膀胱內高濃度血小板血漿注射在預防婦女反覆性泌尿道感染的效果

李宇坤、郭漢崇

花蓮慈濟醫院 泌尿部

Effectiveness Of Platelet-Rich Plasma Injection In The Prophylaxis Of Recurrent Urinary Tract Infection In Women

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: To investigate the therapeutic efficacy of intravesical platelet-rich plasma (PRP) injections as prophylaxis for older adult women with recurrent urinary tract infection (rUTI).

Materials and Methods: This proof-of-concept study enrolled 63 women with rUTI in PRP treatment and control groups after achieving control of the most recent urinary tract infection (UTI) episode. The treatment group was 34 women whom received 4 monthly intravesical PRP injections. The control group was 30 women who received continuous antibiotic prophylaxis for 3 months. After completion of PRP antibiotic treatment, outpatient follow-up was continued for up to 12 months. Treatment was considered successful if ≤2 UTI episodes occurred during follow-up; otherwise, the outcome was considered treatment failure. The frequency of symptomatic UTI episodes before and after PRP treatment was compared with that of the controls. Regression analysis was used to determine the association between potential predictors for a failed treatment outcome.

Results: At the study endpoint, 33 PRP and 25 control group patients were available for follow-up for at least 6 months. After 4 PRP injections, the frequency of rUTI episodes per month was significantly decreased compared with baseline (0.46 ± 0.27 vs. 0.28 ± 0.30, p = 0.047). The PRP treatment success rate was 51.5% (17 of 33) for the PRP group versus 48% (12 of 25) for the control group. The PRP treatment success group had significantly greater voided volume, less post-void residual volume, and higher voiding efficiency than the PRP treatment failure group. A higher baseline voiding efficacy ≥ 0.71 was significantly associated with successful outcome (OR 16.56; p = 0.049).

Conclusions: Treatment with repeat intravesical PRP injections decreased the UTI recurrence rate within 1 year in women with rUTI. The treatment success rate was about 51.5%. A voiding efficiency ≥ 0.71 was associated with better treatment outcome.