膀胱內高濃度血小板血漿注射在預防婦女反覆性迷你尿道感染的角色

-治療成功預測因子

李宇坤、郭漢崇

花蓮慈濟醫院 泌尿部

The role of PRP injection in the prophylaxis of recurrent UTI in women

-any predictive factor?

Yu Khun Lee, Hann-Chorng Kuo

Department of Urology, Hualien Tzu Chi Hospital, Buddhist Tzu Chi Medical Foundation and Tzu Chi University, Hualien 970, Taiwan

Purpose:

We recently conducted a clinical study using autologous intraveiscal platelet-rich plasma (PRP) injections to treat patients with intractable recurrent urinary tract infection (UTI). The aim of this study is to determine the predictive factor of treatment success.

Materials and Methods:

We enrolled women with intractable recurrent UTI for at least 2 years. The patients underwent 4 monthly intravesical PRP injections and were followed up for 1 year. We compared patients UTI frequency before and after PRP injection. The patients with UTI recurrence less than twice within 1 year were considered successful. We analyzed baseline demographics, characteristics and urodynamic data to find the predictive factor of successful.

Results:

A total of 34 patients (mean age, 68.59 ± 8.72 years, range from 51 to 83 years) with recurrent UTI were enrolled in this study. The mean duration of recurrent UTI was 6.39±7.41 years. At the baseline, nineteen (55.9%) patients had recurrent UTI (≦3/year) , fifteen (44.1%) patients had persistent UTI (> 3/year). There was significantly reduced UTI frequency after treatment (0.46±0.27 vs 0.28±0.30 times/month, p=0.001). Seventeen of the 33 patients (51.5%) had successful outcome. The patients without neurogenic voiding dysfunction (NVD) and diabetes mellitus (DM) had higher successful rate after intravesical PRP injection. The patients with successful outcome had better voiding efficacy at the baseline than the patients with unsuccessful outcome.

Conclusions:

The study revealed intravesical PRP injection could prevent recurrent UTI in women. Patients with better voiding efficacy or without underlying co-morbidities of neurogenic voiding dysfunction nor DM, might be predictive factors of successful treatment outcome.