LUTS: Lower Urinary Tract Symptoms最新文献_第4页

Effects of onabotulinum toxin-A injection on sexual function in women with refractory interstitial cystitis/bladder pain syndrome: A prospective study 注射奥博毒素-A 对难治性间质性膀胱炎/膀胱疼痛综合征妇女性功能的影响：前瞻性研究。

IF 1.3 4区医学 Q3 UROLOGY & NEPHROLOGY

LUTS: Lower Urinary Tract Symptoms

Pub Date : 2024-03-25 DOI: 10.1111/luts.12511

Murat Can Karaburun, Eralp Kubilay, Derya Öztuna, Mehmet İlker Gökçe, Evren Süer, Ömer Gülpınar

Objectives

To determine the effect of intravesical onabotulinum toxin-A (BoNT-A) treatment on sexual functions in female patients with refractory interstitial cystitis/bladder pain syndrome (IC/BPS).

Methods

Female patients with IC/BPS refractory to previous treatments were included in the study between January 2020 and April 2022. Patients were treated with the trigone-sparing injection (Group 1) or trigone-included injection (Group 2) techniques. 100 Units of BoNT-A was applied submucosally on 20 different points. The patients were evaluated with visual analog scale (VAS), O'Leary-Sant Interstitial Cystitis Symptom Index (ICSI), Interstitial Cystitis Problem Index (ICPI), Female Sexual Function Index (FSFI) questionnaires, 3-day voiding diary, uroflowmetry, and post-voiding residual volume analysis in the preoperative period, as well as on the 30th and 90th days postoperatively. For the repeated measurements, analysis of variance was used to assess the time-dependent variation across groups.

Results

The baseline FSFI score of the patients was 15.96 ± 3.82. Following the treatment, the FSFI scores were 22.43 ± 4.93 and 24.41 ± 5.94 on the 30th and 90th days, respectively (p < .001). We observed statistically significant improvement in all FSFI subdomains (p < .05). Statistically significant improvements with treatment on ICSI, ICPI, and VAS scores were achieved (p < .05). Preoperative FSFI scores were similar in Group 1 and Group 2 (p = .147). While the preoperative FSFI scores were 17.00 ± 3.73 and 14.84 ± 3.72 for Group 1 and Group 2, respectively, the scores after the treatment were 22.85 ± 5.01 and 21.98 ± 5.01 on the 30th day, and 24.62 ± 6.06 and 24.19 ± 6.05 on the 90th day postoperatively. Significant improvement was observed in FSFI scores with treatment, and no difference was observed between the two groups in terms of treatment response (p = .706).

Conclusions

Intravesical BoNT-A injection in the treatment of women with refractory IC/BPS improves sexual functions. It also significantly improves pain and symptom scores. Both trigone-sparing and trigone-including injections are similarly safe and effective.

目的方法：在2020年1月至2022年4月期间，纳入既往治疗无效的女性间质性膀胱炎/膀胱疼痛综合征（IC/BPS）患者：2020年1月至2022年4月期间，研究纳入了既往治疗无效的女性间质性膀胱炎/膀胱疼痛综合征患者。患者采用三叉神经分离注射（第1组）或三叉神经包含注射（第2组）技术进行治疗。在 20 个不同点的粘膜下注射 100 单位的 BoNT-A。患者在术前、术后第 30 天和第 90 天分别接受了视觉模拟量表（VAS）、O'Leary-Sant 间质性膀胱炎症状指数（ICSI）、间质性膀胱炎问题指数（ICPI）、女性性功能指数（FSFI）问卷调查、3 天排尿日记、尿流率测定和排尿后残余量分析。对于重复测量，采用方差分析来评估各组间随时间变化的差异：结果：患者的基线 FSFI 得分为 15.96 ± 3.82。治疗后，第 30 天和第 90 天的 FSFI 评分分别为（22.43 ± 4.93）和（24.41 ± 5.94）（p 结论：BoNT-A 注射后，第 30 天和第 90 天的 FSFI 评分分别为（22.43 ± 4.93）和（24.41 ± 5.94）：膀胱内注射 BoNT-A 可改善难治性 IC/BPS 妇女的性功能。它还能明显改善疼痛和症状评分。保留三叉神经和包括三叉神经的注射同样安全有效。

