经膀胱镜局部注射肉毒素A治疗逼尿肌反射亢进所致顽固性急迫性尿失禁  

Treatment of urge urinary incontinence caused by detrusor hyperreflexia with injecting botulinum toxin A into the detrusor under the guide of cystoscopy

作　　者：左毅刚[1] 王剑松[1] 詹辉[1] 柯昌兴[1] 王超[1] 

机构地区：[1]昆明医学院第二附属医院泌尿外科,昆明650101

出　　处：《临床泌尿外科杂志》2005年第9期548-549,552,共3页Journal of Clinical Urology

摘　　要：目的:探讨经膀胱镜局部注射肉毒素A治疗逼尿肌反射亢进所致顽固性急迫性尿失禁的疗效。方法:对9例确诊为逼尿肌反射亢进且保守治疗无效的急迫性尿失禁患者行膀胱镜引导下逼尿肌内注射肉毒素A,每次剂量300 U。术前注意排除伴有膀胱颈梗阻者。比较手术前后患者的临床症状、控尿能力、剩余尿量、初尿意膀胱容量及膀胱最大容量有无差异,有无肉毒素所致的不良反应以及多次注射者有无抗药性产生。结果:9例患者手术过程顺利,术后临床症状、控尿能力、初尿意膀胱容量及膀胱最大容量均较术前有明显改善,剩余尿量无明显变化,无不良反应发生,无肉毒素A的抗药性产生。结论:膀胱镜引导下逼尿肌内注射肉毒素A是一种微创、简便、有效而安全的治疗顽固性逼尿肌反射亢进的方法。Objective：To evaluate the efficacy of injecting botulinum toxin A into the detrusor under the guide of cystoscopy on urge urinary incontinence caused by detrusor byperreflexia. Methods：A total of 9 patients with urge urinary incontinence were included into the study, all of them had accepted a failure conservative treatment, and been excluded the possibility of having a BOO（Bladder outlet obstruction）. Injected botulinum toxin A into the detrusor under the guide of cystoscopy with the dose of 300 U every time, then compared the symptom, urine con trol, residual volume, first desire volume and max bladder volume after operation with those before operation, at the same time, observing the side-effect and immunoresistance of botulinum toxin A. Results： 9 patients all accepted a successful operation. The symptom, urine control, first desire volume and max bladder volume all improved ob viously after operation, but the residual volume kept unchanged. No side effect and immunoresistance took place. Conclusions：Injecting botulinum toxin A into the detrusor under the guide of cystoscopy is a effective and safe method to urge urinary incontinence caused by detrusor hyperreflexia, which not only is easy to be performed but also can cause minimal injury.

关 键 词：膀胱镜术 肉毒素A 逼尿肌反射亢进 尿失禁 

分 类 号：R694[医药卫生—泌尿科学]