| 原 文 |
題 目 |
Treatment of stress urinary incontinence with low-intensity extracorporeal shock wave therapy in a vaginal balloon dilation induced rat model |
| 作 者 |
Alex K. Wu, Xiaoyu Zhang, Jianwen Wang, Hongxiu Ning, Uwais Zaid, Jaqueline D. Villalta, Guifang Wang, Lia Banie, Guiting Lin, Tom F. Lue |
| 出 處 |
Transl Androl Urol 2018;7(Suppl 1):S7-S16 |
| 出版日期 |
2018 |
| 評 論 |
應力性尿失禁的盛行率很高，因為治療產生的費用也不少。治療方法包括骨盆底運動、藥物、以及尿道下吊帶手術。近年來，再生醫學的發展，將低能量震波(Li-ESWL)廣泛用於治療勃起功能障礙以及慢性骨盆腔發炎，由於低能量震波能夠促進肌肉細胞生長及修復、血管新生以及神經再生，因此作者想知道低能量震波是否也能在應力性尿失禁治療上發揮作用。實驗設計上，作者將大鼠的陰道內以氣球擴張四小時(vaginal balloon dilation, VBD)，模擬產程延滯造成的骨盆底損傷。低能量體外震波則是在大鼠下腹骨盆部位以探頭進行治療，每周兩次，一共四周。實驗大鼠一共分為四組: 對照組(10隻)、VBD only (9隻)、VBD + Li-ESWL(11隻)。實驗後，測量每隻老鼠的漏尿壓力(leak point pressure)，之後將大鼠犧牲以進行尿道組織檢查。研究發現，VBD + Li-ESWL組與VBD only組相比，有較高的漏尿壓力，且達到統計顯著性。組織學檢驗發現，VBD + Li-ESWL組也較VBD only組有較多的尿道括約肌組織再生以及血管新生。雖然這只是動物實驗，實驗大鼠數量也不多，但低能量體外震波是個非侵入性又相對安全的治療，未來若能累積更多研究，說不定能成為應力性尿失禁新的治療方法。
|
| abstract |
More than 25% of women suffer from stress urinary incontinence (SUI) in the United States and the annually cost related to management of this condition is high. Current treatments for SUI, including oral medications, urethral bulking agents, and urethral sling surgeries. Low-intensity extracorporeal shock wave therapy (Li-ESWT) has been applied in regenerative medicine to stimulate skeletal muscle growth and accelerate repair. Li-ESWL therapy has been used to treat erectile dysfunction and chronic pelvic pain syndrome. To investigate the outcomes and mechanisms of Li-ESWT on SUI, the authors designed a rat model with vaginal balloon dilation. The results showed Li-ESWT ameliorated SUI by promoting angiogenesis, progenitor cell recruitment, and urethral sphincter regeneration in a rat model induced by VBD. Li-ESWT represents a potential novel non-invasive therapy for SUI.
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