Non-ablative erbium YAG laser for the treatment of type III stress urinary incontinence (intrinsic sphincter deficiency)
Non-ablative erbium YAG laser for the treatment of type III stress urinary incontinence (intrinsic sphincter deficiency)
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DOI：
10.1007/s10103-017-2170-5
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发表时间：
2017-04-01
影响因子：
2.1
通讯作者：
Brandi, Hugo
中科院分区：
文献类型：
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作者：
Gaspar, Adrian;Brandi, Hugo
这项初步研究的目的是确定一种新的非消融性Er-YAG激光手术治疗III型压力性尿失禁(固有括约肌缺陷)的安全性和有效性。22名Valsalva泄漏点压力小于60 cm H2O的患者接受了非消融性铒激光治疗，通过特殊设计的插管在整个尿路内发射低通量脉冲。治疗包括两次治疗，其间间隔3周。分别在术后3个月和6个月通过尿失禁期间生活质量问卷和1小时尿垫试验评估治疗效果。两种评估方法在大小便失禁严重程度和生活质量改善方面显示出相似的改善程度。所有患者对治疗的耐受性良好，不良反应轻微且短暂。这项初步研究的结果显示，III型压力性尿失禁有显著改善。尽管本研究的局限性在于患者人数少、随访时间短，但对于III型压力性尿失禁患者，这种非消融性的尿路内激光手术似乎是一种安全有效的选择。应该进行更多的对照研究，以证实这一数据并评估长期效果。
The objective of this pilot study was to determine the safety and efficacy of a new non-ablative erbium YAG laser procedure for the treatment of type III stress urinary incontinence (intrinsic sphincter deficiency) in women. Twenty-two patients with a Valsalva leak point pressure less than 60 cm H2O were recruited and treated with a non-ablative erbium laser delivering low fluence pulses inside the whole length of the urethra through a specially designed cannula. Treatment consisted of two treatment sessions with a 3-week interval in-between. Therapeutic efficacy, as assessed by a questionnaire addressing quality of life during urinary incontinence and the 1-h pad test, was measured at 3 and 6 months after the procedure. Both methods of assessment showed similar levels of improvement in terms of incontinence severity and improvement in quality of life. All patients tolerated the therapy well and adverse effects were mild and transient. The results of this pilot study showed significant improvement of type III stress urinary incontinence. Despite the limitations of this study, being small patient number and short follow-up, this non-ablative intraurethral erbium YAG laser procedure seems to be a safe and efficacious alternative for patients with type III stress urinary incontinence. More controlled studies should be performed to confirm this data and to evaluate the long-term effects.