PDF(849 KB)
两种新型能量技术治疗压力性尿失禁临床疗效观察
郑小花, 宋岩峰, 陈春花, 王晓晓, 林超琴, 徐颖
中国实用妇科与产科杂志 ›› 2025, Vol. 41 ›› Issue (6) : 658-661.
PDF(849 KB)
PDF(849 KB)
两种新型能量技术治疗压力性尿失禁临床疗效观察
Clinical efficacy of two new energy techniques in the treatment of stress urinary incontinence
目的 比较经阴道点阵式CO2激光与人工智能（AI）温控射频治疗压力性尿失禁的中远期临床疗效。 方法 回顾性分析2020年1月至2022年5月因压力性尿失禁于福建省妇幼保健院门诊行盆底康复治疗患者100例完整的病例资料，其中46例行点阵式CO2激光治疗（激光组），54例行AI温控射频治疗（射频组）。疗程结束后6、12个月比较两组患者的临床疗效（1h尿垫）、国际尿失禁委员会尿失禁问卷简表（ICI-Q-SF）评分。 结果 治疗后6个月，激光组与射频组有效率分别为91.3%（42/46）、72.2%（39/54），激光组总有效率高于射频组（P<0.05），尤其是对于轻度尿失禁（96.4% vs. 60.0%）及年龄>40岁（88.5% vs. 60.0%）患者，两组ICI-Q-SF评分与治疗前相比均降低，两组间比较激光组评分低于射频组[（5.21±3.07）分 vs. （6.59±3.64）分，P<0.05]；治疗后12个月与治疗后6个月相比，激光组有效率降低（65.2% vs. 91.3%，P<0.05），射频组有效率差异无统计学意义（68.5% vs. 72.2%，P>0.05），两组间有效率及ICI-Q-SF评分比较差异均无统计学意义。 结论 经阴道点阵式CO2激光、AI温控射频均可有效治疗压力性尿失禁，治疗后6个月激光疗效优于AI温控射频，尤其对于轻度尿失禁和年龄>40岁患者，治疗后12个月激光与AI温控射频疗效相近。
Objective To compare the mid-term and long-term clinical efficacy of transvaginal dot-matrix CO2 laser with that of AI temperature-controlled radiofrequency in the treatment of stress urinary incontinence. Methods Complete data of 100 patients who received treatment for stress urinary incontinence in outpatient department from January 2020 to May 2022 were retrospectively analyzed.Among them, 46 patients received dot-matrix CO2 laser therapy（laser group）and 54 patients received AI temperature-controlled RF therapy（RF group）.At 6 and 12 months after the end of treatment the clinical efficacy（1-hour urine pad）and the Urinary Incontinence Questionnaire（ICI-Q-SF）score of the International Urinary Incontinence Committee were compared between the two groups. Results At 6 months，the effective rate of laser group and RF group was 91.3%（42/46）and 72.2%（39/54）.The total effective rate in laser group was higher than that in RF group（P<0.05），especially in patients with mild urinary incontinence（96.4% vs. 60.0%）or age > 40 years old（88.5% vs. 60.0%）.The ICI-Q-SF score of the two groups was lower than before treatment，and the score of the laser group was lower than that of the RF group[（5.21±3.07）vs. (6.59 ± 3.64）, P<0.05].At 12 months，the effective rate in laser group was lower than that at 6 months（91.3% vs. 65.2%, P<0.05），but there was no significant difference in RF group（72.2% vs. 68.5%, P>0.05）. There was no significant difference in effective rate or ICI-Q-SF score between the two groups. Conclusion Both transvaginal dot-matrix CO2 laser and AI temperature-controlled radiofrequency therapy are effective in the treatment of stress urinary incontinence，and the effect of laser therapy is better than that of radiofrequency after 6 months，especially for patients with mild urinary incontinence or age > 40 years，but the effect of them are similar after 12 months.
stress urinary incontinence / transvaginal / CO2 laser / temperature-controlled radiofrequency
| [1] |
|
| [2] |
全晓洁, 常小霞, 沈玮, 等. 电刺激联合生物反馈疗法对女性压力性尿失禁生活质量影响研究[J]. 中国实用妇科与产科杂志, 2021, 37(10):1066-1069. DOI: 10. 19538/j. fk2021100120.
