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| 發表人 | 討論主題 | 發表時間 | 討論數 |
| 李偉嘉 | 以甲型阻斷劑治療重複性尿路感染合併功能性異常解尿的婦女:一個前瞻性的隨機實驗 | 2014/10/29 下午 06:42:48 | 0 |
| 原 文 | 題 目 | α1-blocker for the treatment of recurrent urinary tract infections in women with dysfunctional voiding: A prospective randomized study. |
| 作 者 | Minardi D, Pellegrinelli F, Conti A et al | |
| 出 處 | International Journal of Urology, | |
| 出版日期 | [Epub] | |
| 評 論 | 在筆者的門診中，女性患者因功能性異常解尿前來就診的不在少數。以甲型阻斷劑運用在此類患者，也是筆者常使用的方式之一。在本文中，作者Minardi等人，將因為功能性異常解尿，導致重複性尿路感染而來就診的病患，隨機分為四組進行治療模式的探討。第一組為尿流生理回饋訓練。第二組為使用甲型阻斷劑。第三組為尿流生理回饋訓練合併使用甲型阻斷劑。第四組為不進行治療。研究的評估方式有以美國泌尿科醫學會症狀評分，也在固定的時間間隔裡進行尿路動態檢察。同時，每個月持續檢驗尿液的細菌培養。研究顯示以第三組的實驗結果，較能改善各種尿路動態檢查參數，包括增加最大尿流速、降低餘尿、降低尿道壓和降低尿路感染的盛行率。因此以尿流生理回饋訓練合併使用甲型阻斷劑治療因功能性異常解尿導致重複性尿路感染的婦女能有效的改善其症狀與生活品質。 | |
| abstract |
OBJECTIVES: To evaluate the therapeutic effects of tamsulosin on recurrent urinary tract infections in women with dysfunctional voiding. METHODS: A total of 155 women with recurrent urinary tract infections and dysfunctional voiding were included and randomly assigned to the following groups: uroflowmetry biofeedback (group 1), α1-adrenoceptor antagonists (group 2), uroflowmetry biofeedback combined with α1-adrenoceptor antagonists (group 3) and no treatment (group 4). Patients were evaluated by the American Urological Association Symptom Index at 3, 6 and 12 months. Urodynamics was carried out in patients of groups 1, 2, and 3 at 3, 6 and 12 months, as urodynamics was only carried out at 12 months in group 4. All patients were followed up for 1 year with monthly urine cultures. RESULTS: The incidence of storage and emptying symptoms decreased significantly at 3, 6 and 12 months. Mean flow rate, flow time and voiding volume increased significantly (with a better outcome in patients of group 3), as post-void residual urine decreased. Mean opening detrusor pressure and detrusor pressure at maximum flow decreased significantly (with a better outcome in patients of group 3). Mean urethral closure pressure and maximum urethral closure pressure decreased significantly with a more significant decrease for patients in group 3. The prevalence of urinary tract infection decreased significantly in all groups after treatment, and this decrease remained stable during the follow up. CONCLUSIONS: In women with dysfunctional voiding and recurrent urinary tract infection, tamsulosin associated with uroflowmetry biofeedback might be an effective and safe treatment option for improving urinary symptoms and quality of life. |
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