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引用次数: 0

Correction to “Predictive factors for the success of trial without catheter for men with urinary retention” 更正 "男性尿潴留患者无导尿管试验成功的预测因素"。

IF 1.3 4区医学 Q3 UROLOGY & NEPHROLOGY

LUTS: Lower Urinary Tract Symptoms

Pub Date : 2024-02-14 DOI: 10.1111/luts.12510

Takanashi M, Ito H, Fukazawa T, et al. Predictive factors for the success of trial without catheter for men with urinary retention. Lower Urinary Tract Symptoms. 2023;15(5):173-179. doi:10.1111/luts.12492

In Results section of abstract, “(P = 0.042, odds ratio [OR] 1.701) and PS <2 in naïve patients (P = 0.001, OR 2.710)” was incorrect. This should have read “(P = 0.021, odds ratio [OR] 1.037) and PS <2 in naïve patients (P < 0.001, OR 3.941)”.

We apologize for this error.

Takanashi M, Ito H, Fukazawa T, et al. 男性尿潴留患者无导尿管试验成功的预测因素。下尿路症状》。doi:10.1111/luts.12492在摘要的结果部分，"（P = 0.042，几率比 [OR] 1.701）和天真患者的 PS <2（P = 0.001，OR 2.710）"不正确。我们对此表示歉意。

引用次数: 0

Comparison between combination of tamsulosin and Pentoxifylline versus tamsulosin alone in the treatment of lower urinary tract symptoms due to benign prostate hyperplasia: A preliminary study 在治疗良性前列腺增生引起的下尿路症状方面，坦索罗辛和喷托非利辛联合用药与单用坦索罗辛的比较：一项初步研究

IF 1.3 4区医学 Q3 UROLOGY & NEPHROLOGY

LUTS: Lower Urinary Tract Symptoms

Pub Date : 2024-01-03 DOI: 10.1111/luts.12509

Mehdi Shirazi, Alireza Dehghanmanshadi, Soroush Sadr, Zahra Jahanabadi

Background

In older adults, bladder outlet obstruction (BOO) is prevalent, primarily due to benign prostatic hyperplasia (BPH). These patients' lower urinary tract symptoms can be treated surgically and with medical therapy. Compared to standard treatment with tamsulosin, Pentoxifylline, a phosphodiesterase inhibitor, could benefit patients with BOO due to its properties on microcirculatory blood flow and oxygenation of ischemic tissues. Hence, this trial intended to study the efficacy of Pentoxifylline combined with tamsulosin in treating BOO patients.

Materials and Methods

This randomized, double-blind clinical trial recruited 60 patients with BPH from a single center in 2022. Upon consent of patients meeting the eligibility criteria, they were randomly allocated to intervention (Pentoxifylline + tamsulosin) and control (placebo + tamsulosin) groups. The patients were evaluated for international prostate symptom score (IPSS), quality of life (QoL), maximum urinary flow rate (Q_max) by uroflowmetry, and post-void residual volume (PVR) by abdominal sonography at the onset of the study and after the 12th week.

Results

Patients who used the combination therapy had significantly better results of prostate symptoms and quality of life improvement (IPSS: −36.6%, QoL: −45.3%) compared to patients who received tamsulosin alone (IPSS: −21.2%, QoL: −27.7%) (p < .001). Also, this study shows that the improvement in maximum urinary flow rate and residual volume by combination therapy is significantly higher (Q_max: +42.5%, PVR: −42.6%) compared to monotherapy (Q_max: +25.1%, PVR: −26.1%) (p < .001).

Conclusion

When combined with tamsulosin, Pentoxifylline could significantly improve the lower urinary symptoms of BPH patients. It is well tolerated, and the treatment outcomes are better in patients who receive the combination of Pentoxifylline and tamsulosin than those who only receive tamsulosin.

