| 原 文 |
題 目 |
Prospective randomized comparison of oxybutynin, functional electrostimulation, and pelvic floor training for treatment of detrusor overactivity in women. |
| 作 者 |
Arruda RM, Castro RA, Sousa GC, Sartori MG, Baracat EC, Girão MJ. |
| 出 處 |
Int Urogynecol J Pelvic Floor Dysfunct. |
| 出版日期 |
Aug. 2008 |
| 評 論 |
目前針對膀胱逼尿肌過度活性或是所謂膀胱過動症的治療還是以藥物為主，另外除了較為具有侵入性的治療例如肉毒桿菌注射以及膀胱擴大術等，還有一些比較具有低侵入性或者無侵入性的治療可以選擇，例如文中所提之口服藥物，或是電刺激(經陰道或肛門)，或是骨盆底肌肉收縮之訓練等等，另外例如脛骨神經刺激或薦神經刺激等治療也頗廣為人知，每一種治療都有其優缺點，每位病患對每一種治療的效果也不盡然相同，是該慶幸我們擁有如此多樣的治療工具讓病患選擇，還是該擔憂我們其實找不到一種最好的方法來治療病人呢 ? 任何有下尿路症狀疑似有膀胱過動的病患求診時醫師除了基本的尿液檢查以及身體評估之外之外，病史必須要詢問到任何可能造成頻尿以及尿急的食物或是水分的攝取情形，經常可見病患在調整生活習慣(戒掉咖啡茶葉，水分攝取勿過多等等)之後症狀就好了大半，因此在就診前可以先做自我診斷以及調整，或許可以少掉很多就醫跟吃藥的機會。
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| abstract |
The purpose of this study is to compare the effectiveness of oxybutynin, functional electrostimulation (FES), and pelvic floor training (PFT) for treatment of women with detrusor overactivity. Sixty-four subjects were randomized to oxybutynin (n=22), FES (n=21), or PFT (n=21). Women were evaluated before and after completion of 12 weeks of treatment by subjective response, voiding diary, and urodynamic test. There was subjective symptomatic improvement in 77% of the women treated with oxybutynin, 52% with FES, and 76% with PFT. Urgency resolved in 64% of women treated with oxybutynin, 52% with FES, and in 57% with PFT. Urodynamic evaluation was normal in 36% treated with oxybutynin, 57% with FES, and 52% with PFT. Maximum detrusor involuntary contraction pressure decreased in all groups (p<0.05). All treatments were equally effective. Subjective reduction of urge-incontinence episodes was associated with symptomatic improvement.
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