Lutchka Jonathan, Vercnocke Jack, Fisher Emily, Radoiu Codrut, Jeberaeel Julian, Lucas Steven, Dhar Nivedita
Wayne State University School of Medicine, Detroit, MI, USA.
John D. Dingell VA Medical Center, Detroit, MI, USA.
Urologia. 2024 Aug;91(3):623-627. doi: 10.1177/03915603241248014. Epub 2024 Apr 22.
Chronic radiation cystitis (CRC) develops after radiation therapy and can present with symptoms like urinary frequency, urgency, pelvic pain, and nocturia. We have previously reported that amniotic bladder therapy (ABT) provides symptomatic improvement in refractory CRC patients for up to 3 months. Herein, we evaluated the durability of ABT up to 6 months.
CRC patients recalcitrant to previous treatments received ABT comprised of intra-detrusor injections of 100 mg micronized AM 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, SF-12 Health Survey) were repeated at pre-op and 2, 4, 8, 12, 16, 20, 24, and 36 weeks post-injection.
Five consecutive patients with a mean age of 64.4 ± 20.1 years with a median CRC duration of 10 years were included and followed for 6 months. After ABT, the lower urinary tract symptoms improved as early as 2 weeks and were maintained up to 20 weeks. BPIC significantly improved from 36.6 ± 1.1 at baseline to 12.6 ± 1.5 at 16 weeks and 13.8 ± 2.9 at 20 weeks. At 24 and 36 weeks, the improvement was maintained in four (80%) of the five patients (BPIC = 13.8 ± 1.0). Uroflow assessment showed voiding volume improved two-fold in four of the five patients at 24 weeks compared to baseline.
Our data suggest that a significant number of CRC patients may have durable benefit after ABT. Despite this, some of them can show symptoms rebound at 24 weeks.
慢性放射性膀胱炎（CRC）在放射治疗后发生，可出现尿频、尿急、盆腔疼痛和夜尿等症状。我们之前报道过，羊膜膀胱治疗（ABT）可使难治性CRC患者的症状改善长达3个月。在此，我们评估了ABT长达6个月的疗效持久性。
对先前治疗无效的CRC患者接受ABT，包括在10 mL 0.9%无防腐剂氯化钠中稀释100 mg微粉化羊膜进行膀胱逼尿肌内注射。在术前以及注射后2、4、8、12、16、20、24和36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、SF-12健康调查）。
纳入了5例连续患者，平均年龄64.4±20.1岁，CRC中位病程为10年，并随访6个月。ABT后，下尿路症状最早在2周时改善，并维持至20周。BPIC从基线时的36.6±1.1显著改善至16周时的12.6±1.5以及20周时的13.8±2.9。在24周和36周时，5例患者中有4例（80%）维持改善（BPIC = 13.8±1.0）。尿流率评估显示，与基线相比，5例患者中有4例在24周时排尿量增加了两倍。
我们的数据表明，相当数量的CRC患者在ABT后可能有持久的获益。尽管如此，其中一些患者在24周时可能出现症状反弹。
