【摘要翻译】膀胱c-纤维去敏感对BPH相关的贮尿性LUTS的长期改善作用：初步研究

[文题]Bladder C-Fiber Desensitization Induces a Long-Lasting Improvement of BPH-Associated Storage LUTS: A Pilot Study
膀胱c-纤维去敏感对BPH相关的贮尿性LUTS的长期改善作用：初步研究
[来源]European Urology
[年、卷、期、页]2004. 46（1）：Pages 88-94
[作者]Paulo Dinis, Jo?o Silva, Maria José Ribeiro, António Avelino, Mário Reis and Francisco Cruz
[原文摘要]
Objectives: To evaluate the effect of bladder C-fiber desensitization on BPH-associated storage LUTS.
Methods: Twelve patients with predominant BPH-associated storage LUTS gave written informed consent to enter the study. IPSS and QoL scores, micturition chart, uroflowmetry, cystometry and post-void residual (PVR) were obtained at baseline and at 1, 3 and 6 months after a single intravesical administration of 50 nM resiniferatoxin (RTX) solution.
Results: Mean IPSS score decreased from 20.1±6.0 to 10.5±4.4 at 1 month (p=0.0001), to 10.3±4.4 at 3 months (p=0.00001) and to 9.8±5.7 at 6 months (p=0.00001). Mean QoL score decreased from 4.5±1 to 2.5±1 at 1 month (p=0.0001), to 2.3±1 at 3 months (p=0.0004) and to 2.6±1.2 at 6 months (p=0.0003). Mean urinary frequency decreased from 15.2±8.5 to 10.8±7.3 at 1 month (p=0.0002), to 10.2±4.9 at 3 months (p=0.002) and to 11.7±9.2 at 6 months (p=0.005). Urge incontinence, which was present in six cases, disappeared in 4 patients and decreased to less than half in the other two. Mean first desire to void and maximal cystometric capacity increased significantly after RTX whereas uroflowmetry and PVR were not altered.
Conclusions: Intravesical desensitization of bladder C fibres with intravesical RTX might be useful in the treatment of patients with predominant BPH associated storage LUTS.
[中文译文]
目的：评估膀胱c-纤维去敏感对BPH相关的贮尿性LUTS的作用。
方法：12例有主要以BPH相关贮尿性LUTS的患者签署知情同意书后参与研究。患者接受单次膀胱灌注50nM树脂毒素（RTX）溶液，分别于治疗前及治疗后1、3和6月记录IPSS和QoL评分、排尿日记、尿流率、膀胱测压、和排尿后残余尿。
结果：平均IPSS评分由治疗前的20.1±6.0降低为治疗后1月的10.5±4.4（p=0.0001），治疗后3月的10.3±4.4(p=0.00001)和治疗后6月的9.8±5.7(p=0.00001)。平均QoL评分由治疗前的4.5±1降低为治疗后1月的2.5±1（p=0.0001），治疗后3月的2.3±1(p=0.0004)和治疗后6月的2.6±1.2(p=0.0003)。平均排尿次数由治疗前的15.2±8.5降低为治疗后1月的10.8±7.3（p=0.0002），治疗后3月的10.2±4.9(p=0.002)和治疗后6月的11.7±9.2(p=0.005)。6例患者存在尿急，治疗后4例消失，另2例降低一半。平均首次尿意和最大膀胱容量均于RTX治疗后明显增加，而尿流率和排尿后残余尿均无明显变化。
结论：应用膀胱内灌注RTX以使膀胱c-纤维去敏感可能对主要以BPH相关的LUTS患者治疗有益。
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[个人评论]本法治疗效果显示以主观症状的缓解为主，而尿流率、残余尿这两个客观指标却没有明显变化，说明治疗仍不能缓解对上尿路的潜在损害。可能只能用于实在连造瘘都不能承受而且预期寿命很短的病人。个人见解，希望高人指点。