SF-12 评分也得到改善。1 例患者在第 2 周发生急性尿路感染，但经口服抗生素治疗成功。未观察到与微化 AM 注射相关的其他不良事件。尿流评估显示所有 5 名患者的排尿量均增加。
这些数据为 ABT 在治疗慢性炎症性膀胱疾病（如 CRC）患者方面的潜在益处提供了额外证据。
