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尿动力学研究结果及维贝格隆对I型人类T细胞白血病病毒相关脊髓病/热带痉挛性截瘫所致神经源性下尿路功能障碍的影响。

Urodynamic findings and vibegron effects on neurogenic lower urinary tract dysfunction caused by human T-cell leukemia virus type I-associated myelopathy/tropical spastic paraparesis.

作者信息

Kumekawa Tomoyuki, Akaihata Hidenori, Natsuya Hiroki, Harigane Yuki, Imai Hitomi, Matsuoka Kanako, Tanji Ryo, Hata Junya, Ogawa Soichiro, Kojima Yoshiyuki

机构信息

Department of Urology Fukushima Medical University School of Medicine Fukushima Japan.

出版信息

IJU Case Rep. 2024 Aug 29;7(6):438-441. doi: 10.1002/iju5.12773. eCollection 2024 Nov.

DOI:10.1002/iju5.12773
PMID:39498183
原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC11531891/
Abstract

INTRODUCTION

Human T-cell lymphotropic virus type 1 infection can cause HTLV-1-associated myelopathy/tropical spastic paraparesis, characterized by spastic paralysis of both lower limbs. More than 90% of HAM/TSP patients show lower urinary tract symptoms and dysfunction.

CASE PRESENTATION

A 27-year-old woman diagnosed with HAM/TSP presented with overactive bladder. A urodynamic study revealed detrusor overactivity. OAB remained despite improvements in spastic paralysis of the lower limbs after starting prednisolone. The addition of solifenacin likewise failed to improve OAB or DO in this patient. Switching from solifenacin to vibegron improved OAB symptoms.

CONCLUSION

In patients for whom OAB and DO do not improve with steroid treatment and solifenacin, treatment with vibegron may improve OAB symptoms.

摘要

引言

人类嗜T细胞病毒1型感染可导致HTLV-1相关脊髓病/热带痉挛性截瘫，其特征为双下肢痉挛性瘫痪。超过90%的HAM/TSP患者存在下尿路症状和功能障碍。

病例报告

一名27岁被诊断为HAM/TSP的女性出现膀胱过度活动症。尿动力学研究显示逼尿肌过度活动。开始使用泼尼松龙后，尽管下肢痉挛性瘫痪有所改善，但膀胱过度活动症仍存在。加用索利那新同样未能改善该患者的膀胱过度活动症或逼尿肌过度活动。从索利那新换用维贝格隆改善了膀胱过度活动症症状。

结论

对于使用类固醇治疗和索利那新后膀胱过度活动症和逼尿肌过度活动无改善的患者，使用维贝格隆治疗可能改善膀胱过度活动症症状。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/d234/11531891/663b460368b8/IJU5-7-438-g002.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/d234/11531891/f52cbd7f3503/IJU5-7-438-g001.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/d234/11531891/ebe868fe25c6/IJU5-7-438-g003.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/d234/11531891/bf2486cce198/IJU5-7-438-g004.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/d234/11531891/663b460368b8/IJU5-7-438-g002.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/d234/11531891/f52cbd7f3503/IJU5-7-438-g001.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/d234/11531891/ebe868fe25c6/IJU5-7-438-g003.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/d234/11531891/bf2486cce198/IJU5-7-438-g004.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/d234/11531891/663b460368b8/IJU5-7-438-g002.jpg

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