Okui Nobuo, Okui Machiko A
Urogynecology, Yokosuka Urogynecology and Urology Clinic, Kanagawa, JPN.
Urology, Yokosuka Urogynecology and Urology Clinic, Kanagawa, JPN.
Cureus. 2024 Jun 14;16(6):e62363. doi: 10.7759/cureus.62363. eCollection 2024 Jun.
This retrospective cohort study with propensity score (PS) matching aimed to evaluate the efficacy and safety of a combination therapy with vaginal and urethral erbium:yttrium aluminum garnet laser (VEL+UEL) (SP Dynamis; Fotona d.o.o., Ljubljana, Slovenia) in the treatment of overactive bladder with urinary incontinence (OAB-wet).
The study included female OAB-wet patients aged 65 and above who were already taking OAB medication. Data obtained from electronic medical records were subjected to propensity score matching. All patients received instructions on pelvic floor exercises and were prescribed an appropriate dose of OAB medication. The VEL+UEL group (n=30) underwent three monthly laser sessions, while the control group (n=30) did not receive the treatment. Clinical outcomes were evaluated using the Overactive Bladder Symptom Score (OABSS), International Consultation on Incontinence Questionnaire-Short Form (ICIQ-SF), three-day urination diary, and Vaginal Health Index Score (VHIS). Medication usage and adverse events were also assessed. Statistical analysis and R code were performed using the AI chatbot GPT-4.0.
The VEL+UEL group showed significant improvements in OABSS score, ICIQ-SF score, voided volume, daytime frequency, nocturia, and VHIS after 12 months of treatment (p<0.001). Notably, 13.3% of patients transitioned from OAB-wet to OAB-dry. In contrast, the control group did not exhibit significant changes. Medication use was significantly reduced in the VEL+UEL group compared to the control group (p<0.001). No long-term side effects were reported.
Combination therapy with VEL+UEL demonstrated efficacy and safety in the treatment of OAB-wet. Improvements in OAB symptoms, voided volume, frequency, nocturia, and vaginal health were observed, with a subset of patients transitioning to OAB-dry. VEL+UEL therapy offers a potential treatment option for OAB-wet, reducing medication use and improving patient outcomes. Further research is warranted to investigate the mechanism, long-term effects, safety, and cost-effectiveness of VEL+UEL therapy.
这项采用倾向评分（PS）匹配的回顾性队列研究旨在评估阴道和尿道铒：钇铝石榴石激光联合治疗（VEL+UEL）（SP Dynamis；斯洛文尼亚卢布尔雅那的 Fotona d.o.o.）在治疗伴尿失禁的膀胱过度活动症（OAB-wet）中的疗效和安全性。
该研究纳入了65岁及以上且已在服用OAB药物的女性OAB-wet患者。从电子病历中获取的数据进行倾向评分匹配。所有患者均接受盆底肌锻炼指导，并被开具适当剂量的OAB药物。VEL+UEL组（n=30）每月接受三次激光治疗，而对照组（n=30）未接受该治疗。使用膀胱过度活动症症状评分（OABSS）、国际尿失禁咨询问卷简表（ICIQ-SF）（中文版）、三日排尿日记和阴道健康指数评分（VHIS）评估临床结局。还评估了药物使用情况和不良事件。使用人工智能聊天机器人GPT-4.0进行统计分析和R代码编写。
VEL+UEL组在治疗12个月后，OABSS评分、ICIQ-SF评分、排尿量、日间排尿频率、夜尿次数和VHIS均有显著改善（p<0.001）。值得注意的是，13.3%的患者从OAB-wet转变为OAB-dry。相比之下，对照组未出现显著变化。与对照组相比，VEL+UEL组的药物使用量显著减少（p<0.001）。未报告长期副作用。
VEL+UEL联合治疗在治疗OAB-wet方面显示出疗效和安全性。观察到OAB症状、排尿量、频率、夜尿次数和阴道健康有所改善，部分患者转变为OAB-dry。VEL+UEL治疗为OAB-wet提供了一种潜在的治疗选择，可减少药物使用并改善患者预后。有必要进一步研究VEL+UEL治疗的机制、长期效果、安全性和成本效益。
