尿道括約肌注射血小板濃厚液在女性應力性尿失禁之治療成效評估

江景翔、郭漢崇

佛教花蓮慈濟醫院 泌尿部

Urethral sphincter injection of platelet-rich plasma in treatment of female stress urinary incontinence

Ching-Hsiang Chiang, Hann-Chorng Kuo

Department of Urology, Buddhist TzuChi Hospital, Hualien, Taiwan

Purpose:

We investigate the efficacy of repeat PRP injections might benefit to women who have female stress urinary incontinence (SUI).

Materials and Methods:

This study is a single-center, prospective study of female SUI patient with duration> 1year, from 2019 to 2020 (n=19). All patient has diagnosed with intrinsic sphincter deficiency, which was been established based on characteristic symptoms and video urodynamic study (VUDS). Urethral sphincter injection at 5 sites was done circumferentially that 1ml in each injection site under general anesthesia, and all cases received repeat injection every month for a total of 4 times treatment. The primary outcome is the difference of VAS score, and the global response assessment score after PRP urethral injection. Patients with global response assessment (GRA) scale of ≥ 2 were considered to have satisfactory outcomes.

Results:

The mean age of included case is 59.9±15.5 year-old. The average difference of VAS after PRP injection is -2.6±2.2, and the average GRA score is 1.4±1.1. During follow-up, 9 (47.4 %) patients had satisfactory outcomes and the subjective assessment score had revealed statistically significant improvement after PRP injection. The Wet-to-totally dry rate is 21.1% (4 of 19). At post-operative follow-up VUDS data showed significantly improved in the abdominal leak-point pressure. The multiple of platelet concentration in PRP relative to peripheral blood were associated with unsatisfactory outcomes.

Conclusion:

Urethral sphincter PRP injection might be a feasible treatment to improve female urinary incontinence, lead to improvement in quality of life. It is a non-invasive management with acceptable satisfactory outcome.