|
| [3] |
Lasers and energy-based technologies have been developed for genitourinary applications over the past several decades.This consensus article aims to categorize the published articles and clinical trial data that culminated in protocol development of technology for genitourinary applications, and to develop consistent parameters in future clinical trials.The published articles and clinical trials data on lasers and energy-based devices applied to genitourinary conditions were categorized according to device and condition and consensus developed on protocols and parameters.The devices in genitourinary applications were classified as fractional lasers, radiofrequency and high-intensity focused electromagnetic field therapy. The consensus of the protocols and parameters based upon the published clinical trials of their application to the vaginal and urologic conditions associated with genitourinary syndrome of menopause was developed and organized according to device and condition.The status of FDA clearances and future pathways are discussed.This consensus article categorizes and presents the protocols and practices for the main classes of lasers and energy-based devices for genitourinary applications in future clinical trials.© 2023 Wiley Periodicals LLC.
|
| [4] |
王慧兰, 朱倩, 王美燕, 等. 盆底肌肉锻炼联合电刺激生物反馈疗法治疗盆底功能障碍性疾病临床效果研究[J]. 中国实用妇科与产科杂志, 2023, 39(1):115-118. DOI: 10. 19538/j. fk2023010126.
|
| [5] |
庞海玉, 朱兰, 徐涛, 等. 基于随机森林算法的中国女性尿失禁发病危险因素研究[J]. 中华妇产科杂志, 2021, 56(8):554-560.DOI: 10.3760/cma.j.cn112141-20210518-00272.
|
| [6] |
尹嘉惠, 庞海玉, 刘静怡, 等. 中国高血压女性尿失禁及其亚型的危险因素:一项为期4年的前瞻性队列研究[J]. 中国实用妇科与产科杂志, 2024, 40(5):549-555. DOI: 10. 19538/j. fk2024050115.
|
| [7] |
Conservative treatment is recommended as first-line therapy for stress urinary incontinence (SUI). We hypothesized that CO laser treatment would demonstrate safety and efficacy for women with SUI.A prospective, open-label, cohort study of 33 women (mean age 43 years) referred from a continence clinic after urologist/urogynecologist assessment, with a verified stress urinary incontinence diagnosis based on urodynamic testing. The participants completed three outpatient treatments with laser therapy and were subsequently evaluated at 1, 3 and 6 months. The independent t and chi-square tests were used to assess changes in sanitary pad usage and SUI symptoms.Sanitary pad usage decreased from a median of 12 per day at baseline to 7 at 1-3 months post-treatment (P < 0.0001) and returned to 12 at 6 months post-treatment. Scores on the Urogenital Distress Inventory and the International Consultation of Incontinence Questionnaire decreased (improved) significantly at 1-3 months post-treatment: from 45 ± 2 and 16 ± 4, respectively, to 29.3 ± 14.7 and 8.15 ± 3.1, respectively (P < 0.0001). The scores returned to levels similar to baseline at 6 months after treatment. Participants reported mild and transient side effects, with significant improvement in quality of life.Laser therapy can be an optional conservative treatment for women who seek minimally invasive non-surgical treatment for the management of SUI. No serious adverse effects were reported though the sample size was not large, a possible limitation of the study. Further large randomized control trials are needed to appraise the efficacy and safety of laser therapy for stress urinary incontinence and to demonstrate the ultimate utility of this modality.
|
| [8] |
|
| [9] |
Vaginal rejuvenation is a topic of interest to multiple specialties, including dermatologists, plastic and reconstructive surgeons, urologists, and gynecologists. Evidence suggests that minimally invasive, energy-based devices-radiofrequency and laser therapy-are effective at vaginal tightening and decreasing symptoms of genitourinary syndrome of menopause (GSM) and/or vulvovaginal atrophy (VVA).A systematic review was completed using PubMed in November 2018 with search terms "vaginal" or "vagina" and "rejuvenation" or "tightening" or "laxity" or "radiofrequency" or "laser," as well as "genitourinary syndrome of menopause," "pelvic prolapse," "atrophic vaginitis," "vulvovaginal atrophy," "sexual function," "urinary incontinence," and "radiofrequency" or "laser." Inclusion criteria were articles written in English and clinical trials or case reports/series dealing with human subjects.We identified 59 studies (3,609 women) treated for vaginal rejuvenation using either radiofrequency or fractional ablative laser therapy. Studies report improvement in symptoms of GSM/VVA and sexual function, high patient satisfaction, and minor adverse events, including treatment-associated pain, swelling, or vaginal discharge.This review demonstrates radiofrequency and laser are efficacious for the treatment of vaginal laxity and/or atrophy. Further research needs to be completed to determine which specific pathologies can be treated, if maintenance treatment is necessary, and long-term safety concerns.Copyright © 2020 by the American Society for Dermatologic Surgery, Inc. Published by Wolters Kluwer Health, Inc. All rights reserved.
|
/
| 〈 |
|
〉 |