在老年人中，膀胱出口梗阻（BOO）很普遍，主要是由于良性前列腺增生症（BPH）引起的。这些患者的下尿路症状可通过手术和药物治疗进行治疗。与使用坦索罗辛的标准治疗相比，磷酸二酯酶抑制剂本妥昔单抗（Pentoxifylline）可促进微循环血流和缺血组织的供氧，从而使BOO患者受益。因此，本试验旨在研究本妥昔单抗联合坦索罗辛治疗 BOO 患者的疗效。

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引用次数: 0

Multimodal therapies and strategies for the treatment of interstitial cystitis/bladder pain syndrome in Taiwan 台湾间质性膀胱炎/膀胱疼痛综合征的多模式治疗与策略。

IF 1.3 4区医学 Q3 UROLOGY & NEPHROLOGY

LUTS: Lower Urinary Tract Symptoms

Pub Date : 2023-11-21 DOI: 10.1111/luts.12508

Wan-Ru Yu, Hann-Chorng Kuo

Interstitial cystitis/bladder pain syndrome (IC/BPS) is a chronic disease characterized by bladder pain, frequency, and nocturia. The most common pathologies include chronic inflammation and bladder urothelium dysfunction. According to the bladder condition with or without Hunner's lesions, IC/BPS can be divided into “IC” in patients with Hunner's lesion (HIC) and “BPS” in those without Hunner's lesion (NHIC). Previous studies have reported greater central sensitization and interorgan cross-talk in patients with NHIC. Multimodal treatments have been recommended in clinical guidelines under the biopsychosocial model. The bladder–gut–brain axis has also been speculated, and multimodal therapies are necessary. Unfortunately, currently, no treatment has been reported durable for IC/BPS. Patients with IC/BPS usually experience anxiety, depression, holistic physical responses, and even threats to social support systems. The lack of durable treatment outcomes might result from inadequate diagnostic accuracy and differentiation of clinical phenotypes based on the underlying pathophysiology. Precision assessment and treatment are essential for optimal therapy under definite IC/BPS phenotype. This article reviewed currently available literature and proposed a diagnosis and treatment algorithm. Based on bladder therapy combined with suitable physical and psychological therapies, a well-grounded multimodal therapy and treatment algorithm for IC/BPS following a diagnostic protocol are indispensable.

间质性膀胱炎/膀胱疼痛综合征(IC/BPS)是一种以膀胱疼痛、尿频和夜尿为特征的慢性疾病。最常见的病理包括慢性炎症和膀胱尿路上皮功能障碍。根据有无Hunner's病变的膀胱情况，IC/BPS可分为有Hunner's病变的“IC”(HIC)和无Hunner's病变的“BPS”(NHIC)。先前的研究报道了NHIC患者更大的中枢致敏和器官间串扰。在生物心理社会模型下的临床指南中推荐了多模式治疗。膀胱-肠-脑轴也被推测，多模式治疗是必要的。不幸的是，目前还没有关于IC/BPS持久治疗的报道。IC/BPS患者通常会经历焦虑、抑郁、整体身体反应，甚至对社会支持系统构成威胁。缺乏持久的治疗结果可能是由于诊断准确性不足和基于潜在病理生理学的临床表型分化。精确的评估和治疗对于确定IC/BPS表型的最佳治疗至关重要。本文回顾了现有文献，提出了一种诊断和治疗算法。在膀胱治疗的基础上，结合适当的物理和心理治疗，一种基于诊断方案的IC/BPS多模式治疗和治疗算法是必不可少的。

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引用次数: 0

Longitudinal deterioration in lower urinary tract symptoms after artificial urinary sphincter implantation in patients with a history of pelvic radiation therapy 盆腔放射治疗史患者人工尿括约肌植入术后下尿路症状的纵向恶化

IF 1.3 4区医学 Q3 UROLOGY & NEPHROLOGY

LUTS: Lower Urinary Tract Symptoms

Pub Date : 2023-11-20 DOI: 10.1111/luts.12507

Madoka Kataoka, Minato Yokoyama, Yuma Waseda, Masaya Ito, Masaki Kobayashi, Motohiro Fujiwara, Yuki Nakamura, Yudai Ishikawa, Shohei Fukuda, Hajime Tanaka, Soichiro Yoshida, Hitoshi Masuda, Yasuhisa Fujii

Objectives

To evaluate longitudinal changes in lower urinary tract symptoms (LUTS) after artificial urinary sphincter (AUS) implantation in patients undergoing radiation therapy (RT) in comparison to those in non-irradiated patients.

