Urology and Kidney Transplantation department, Hôpital de la Conception, Assistance publique-Hôpitaux de Marseille, Marseille, France.
Neuro-rehabilitation Department, Hôpital Renée-Sabran, Hospice Civil de Lyon, Giens, France.
Fr J Urol. 2024 Nov;34(10):102706. doi: 10.1016/j.fjurol.2024.102706. Epub 2024 Jul 24.
To compare the quality of life (QoL) in the same patients first treated with botulinum toxin A (BTA) injections for neurogenic detrusor overactivity (NDO) and then with bladder augmentation (BA).
Retrospective study of patients who had BA after BTA treatment between January 2012 and December 2022. Qualiveen Short Form questionnaires and a 7-level Likert/PGI-I scale to answer the question "How would you describe your quality of life after surgery compared to when you felt your best with BTA injections?" were collated and analyzed.
Fifty-two BAs for neurogenic bladder (NDO or low compliance) were performed in patients with a median age of 43years [33; 52] previously treated with BTA. After a median follow-up of 33.5 [13.8; 54.3] months, the median Qualiveen-SF global score after BA was significantly higher than that obtained at best BTA efficacy (1.63 [1; 2.63] vs. 2.63 [1.88; 3], P=0.012), as were the scores for the fear, constraints/restrictions and limitations/inconvenience domains. The median PGI-I score was +3 [2; 3] (truly better QoL) and 85.4% of patients reported a QoL after BA superior to the best QoL under BTA.
BA provides a greater range of QoL improvement than BTA injection for patients who have experienced both treatments. Long-lasting effects and absence of need to perform iterative retreatment were the main reasons.
比较首次接受肉毒毒素 A（BTA）注射治疗神经源性逼尿肌过度活动（NDO）的患者与随后接受膀胱扩大术（BA）治疗的患者的生活质量（QoL）。
回顾性研究 2012 年 1 月至 2022 年 12 月期间接受 BTA 治疗后接受 BA 的患者。收集和分析 Qualiveen 简短形式问卷和 7 级 Likert/PGI-I 量表，以回答“与接受 BTA 注射时感觉最佳相比，手术后您的生活质量如何？”这一问题。
对 52 例神经源性膀胱（NDO 或顺应性低）患者进行了 BA，患者中位年龄为 43 岁[33；52]，之前接受过 BTA 治疗。中位随访 33.5 个月[13.8；54.3]后，BA 后 Qualiveen-SF 全球评分中位数明显高于 BTA 最佳疗效时（1.63 [1；2.63] vs. 2.63 [1.88；3]，P=0.012），恐惧、限制/约束和限制/不便域的评分也是如此。PGI-I 评分中位数为+3 [2；3]（生活质量确实更好），85.4%的患者报告 BA 后生活质量优于 BTA 下的最佳生活质量。
对于接受过这两种治疗的患者，BA 提供了比 BTA 注射更大范围的 QoL 改善。长效和无需进行迭代重复治疗是主要原因。
