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羊膜膀胱治疗:治疗间质性膀胱炎/膀胱疼痛综合征的 6 个月随访。

Amniotic bladder therapy: six-month follow up treating interstitial cystitis/bladder pain syndrome.

机构信息

Wayne State University School of Medicine, Detroit, Michigan, USA.

John D. Dingell VA Medical Center, Detroit, Michigan, USA.

出版信息

Can J Urol. 2024 Jun;31(3):11898-11903.

Abstract

INTRODUCTION

Interstitial cystitis/bladder pain syndrome (IC/BPS) is characterized by chronic pelvic pain and usually accompanies lower urinary tract symptoms. We have previously reported that amniotic bladder therapy (ABT) provides symptomatic improvement in refractory IC/BPS patients for up to 3 months. Herein, we evaluated the durability of ABT up to 6 months.

MATERIALS AND METHODS

Consecutive IC/BPS patients received intra-detrusor injections of 100 mg micronized amniotic membrane. Clinical evaluation and patient-reported outcome measurements including Interstitial Cystitis Symptom Index (ICSI), Interstitial Cystitis Problem Index (ICPI), Bladder Pain/ Interstitial Cystitis Symptom Score (BPIC-SS) and Overactive Bladder Assessment Tool (OAB) were assessed.

RESULTS

Twenty-five consecutive recalcitrant IC/BPS patients were included in the study with an average age of 47.4 ± 14.4 years (29-67 years). After ABT, the IC/BPS symptoms improved gradually up to 3 months in all patients with an average improvement in ICSI, ICPI, BPIC-SS and OAB score of 72.8%, 71.9%, and 66.6%, (p < 0.001) respectively, at 3 months. At 4 months after ABT, 7 patients experienced a rebound in symptoms and requested another injection which resulted in a significant improvement in IC/BPS symptoms after 2, 4, and 8 weeks (p < 0.01). For the 18 patients who received only one injection, the IC/BPS symptoms were still significantly lower at 5 and 6 months compared to baseline (p < 0.01), suggesting a possible durable effect based on the ICSI, ICPI, BPIC-SS, and OAB questionnaire scores.

CONCLUSIONS

ABT provided an improvement in pain and lower urinary tract symptoms up to 6 months post-treatment in some refractory IC/BPS patients.

摘要

简介

间质性膀胱炎/膀胱疼痛综合征(IC/BPS)的特征是慢性盆腔疼痛,通常伴有下尿路症状。我们之前报告过,羊膜膀胱治疗(ABT)可为难治性 IC/BPS 患者提供长达 3 个月的症状改善。在此,我们评估了 ABT 长达 6 个月的持久性。

材料和方法

连续的 IC/BPS 患者接受了 100mg 微米化羊膜的膀胱内注射。临床评估和患者报告的结果测量包括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)和膀胱过度活动症评估工具(OAB)。

结果

25 名连续的难治性 IC/BPS 患者被纳入研究,平均年龄为 47.4±14.4 岁(29-67 岁)。在 ABT 后,所有患者的 IC/BPS 症状逐渐改善,3 个月时 ICSI、ICPI、BPIC-SS 和 OAB 评分的平均改善率分别为 72.8%、71.9%和 66.6%(p<0.001)。在 ABT 后 4 个月,7 名患者出现症状反弹并要求再次注射,这导致在 2、4 和 8 周后 IC/BPS 症状显著改善(p<0.01)。对于仅接受一次注射的 18 名患者,与基线相比,5 个月和 6 个月时 IC/BPS 症状仍然显著降低(p<0.01),这表明根据 ICSI、ICPI、BPIC-SS 和 OAB 问卷评分可能存在持久的效果。

结论

ABT 在一些难治性 IC/BPS 患者中提供了治疗后长达 6 个月的疼痛和下尿路症状改善。

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