Methods

This retrospective study included 20 and 51 patients with and without a history of pelvic RT (RT and non-RT group, respectively) who were treated with primary AUS implantation for post-radical prostatectomy incontinence between 2010 and 2020. Longitudinal changes in the International Consultation on Incontinence Questionnaire-Short Form (ICIQ-SF), the International Prostate Symptom Score (IPSS), and the Overactive Bladder Symptom Score (OABSS) were calculated with a linear mixed model.

Results

In the RT and non-RT group, 18 (90%) and 48 (94%) patients achieved social continence, defined as daily pad use ≤1 at 1 month after activation of AUS, respectively (p = .555). During the mean follow-up of 38 months, ICIQ-SF, IPSS, and OABSS significantly improved after AUS implantation in both the RT and non-RT groups. In the RT group, ICIQ-SF, IPSS, and OABSS subsequently deteriorated with a slope of 0.62/year (p = .010), 0.55/year (p = .025), and 0.30/year (p = .007), respectively. In the non-RT group, no significant longitudinal changes in subsequent IPSS and OABSS were observed, although ICIQ-SF significantly deteriorated (0.43/year, p = .006). Comparing between the groups, the slopes of IPSS and OABSS were significantly greater in the RT group than in the non-RT group (p < .001, and .015, respectively).

Conclusions

Longitudinal deterioration in LUTS that improved immediately after AUS implantation was observed in patients with a history of pelvic RT, but not in patients without a history of pelvic RT.

目的:评价放射治疗(RT)患者人工尿括约肌(AUS)植入术后下尿路症状(LUTS)的纵向变化与未放疗患者的比较。方法:本回顾性研究包括20例和51例有和没有盆腔放疗史的患者(分别为放疗组和非放疗组)，这些患者在2010年至2020年期间接受了原发性AUS植入治疗根治性前列腺切除术后尿失禁。采用线性混合模型计算国际尿失禁咨询问卷简表(ICIQ-SF)、国际前列腺症状评分(IPSS)和膀胱过度活动症状评分(OABSS)的纵向变化。结果:在放疗组和非放疗组中，分别有18例(90%)和48例(94%)患者在AUS激活后1个月达到社交自制，定义为每天使用≤1个尿垫(p = .555)。平均随访38个月，放疗组和非放疗组植入术后ICIQ-SF、IPSS和OABSS均有显著改善。在RT组，ICIQ-SF、IPSS和OABSS随后恶化，斜率分别为0.62/年(p = 0.010)、0.55/年(p = 0.025)和0.30/年(p = 0.07)。在非rt组中，尽管ICIQ-SF显著恶化(0.43/年，p = 0.006)，但随后IPSS和OABSS没有明显的纵向变化。各组间比较，放疗组的IPSS和OABSS斜率明显大于非放疗组(p)。结论:有盆腔放疗史的患者在AUS植入后立即改善LUTS纵向恶化，而没有盆腔放疗史的患者则没有。

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引用次数: 0

Association between voiding lower urinary tract symptoms and findings on dynamic magnetic resonance imaging with regard to pelvic organs and their supportive structures 排尿性下尿路症状与盆腔器官及其支撑结构的动态磁共振成像结果之间的关系。

IF 1.3 4区医学 Q3 UROLOGY & NEPHROLOGY

LUTS: Lower Urinary Tract Symptoms

Pub Date : 2023-10-22 DOI: 10.1111/luts.12506

Shoutarou Watanabe, Kurenai Kinno, Yasuharu Takeuchi, Yoshitomo Sawada, Noritoshi Sekido

Objectives

Pelvic organ prolapse (POP) causes voiding lower urinary tract symptoms (vLUTS). In the present study, we investigated the association between vLUTS and pelvic organ mobility (POM), including relevant supportive structures, on dynamic magnetic resonance imaging (dMRI).

