索利那新联合TURP治疗BPH合并OAB的效果及对尿动力学指标的影响

Effect of solifenacin combined with TURP in the treatment of BPH complicated with OAB and the influence on urodynamic indexes

目的观察索利那新联合经尿道前列腺电切术(TURP)治疗良性前列腺增生(BPH)合并膀胱过度活动症(OAB)的效果及对尿动力学指标的影响。方法前瞻性选取2017年9月至2023年1月海南省肿瘤医院收治的76例BPH合并OAB患者作为研究对象。按随机数字表法分为观察组和对照组,每组各38例。两组均行TURP,对照组术后予以常规治疗,观察组予以索利那新治疗。比较两组治疗前、治疗8周后国际前列腺症状评分(IPSS)、膀胱过度活动症评分(OABSS)、尿动力学指标[残余尿量(PVR)、膀胱最大容量(MBC)、最大排尿压(MVP)、最大尿流率(Qmax)]、手术时间、置管期排尿指标(膀胱痉挛次数与时间)、自主排尿期排尿指标(排尿次数、急迫性尿失禁次数与每次尿量)、不良反应情况。结果治疗8周后,观察组IPSS、OABSS分别为(11.18±2.16)、(5.67±0.96)分,均显著低于对照组[(15.23±2.89)、(8.23±1.48)分],差异均有统计学意义(P<0.05)。治疗8周后,观察组PVR为(15.83±2.91)mL,明显少于对照组[(18.14±3.52)mL],MBC、Qmax分别为(307.42±56.24)mL、(14.29±2.65)mL/s,均明显大于对照组[(261.73±49.36)mL、(13.05±2.47)mL/s],差异均有统计学意义(P<0.05)。观察组置管期膀胱痉挛次数与时间、自主排尿期排尿次数、急迫性尿失禁分别为(11.25±2.08)次/周、(17.02±3.19)min/次、(8.12±1.48)次/d、(1.32±0.25)次/d,均明显少于对照组[(13.46±2.57)次/周、(19.76±3.72)min/次、(9.45±1.73)次/d、(1.64±0.31)次/d],每次尿量为(204.57±38.6)mL,高于对照组[(179.45±31.90)mL],差异均有统计学意义(P<0.05)。两组不良反应总发生率比较,差异无统计学意义(P>0.05)。结论索利那新联合TURP治疗BPH合并OAB,能够有效减轻患者前列腺及膀胱过度活动症状,改善尿动力学及排尿情况,且安全性好。

Objective To observe the effect of solifenacin combined with transurethral resection of prostate(TURP)in the treatment of benign prostatic hyperplasia(BPH)complicated with overactive bladder(OAB)and the influence on urodynamic indexes.Methods A total of 76 patients with BPH combined with OAB admitted to Hainan Cancer Hospital from September 2017 to January 2023 were prospectively selected as the study subjects,and they were divided into observation group and control group according to the random number table method,with 38 cases in each group.Both groups received TURP,the control group received routine treatment after surgery,and the observation group received sorinacin treatment after surgery.The international prostate symptom score(IPSS),overactive bladder symptom score(OABSS),urodynamic indexes[residual urine volume(PVR),maximum bladder capacity(MBC),maximum voided pressure(MVP)and maximum urine flow(Qmax)]before and after 8 weeks of treatment,operation time,urination indexes during catheterization(frequency and time of bladder spasm),urination indexes during spontaneous urination(frequency of urination,frequency of urge incontinence,urine volume each time)and adverse reactions were compared between the two groups.Results After 8 weeks of treatment,the IPSS and OABSS of the observation group were(11.18±2.16)and(5.67±0.96)pionts,respectively,which were significantly lower than those of the control group(15.23±2.89)and(8.23±1.48)points,the differences were statistically significant(P<0.05).After 8 weeks of treatment,the PVR of the observation group was(15.83±2.91)mL,which was significantly lower than that of the control group[(18.14±3.52)mL],the MBC and Qmax were(307.42±56.24)mL and(14.29±2.65)mL/s,respectively,which were significantly higher than those of the control group[(261.73±49.36)mL and(13.05±2.47)mL/s],and the differences were statistically significant(P<0.05).The number and time of bladder spasm during catheterization,the number of micturition during autonomous micturition,and urgent Urinary incontinence in the observation group were(11.25±2.08)times/week,(17.02±3.19)min/time,(8.12±1.48)times/day,and(1.32±0.25)times/day,respectively,which were significantly less than those in the control group[(13.46±2.57)times/week,(19.76±3.72)min/time,(9.45±1.73)times/day,and(1.64±0.31)times/day],and the urine volume per time was(204.57±38.6)mL,which was higher than that in the control group[(179.45±31.90)mL],and the differences were statistically significant(P<0.05).There was no statistically significant difference in the total incidence of adverse reactions between the two groups(P>0.05).Conclusion Solifenacin combined with TURP can effectively relieve prostate and overactive bladder symptoms,improve urodynamics and urination in patients with BPH and OAB,with good safety.