Du Kun, Sun Xiaoliang, Yang Fan, Qiu Zhijian, Li Lianjun, Zhao Yong, Zhang Haiyang
Department of Urology, Shandong Provincial Hospital Affiliated to Shandong First Medical University, Jinan, China.
Department of Anesthesiology, The First Affiliated Hospital of Shandong First Medical University & Shandong Provincial Qianfoshan Hospital, Shandong Institute of Anesthesia and Respiratory Critical Medicine, Jinan, China.
Transl Androl Urol. 2024 Jul 31;13(7):1164-1172. doi: 10.21037/tau-24-67. Epub 2024 Jul 15.
Refractory overactive bladder (OAB) in women is a common yet challenging condition for which traditional treatments have been unsatisfactory. This study aimed to evaluate the efficacy and safety of transurethral bladder mucosal GreenLight laser-selective vaporization for treating refractory OAB in women.
The female patients with refractory OAB who were admitted to the Department of Urology, Shandong Provincial Hospital Affiliated to Shandong First Medical University between May 2022 and July 2023 were examined retrospectively in this study. Transurethral bladder mucosal GreenLight laser-selective vaporization was used to treat the patients, and the perioperative and postoperative parameters were reviewed and compared. Bladder mucosa was examined by immunohistochemical staining to explore the expressions of TRPV1, P2X3, tumor necrosis factor alpha (TNF-α), and interleukin 6 (IL-6) before and after treatments.
Surgeries were performed successfully for all 32 patients in 57.38±11.22 minutes with minimal intraoperative bleeding. Twelve weeks post-surgery, there was a significant decrease (P<0.05) in the patients' Overactive Bladder Symptom Score (OABSS), 3-day bladder diary (daytime frequency, nocturia, urgency, and urgency incontinence), and Overactive Bladder questionnaire Short Form (OAB-qSF) score. After treatments, both first desire to void (FDV) and maximum bladder pressure capacity (MCBC) increased significantly (P<0.05). The immunohistochemical analysis revealed that the GreenLight laser significantly reduced the expressions of TRPV1, P2X3, TNF-α, and IL-6 in the bladder mucosa (P<0.05). No severe complications were observed after interventions.
For female patients with refractory OAB who have shown poor response to conventional treatment approaches, transurethral bladder mucosal GreenLight laser-selective vaporization may represent a promising alternative treatment option.
女性难治性膀胱过度活动症（OAB）是一种常见但具有挑战性的病症，传统治疗方法效果并不理想。本研究旨在评估经尿道膀胱黏膜绿激光选择性汽化术治疗女性难治性OAB的疗效和安全性。
本研究回顾性分析了2022年5月至2023年7月期间在山东第一医科大学附属山东省立医院泌尿外科收治的难治性OAB女性患者。采用经尿道膀胱黏膜绿激光选择性汽化术治疗患者，并对围手术期和术后参数进行回顾和比较。通过免疫组化染色检查膀胱黏膜，以探讨治疗前后瞬时感受器电位香草酸受体1（TRPV1）、嘌呤能受体P2X3（P2X3）、肿瘤坏死因子α（TNF-α）和白细胞介素6（IL-6）的表达情况。
所有32例患者手术均成功完成，手术时间为57.38±11.22分钟，术中出血极少。术后12周，患者的膀胱过度活动症症状评分（OABSS）、3天膀胱日记（白天排尿频率、夜尿、尿急和急迫性尿失禁）以及膀胱过度活动症问卷简表（OAB-qSF）评分均显著降低（P<0.05）。治疗后，首次排尿欲望（FDV）和最大膀胱压力容量（MCBC）均显著增加（P<0.05）。免疫组化分析显示，绿激光显著降低了膀胱黏膜中TRPV1、P2X3、TNF-α和IL-6的表达（P<0.05）。干预后未观察到严重并发症。
对于对传统治疗方法反应不佳的难治性OAB女性患者，经尿道膀胱黏膜绿激光选择性汽化术可能是一种有前景的替代治疗选择。