Methods

We included 118 patients who had POP of stage II or less before straining and stage III or more when straining during dMRI. The presence of vLUTS and overactive bladder (OAB) was determined by a voiding subscore of the International Prostate Symptom Score (vIPSS) ≥5 and the OAB symptom score, respectively. POM was measured by dMRI before and during straining, and patients with and without vLUTS as well as patients with and without vLUTS and/or OAB were compared. p < .05 was considered to be statistically significant.

Results

According to vIPSS, 42 patients (35.6%) had vLUTS. On dMRI, patients with vLUTS showed a significantly more ventral position and/or movement of the bladder and cervix. Moreover, patients with vLUTS and OAB had significantly more ventral movement of the uterine cervix and a larger strain on imaginary uterosacral and cardinal ligaments than those without these symptoms. In addition, patients with vLUTS and OAB had significantly higher vIPSS than those with vLUTS alone.

Conclusions

vLUTS may be associated with the proximity of the bladder and cervix to the pubic bone and consequent compression of the urethra by the prolapsed organs. vLUTS with OAB might indicate more advanced lower urinary tract dysfunction than vLUTS alone.

目的：盆腔器官脱垂（POP）引起下尿路排尿症状（vLUTS）。在本研究中，我们在动态磁共振成像（dMRI）上研究了vLUTS与盆腔器官移动性（POM）之间的关系，包括相关的支撑结构。方法：我们纳入了118名患者，他们在拉伸前POP为II期或更低，在dMRI拉伸时POP为III期或更高。vLUTS和膀胱过度活动（OAB）的存在分别通过国际前列腺症状评分（vIPSS）≥5的排尿分量表和OAB症状评分来确定。在应变前和应变过程中通过dMRI测量POM，并比较有和没有vLUTS的患者以及有和没有vLUTS和/或OAB的患者。p 结果：根据vIPSS，42例（35.6%）患者有vLUTS。在dMRI上，vLUTS患者显示膀胱和宫颈的腹侧位置和/或运动明显增多。此外，与没有这些症状的患者相比，患有vLUTS和OAB的患者子宫颈的腹侧运动明显更多，假想的子宫骶骨和主韧带的应变更大。此外，vLUTS和OAB患者的vIPSS显著高于单独使用vLUTS的患者。结论：vLUTS可能与膀胱和宫颈靠近耻骨以及由此引起的脱垂器官对尿道的压迫有关。与单独使用vLUTS相比，使用OAB的vLUTS可能表明更晚期的下尿路功能障碍。

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引用次数: 0

Optimal endoscopic treatment and partial cystectomy with or without bladder augmentation for Hunner-type interstitial cystitis Hunner型间质性膀胱炎的最佳内镜治疗和部分膀胱切除术，包括或不包括膀胱扩大术。

IF 1.3 4区医学 Q3 UROLOGY & NEPHROLOGY

LUTS: Lower Urinary Tract Symptoms

Pub Date : 2023-09-26 DOI: 10.1111/luts.12505

Jiwoong Yu, Chung Un Lee, Kyu-Sung Lee, Kwang Jin Ko

Interstitial cystitis/bladder pain syndrome (IC/BPS) presents a significant challenge for urologists in terms of management, owing to its chronic nature and adverse impact on patient quality of life. Given the potential distinction between two disease entities within IC/BPS, namely Hunner-type IC and BPS without Hunner lesion, there is a need for an optimal therapeutic approach that focuses on the bladder lesions in Hunner-type IC. In cases where Hunner lesions are observed, complete transurethral ablation of these lesions should be prioritized as the initial intervention, as it has demonstrated effectiveness in symptom control. However, recurrence remains a limitation of this intervention. The techniques of resection and coagulation are equally effective in terms of symptom relief and recurrence prevention. Reconstructive surgery becomes necessary in cases of end-stage IC/BPS where various therapeutic approaches have failed. Patient selection is crucial in reconstructive surgery, particularly for patients with clear Hunner lesions and small bladder capacity who have not responded to previous treatments. Furthermore, it is vital to consider the patients' expectations and preferences adequately. Based on a comprehensive review of the literature and our own clinical experiences, subtotal cystectomy followed by bladder augmentation is considered a safe and effective surgical option. This stepwise and tailored therapeutic approach aims to optimize patients' quality of life by specifically targeting Hunner-type IC.

