A型肉毒毒素注射治疗女性尿道疼痛综合征的短期疗效和安全性

The short-termn efficacy and safety of injection of botulinum toxin A for female urethral pain syndrome

目的探讨A型肉毒毒素(BTX-A)注射治疗女性尿道疼痛综合征(UPS)的短期疗效和安全性。方法回顾性分析2021年2-9月四川大学华西医院收治的8例女性UPS患者的病例资料。年龄(47.87±11.33)岁。病程3(1.0,10.8)年。治疗前疼痛视觉模拟评分(VAS)(5.38±1.92)分,盆腔疼痛+尿频/尿急症状评分(PUF)(10.75±5.12)分,女性性功能量表评分(FSFI)(14.53±11.63)分。患者取截石位,应用100UBTX-A,分别于尿道口3、6、9、12点位置,以及尿道中段和膀胱颈左右两侧注射,共10针。记录患者治疗后1、3、6个月的VAS、PUF评分、FSFI评分和并发症情况。结果本组8例,治疗后1、3、6个月的VAS分别为(3.25±2.12)分、(2.88±2.23)分、(2.88±2.23)分,与治疗前比较差异均有统计学意义(P<0.05);PUF评分分别为(6.63±3.93)分、(6.25±4.03)分、(5.13±3.31)分,仅治疗后6个月与治疗前比较差异有统计学意义(P=0.03);FSFI评分分别为(14.68±11.56)分、(16.76±12.17)分、(16.76±12.17)分,与治疗前比较差异均无统计学意义(P>0.05)。1例治疗后出现短暂性排尿困难。结论BTX-A注射治疗UPS安全、有效,可用于保守治疗无效的UPS患者。

Objective To explore the efficacy and safety of injection of botulinum toxin A(BTX-A)for female urethral pain syndrome(UPS).Methods This study retrospectively included 8 women with UPS who were treated by injection of BTX-A in West China Hospital of Sichuan University from February 2021 to September 2021.The average age was(47.87±11.33)years old,the median disease duration was 3(1.0,10.8)years.Before treatment,The visual analogue scale(VAS)was(5.38±1.92),the Pain,Urgency,Frequency score(PUF)was(10.75±5.12),and the female sexual function index(FSFI)was(14.53±11.63).100U BTX-A was injected at the 3,6,9,and 12 oclock positions of the urethral meatus,as well as at the mid-urethra and the left and right sides of the bladder neck,totaling 10 injections.The VAS,PUF score,FSFI score,and complications were recorded at 1,3,and 6 months after treatment.Results The VAS score decreased to(3.25±2.12),(2.88±2.23)and(2.88±2.23)at 1,3,and 6 months,showing statistically significant differences compared to the pre-treatment scores(P<0.05);post-treatment PUF score declined to(6.63±3.93),(6.25±4.03)and(5.13±3.31),respectively,with only the 6-month score showing a statistically significant difference compared to the pre-treatment score(P=0.03).The FSFI score increased slightly to(14.68±11.56),(16.76±12.17)and(16.76±12.17)at 1,3,and 6 months postinjection,respectively,with no statistically significant differences compared to the pre-treatment scores(P>0.05).Only 1 patient had transient dysuria.Conclusion BTX-A injection is a safe and effective treatment for UPS,and it can be used for UPS patients who are unresponsive to conservative therapy.