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羊膜膀胱疗法:微粉化羊膜/绒毛膜治疗间质性膀胱炎/膀胱疼痛综合征(IC/BPS)6个月的研究。

Amniotic bladder therapy: study of micronized amnion/chorion for the treatment of interstitial cystitis/bladder pain syndrome (IC/BPS) at 6 months.

作者信息

O'Hollaren Kyle, Considine Jack, Radoiu Codrut, Madan Raghav, Liaw Aron, Dhar Nivedita

机构信息

Wayne State University School of Medicine, Detroit, MI, USA.

John D. Dingell VA Medical Center, 4646 John R Street, Detroit, MI, 48201, USA.

出版信息

Int Urol Nephrol. 2025 Mar;57(3):753-758. doi: 10.1007/s11255-024-04251-x. Epub 2024 Oct 23.

Abstract

BACKGROUND

Intravesical application of birth tissue has been reported to inhibit inflammation, alleviate collagen fiber accumulation, and enhance bladder tissue generation. We have previously reported that intra-detrusor micronized amnion monolayer (AM) injections provide short-term clinical improvement in refractory IC/BPS patients. Herein, we evaluate the therapeutic responses and adverse events of micronized amnion/chorion bilayer (AC) in patients with refractory IC/BPS with 6 months follow-up.

METHODS

Fifteen patients affected by IC/BPS who failed conventional therapy received 100 mg of reconstituted micronized AC was injected intra-detrusor via cystoscopy under general anesthesia, using a 23-gauge needle. Twenty 0.5-mL injections were administered into the lateral and posterior bladder walls, avoiding the dome and trigone. Changes in interstitial cystitis symptom index (ICSI), Interstitial cystitis problem index (ICPI), Bladder pain/ interstitial cystitis symptom score (BPIC-SS) and Overactive Bladder Assessment Tool (OAB), from baseline to 6 months post-injection were evaluated retrospectively. The safety of injections was analyzed.

RESULTS

Fifteen total refractory IC/BPS patients with an average age of 41.1 ± 14.5 years were included in the study, receiving intra-detrusor injections of 100 mg of micronized AC. One month after injections, significant improvement in IC/BPS symptom scores was noted in all patients. All patients maintained a sustained clinical response at 6 months post-injection. No product-related adverse events were observed.

CONCLUSION

Our findings indicate that the AC formulation significantly reduces time to symptom relief in patients with refractory interstitial cystitis/bladder pain syndrome (IC/BPS) and maintains a sustained response up to 6 months post-injection. These results suggest a promising clinical benefit of using an amnion/chorion bilayer product for treating IC/BPS. Further research is needed to confirm these findings and assess the long-term durability of this treatment approach. This study represents the first evidence supporting the clinical advantages of an amnion/chorion bilayer product in managing IC/BPS.

摘要

背景

据报道,膀胱内应用出生组织可抑制炎症、减轻胶原纤维堆积并促进膀胱组织生成。我们之前曾报道,膀胱逼尿肌内注射微粉化羊膜单层(AM)可为难治性间质性膀胱炎/膀胱疼痛综合征(IC/BPS)患者带来短期临床改善。在此,我们对难治性IC/BPS患者进行了6个月随访,以评估微粉化羊膜/绒毛膜双层(AC)的治疗反应和不良事件。

方法

15例接受传统治疗无效的IC/BPS患者在全身麻醉下通过膀胱镜检查,使用23号针头将100mg复溶的微粉化AC注射到膀胱逼尿肌内。在膀胱侧壁和后壁进行20次0.5mL注射,避开膀胱顶部和三角区。回顾性评估从基线到注射后6个月期间,间质性膀胱炎症状指数(ICSI)、间质性膀胱炎问题指数(ICPI)、膀胱疼痛/间质性膀胱炎症状评分(BPIC-SS)和膀胱过度活动症评估工具(OAB)的变化。分析注射的安全性。

结果

本研究共纳入15例难治性IC/BPS患者,平均年龄41.1±14.5岁,接受了100mg微粉化AC的膀胱逼尿肌内注射。注射后1个月,所有患者的IC/BPS症状评分均有显著改善。所有患者在注射后6个月均维持了持续的临床反应。未观察到与产品相关的不良事件。

结论

我们的研究结果表明,AC制剂可显著缩短难治性间质性膀胱炎/膀胱疼痛综合征(IC/BPS)患者的症状缓解时间,并在注射后6个月内维持持续反应。这些结果表明,使用羊膜/绒毛膜双层产品治疗IC/BPS具有良好的临床益处。需要进一步研究来证实这些发现并评估这种治疗方法的长期有效性。本研究是支持羊膜/绒毛膜双层产品在治疗IC/BPS方面临床优势的首个证据。

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