间质性膀胱炎/膀胱疼痛综合征（IC/BPS）由于其慢性性质和对患者生活质量的不利影响，在管理方面对泌尿科医生提出了重大挑战。鉴于IC/BPS中两种疾病实体（即Hunner型IC和无Hunner病变的BPS）之间的潜在区别，需要一种最佳的治疗方法，重点关注Hunner类型IC中的膀胱病变。在观察到Hunner病变的情况下，应优先考虑对这些病变进行完全经尿道消融术作为初步干预，因为它已证明在症状控制方面是有效的。然而，复发仍然是这种干预措施的局限性。切除和凝固技术在症状缓解和预防复发方面同样有效。在各种治疗方法都失败的终末期IC/BPS病例中，重建手术是必要的。在重建手术中，患者的选择至关重要，尤其是对于Hunner病变明显、膀胱容量小、对以前的治疗没有反应的患者。此外，充分考虑患者的期望和偏好至关重要。根据对文献的全面回顾和我们自己的临床经验，膀胱次全切除术后膀胱扩大术被认为是一种安全有效的手术选择。这种循序渐进、量身定制的治疗方法旨在通过专门针对Hunner型IC来优化患者的生活质量。

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引用次数: 0

Effects of a new selective β3-adrenoceptor agonist, vibegron, on bladder and urethral function in a rat model of Parkinson's disease 一种新的选择性β3-肾上腺素受体激动剂vibegron对帕金森病大鼠膀胱和尿道功能的影响

IF 1.3 4区医学 Q3 UROLOGY & NEPHROLOGY

LUTS: Lower Urinary Tract Symptoms

Pub Date : 2023-09-18 DOI: 10.1111/luts.12503

Mio Togo, Takeya Kitta, Hiroki Chiba, Madoka Higuchi, Naohisa Kusakabe, Mifuka Ouchi, Yui Abe-Takahashi, Hidehiro Kakizaki, Nobuo Shinohara

Objectives

Parkinson's disease caused by the loss of dopaminergic neurons induces not only motor dysfunction but also lower urinary tract dysfunction. Patients with Parkinson's disease have recently been reported to experience both urge urinary incontinence (overactive bladder) and stress urinary incontinence, the latter of which occurs when the pressure of the bladder exceeds that of the urethra. Vibegron is a highly selective novel β₃-adrenoceptor agonist approved for the treatment of overactive bladder. However, how β₃-adrenoceptor agonists affect urethral function remains unclear. In a clinical report, the urethral function of patients with Parkinson's disease was shown to be degraded. The present study aimed to investigate the effects of vibegron on lower urinary tract activity in a rat model of Parkinson's disease.

Methods

In a rat model of Parkinson's disease induced by unilateral 6-hydroxydopamine injection into the substantia nigra pars compacta, we examined the effects of vibegron on bladder and urethral activity.

Results

Cystometric analysis revealed that, compared with vehicle injection, intravenous injection of 3 mg/kg vibegron significantly increased the inter-contraction interval (p < .05) and reduced voiding pressure (p < .01). However, no significant effects on urethral function were observed.

Conclusions

The results of the present study provide corroborating evidence that bladder dysfunction is suppressed by the administration of vibegron in Parkinson's disease model rats, confirming that vibegron is effective for treating overactive bladder without further worsening urethral function. These findings may contribute to a better understanding of the mechanisms of β₃-adrenoceptor agonists.

