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| 發表人 | 討論主題 | 發表時間 | 討論數 |
| 陳欣宏 | 女性膀胱出口阻塞治療方式的比較 | 2011/8/10 上午 11:53:26 | 0 |
| 原 文 | 題 目 | Comparison of alpha-blocker, extracorporeal magnetic stimulation alone and in combination in the management of female bladder outlet obstruction. |
| 作 者 | Koh JS, Kim SJ, Kim HS, Kim JC. | |
| 出 處 | ||
| 出版日期 | Int Urogynecol J Pelvic Floor Dysfunct Jul; 22(7):849-54; 2011 | |
| 評 論 | 女性膀胱出口阻塞 (bladder outlet obstruction, BOO)的發生率雖然不高，但如果以尿動力學的標準(maximum flow rate (Qmax)<15 ml/s, combined with detrusor pressure at maximum flow rate (PdetQmax)>20 cmH2O in pressure flow study)來看，發現有高達7-30%的女性病患符合診斷標準，且統計發現有62-72%這類病患同時合併有儲尿症狀(storage symptoms)。但泌尿學界對於女性BOO的臨床診斷標準及其治療方式，卻一直沒有完整的共識。本文便是致力於臨床治療方式，比較藥物(alpha-blocker)及磁波(ExMI)的效果評估，提供非侵入性治療的參考。研究首先排除neurological deficiencies, anatomical cause of obstruction, previous pelvic, spinal, anti-incontinence surgery等特殊情況；然後分別以alpha-blocker(group 1), ExMI(group 2)以及兩者合併(group 3)的方式治療3個月；再以IPSS, QOL, 3-day consecutive voiding diary, and uroflowmetry and PVR評估療效，結果發現3組分別有52.6%, 50.0%及57.1%的改善率；而其中有包括ExMI的治療組，其病患storage symptoms甚至有更好的療效，是臨床上可以提供治療女性BOO不錯的選項。 | |
| abstract |
Introduction and hypothesis : To determine the effects of alpha-blocker, extracorporeal magnetic innervations (ExMI) alone and combination treatment on female bladder outlet obstruction (BOO). Methods: Sixty women with BOO were divided into three groups according to the treatment. After 3 months, the clinical outcomes were evaluated by clinical examination, international prostatic symptom score (IPSS), quality of life (QOL), 3-day voiding diary, uroflowmetry and post-void residual. Results: At 3 months, symptom improvement was 52.6% in alpha-blocker monotherapy (group I), 50.0% in ExMI monotherapy (group II), and 57.1% in combination therapy (group III). Maximum flow rate increased and total IPSS decreased significantly in all groups (p<0.05). Storage symptom subscore was more reduced in groups II and III and QOL improved significantly in group III (p<0.05). Conclusions: This study demonstrates that both alpha-blocker and ExMI were effective in female BOO, and ExMI may be more effective for improving storage symptoms. |
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