愷他命膀胱炎治療效果之臨床評估
林志德、許毓昭、林國仁、陳煜、謝明里、黃世聰、黃信介、張博誌、李威昌
林口長庚紀念醫院外科部 泌尿科系
The treatment effect of Hydrodistention, Cystistate and Antimuscarinic drugs in ketamine cystitis patients
Chih-Te Lin, Kuo-Jen Lin, Wei-Chang Lee, Po-Chih Chang, Hsin-Chieh Huang, Yu Chen, Shih-Tsung Huang, Ming-Li Hsieh, Yu-Chao Hsu*
Division of Urology, Department of Surgery, Chang Gung Memorial Hospital at
Linkou, Chang Gung University, College of Medicine, Taoyuan, Taiwan
Objective: To evaluate the clinical outcome of differrent treatment in ketamine cystitis patients. The treatment categories included hydrodistention, intravesical cystistate, and antimuscarinic drugs treatment.
Methods: A total number of 131 ketamine user between 2010 June and 2016 were December were included. 66 who had completed at least 3 months of follow up were divided 3 groups, including cystoscopic hydrodistention, intravesical cystistate instillation, and antimuscarinic drugs therapy. We review their voiding diary, OASS score, and pain score and analysis with SPSS statistic software. 38 ketamine cystitis patients took cystoscopic hydrodistention under the general anathesia. The hydro-pressure was kept at 80cm/H2O for 15 min and repeated twice. 28 patients took antimuscarinic drugs in outpatient clinic. 18 patient undergoing intravesical cystistate instillation 50ml through Foley 4 times every week initially and followed by 5 times every month.
Results:
The voiding interval increased from 45.35 to 76.25 minutes after antimucarinic drugs (oxbutynine, detrusitol, and vesicare) ( before vs after 45.53±32.24 vs 76.25±43.90 min , p<0.05). Hydrodistension also improve frequency symptoms from 39.17±33.00 to 73.33±37.89 min (p<0.05). 18 patients who complete at least 4 doses of intravesical sodium hyaluronate instillation also get benefit after treatment (before vs after 63.33±36.62 vs 106.39±66.37 min. p<0.05).
Conclusion:
All there treatment modalities improved voiding symptoms by increases the voiding interval. The intravesical sodium hyaluronate improves voiding interval by 43 min which is the best results in the three methods.