目的多巴胺能神经元缺失引起的帕金森病不仅会引起运动功能障碍，还会引起下尿路功能障碍。最近有报道称，帕金森病患者同时会出现冲动性尿失禁（膀胱过度活动）和压力性尿失禁，后者发生在膀胱压力超过尿道压力时。Vibegron是一种高选择性的新型β3-肾上腺素受体激动剂，已被批准用于治疗膀胱过度活动症。然而，β3-肾上腺素受体激动剂如何影响尿道功能仍不清楚。在一份临床报告中，帕金森病患者的尿道功能被证明是退化的。本研究旨在研究vibegron对帕金森病大鼠模型下尿路活动的影响。方法采用单侧黑质致密部注射6-羟基多巴胺诱发帕金森病大鼠模型，观察维勃隆对膀胱和尿道活动的影响。结果囊型分析显示，与载体注射相比，静脉注射3 mg／kgvibgron显著增加收缩间期（p <； .05）和降低的孔隙压力（p <； .01）。然而，未观察到对尿道功能的显著影响。结论本研究的结果为帕金森病模型大鼠的膀胱功能障碍提供了确凿的证据，证实了vibgron对治疗膀胱过度活动有效，而不会进一步恶化尿道功能。这些发现可能有助于更好地理解β3-肾上腺素受体激动剂的机制。

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引用次数: 0

Intravesical injections of autologous platelet-rich plasma for the treatment of refractory interstitial cystitis 膀胱内注射自体富血小板血浆治疗难治性间质性膀胱炎。

IF 1.3 4区医学 Q3 UROLOGY & NEPHROLOGY

LUTS: Lower Urinary Tract Symptoms

Pub Date : 2023-09-13 DOI: 10.1111/luts.12504

Hann-Chorng Kuo

The urothelium acts as a barrier for the urinary bladder that prevents the influx of urinary toxic substances, electrolytes, urea nitrogen, and pathogens into the circulation. Acute or chronic inflammation of the urinary bladder may impair the regenerative function of urothelial cells and thus urothelial cell differentiation. In an inflamed bladder wall, mature apical cells are defective, resulting in impaired barrier function and thus increased urothelial permeability. This is considered to be the potential mechanism of the symptom trigger in patients with interstitial cystitis/bladder pain syndrome (IC/BPS). Previous studies have revealed that increased bladder inflammation, impaired urothelial cell maturation, a defective umbrella cell barrier, and defective junction proteins are prominent in IC/BPS bladders. Platelet-rich plasma (PRP) contains many growth factors and cytokines that are essential proteins for modulating inflammation and promoting tissue regeneration and thus wound healing. As such, PRP has been used as a regenerative therapy in many medical fields. Our preliminary studies have demonstrated that multiple intravesical PRP injections could improve symptoms in 70% of IC/BPS patients. Repeated PRP treatments also improve junctional protein, increase cytoskeleton protein expression, and decrease urinary inflammatory proteins. These preliminary results suggest that PRP injections might reduce bladder inflammation and improve urothelial cell regeneration in IC/BPS patients. This article reviews recently published clinical and basic research on the treatment potential of PRP for IC/BPS patients.

尿路上皮作为膀胱的屏障，防止尿液中有毒物质、电解质、尿素氮和病原体流入循环。膀胱的急性或慢性炎症可能损害尿路上皮细胞的再生功能，从而损害尿路内皮细胞的分化。在发炎的膀胱壁中，成熟的顶端细胞有缺陷，导致屏障功能受损，从而增加尿路上皮通透性。这被认为是间质性膀胱炎/膀胱疼痛综合征（IC/BPS）患者症状触发的潜在机制。先前的研究表明，膀胱炎症增加、尿路上皮细胞成熟受损、伞状细胞屏障缺陷和连接蛋白缺陷在IC/BPS膀胱中尤为突出。富含血小板的血浆（PRP）含有许多生长因子和细胞因子，它们是调节炎症、促进组织再生从而促进伤口愈合的必需蛋白质。因此，PRP已被用作许多医学领域的再生疗法。我们的初步研究表明，多次膀胱内注射PRP可以改善70%的IC/BPS患者的症状。重复的PRP治疗也可以改善连接蛋白，增加细胞骨架蛋白的表达，并减少尿炎症蛋白。这些初步结果表明，PRP注射可能减少IC/BPS患者的膀胱炎症并改善尿路上皮细胞再生。本文综述了最近发表的关于PRP对IC/BPS患者治疗潜力的临床和基础研究。

