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微射频治疗非Hunner病变性间质性膀胱炎/膀胱疼痛综合征的疗效:一项回顾性队列研究

The Efficacy of Micro-Radiofrequency Therapy for Treating Non-Hunner Lesion Interstitial Cystitis/Bladder Pain Syndrome: A Retrospective Cohort Study.

作者信息

Zhao Chesong, Li Pu, Wang Chengming, Liu Jin, Xue Luotong, Zhang Yurong, Meng Xiaoxin, Tang Min

机构信息

Department of Urology, The First Affiliated Hospital of Nanjing Medical University, No. 300 Guangzhou Road, Nanjing, 210000, Jiangsu, China.

Clinical Medicine Research Institution, The First Affiliated Hospital of Nanjing Medical University, Nanjing, Jiangsu, China.

出版信息

Int Urogynecol J. 2025 Jan;36(1):213-220. doi: 10.1007/s00192-024-06008-7. Epub 2024 Dec 16.

Abstract

INTRODUCTION AND HYPOTHESIS

The objective was to explore the efficacy of micro-radiofrequency (micro-RF) therapy for treating non-Hunner interstitial cystitis (NHIC).

METHODS

Forty female NHIC patients were enrolled in this retrospective study from December 2021 to December 2023, with 20 receiving intravesical micro-RF therapy and 20 undergoing hydrodistension (HD). The primary evaluation index was the treatment success rate using the Global Response Assessment (GRA) scale. Secondary indexes included changes from baseline in the visual analog scale (VAS) for pain, Interstitial Cystitis Symptom Index (ICSI) and Interstitial Cystitis Problem Index (ICPI), Pelvic Pain and Urgency/Frequency (PUF) patient symptom scale, and urination parameters. Outcomes were analyzed via t or nonparametric tests.

RESULTS

All 40 patients completed the treatment and follow-up; the treatment success rate of the micro-RF group (70%, 14 out of 20) was slightly higher than that of the HD group (50%, 10 out of 20) at 12 weeks post-treatment, with no significant difference (20%, p = 0.197). The VAS, ICSI, ICPI, PUF, day-time frequency, urgency episodes, and nocturia significantly decreased in both groups after treatment (p < 0.05). Further, the median decline ranges of VAS (-4.0 vs -3.0; p = 0.017; 95% CI -1.45, -0.15) and ICPI (-5.0 vs -4.0; p = 0.011; 95% CI -2.02, -0.283) were significantly larger in the micro-RF group. There were no significant differences in ICSI (-6.5 vs -6.0, p = 0.407), PUF (-10.0 vs. -8.0; p = 0.071), and urgency episodes (-5.5 vs -4.5; p = 0.570).

CONCLUSIONS

Our study showed that the short-term overall efficacy of micro-RF therapy was better than hydrodistension, particularly in managing pain, and might be a new alternative treatment option for patients with NHIC.

摘要

引言与假设

目的是探讨微射频(micro-RF)疗法治疗非Hunner间质性膀胱炎(NHIC)的疗效。

方法

2021年12月至2023年12月,40例女性NHIC患者纳入本回顾性研究,其中20例接受膀胱内微射频治疗,20例接受膀胱水扩张术(HD)。主要评估指标是使用全球反应评估(GRA)量表的治疗成功率。次要指标包括疼痛视觉模拟量表(VAS)、间质性膀胱炎症状指数(ICSI)、间质性膀胱炎问题指数(ICPI)、盆腔疼痛与尿急/尿频(PUF)患者症状量表以及排尿参数相对于基线的变化。通过t检验或非参数检验分析结果。

结果

所有40例患者均完成治疗及随访;治疗后12周,微射频组的治疗成功率(70%,20例中的14例)略高于膀胱水扩张术组(50%,20例中的10例),差异无统计学意义(20%,p = 0.197)。两组治疗后VAS、ICSI、ICPI、PUF、日间排尿次数、尿急发作次数及夜尿次数均显著减少(p < 0.05)。此外,微射频组VAS(-4.0对-3.0;p = 0.017;95%CI -1.45,-0.15)和ICPI(-5.0对-4.0;p = 0.011;95%CI -2.02,-0.283)的中位数下降幅度显著更大。ICSI(-6.5对-6.0,p = 0.407)、PUF(-10.0对-8.0;p = 0.071)和尿急发作次数(-5.5对-4.5;p = 0.570)差异无统计学意义。

结论

我们的研究表明,微射频疗法的短期总体疗效优于膀胱水扩张术,尤其是在疼痛管理方面,可能是NHIC患者的一种新的替代治疗选择。

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