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Number of patients with interstitial cystitis/bladder pain syndrome seen before versus during the COVID-19 pandemic at an academic, urban, multisite urogynecology practice 在学术、城市、多站点泌尿生殖系统实践中，新冠肺炎大流行之前和期间出现的间质性膀胱炎/膀胱疼痛综合征患者人数。

IF 1.3 4区医学 Q3 UROLOGY & NEPHROLOGY

LUTS: Lower Urinary Tract Symptoms

Pub Date : 2023-09-12 DOI: 10.1111/luts.12502

Tahireh Markert, Alexa Courtepatte, Subrina Farah, Jeannine M. Miranne

Objectives

Little is known about the impact of the COVID-19 pandemic on interstitial cystitis/bladder pain syndrome (IC/BPS). We aim to compare the number of newly diagnosed IC/BPS cases and number of patients with flares prior to and during the pandemic.

Methods

We conducted a retrospective cohort study of women ≥18 years who were diagnosed with or treated for IC/BPS between March 2019 and March 2021 at an academic, urban, multisite urogynecology practice. The primary outcome was the number of IC/BPS cases from March 1, 2019 to February 29, 2020 (pre-pandemic) compared with March 1, 2020 to February 28, 2021 (during pandemic). The secondary outcome was the number of patients with flares during those same two time periods. Demographic and clinical characteristics were compared using nonparametric tests and interrupted time series (ITS) was used to evaluate our outcomes of interest. p-Value <.05 was considered significant.

Results

Fifty-four women (4.87% of new patients) were diagnosed with IC/BPS during the pandemic compared with 40 women pre-pandemic (4.05% of new patients). The median age was 35.0. Seventy-two percent were premenopausal, 75% sexually active, and 31% had anxiety, and there were no significant differences between groups. Although the number of patients newly diagnosed with IC/BPS was higher during the pandemic, the diagnosis rates between time periods were not statistically different. Thirty-five patients experienced flares during the pandemic compared with 49 patients the year prior (p = .43). This difference was also not statistically significant on ITS analysis.

Conclusions

Although more patients were diagnosed with IC/BPS during versus before the pandemic, the difference in diagnosis rates was not different between these periods.

目的：对新冠肺炎大流行对间质性膀胱炎/膀胱疼痛综合征（IC/BPS）的影响知之甚少。我们的目的是比较新诊断的IC/BPS病例数和疫情前和疫情期间的发作患者数。方法：我们对≥18岁的女性进行了回顾性队列研究在2019年3月至2021年3月期间，在一家学术、城市、多站点的泌尿生殖系统诊所被诊断为IC/BPS或接受IC/BPS治疗的年龄。主要结果是2019年3月1日至2020年2月29日（疫情前）的IC/BPS病例数，而2020年3月一日至2021年2月28日（疫情期间）。次要结果是在这两个时间段内出现发作的患者数量。使用非参数检验比较人口统计学和临床特征，并使用中断时间序列（ITS）来评估我们感兴趣的结果。p值结果：54名女性（占新患者的4.87%）在疫情期间被诊断为IC/BPS，而疫情前为40名女性（新患者的4.05%）。中位年龄为35.0岁。72%的人是绝经前，75%的人性活跃，31%的人有焦虑，各组之间没有显著差异。尽管新诊断为IC/BPS的患者人数在疫情期间较高，但不同时期的诊断率没有统计学差异。与前一年的49名患者相比，有35名患者在疫情期间出现了突发症状（p = .43）。这种差异在ITS分析中也没有统计学意义。结论：尽管与疫情前相比，更多的患者在疫情期间被诊断为IC/BPS，但这两个时期的诊断率差异不大。

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引用次数: 0