Objective: To compare the clinical therapeutic effect between electroacupuncture at "four points of sacral region" and transurethral Erbium laser in treatment of moderate to severe stress urinary incontinence after radical prostatectomy.
Methods: A total of 68 patients of moderate to severe stress urinary incontinence after radical prostatectomy were divided into an electroacupuncture group (34 cases) and an Erbium laser group (34 cases, 3 cases dropped off) according to the settings. In the electroacupuncture group, electroacupuncture was applied at "four points of sacral region", i.e. points of 0.5 cun beside bilateral sacrococcygeal joints and bilateral Huiyang (BL 35), with continuous wave, 2 Hz in frequency, 60 min each time, once every other day, 3 times a week, 12 times as one course of treatment. In the Erbium laser group, transurethral Erbium laser technology was given, once every 4 weeks as one course of treatment. Both groups were treated for 5 courses. The scores of the International Consultation on Incontinence questionnaire-short form (ICI-Q-SF) and the incontinence quality of life questionnaire (I-QOL) were observed before treatment, after each course of treatment and in follow-up after 1 and 2 months of treatment completion, respectively, and the clinical efficacy was evaluated after treatment in the two groups.
Results: Compared with those before treatment, the ICI-Q-SF scores were decreased while the I-QOL scores were increased after 5 courses of treatment and in follow-up after 1, 2 months of treatment completion in the two groups (P<0.01). The ICI-Q-SF score in follow-up after 2 months of treatment completion were higher than that after 5 courses of treatment in the Erbium laser group (P<0.05). After 3, 4, 5 courses of treatment and in follow-up after 1 and 2 months of treatment completion, the ICI-Q-SF scores in the electroacupuncture group were lower than those in the Erbium laser group (P<0.05, P<0.01); after 2, 3, 4, 5 courses of treatment and in follow-up after 1 and 2 months of treatment completion, the I-QOL scores in the electroacupuncture group were higher than those in the Erbium laser group (P<0.01). The change ranges of ICI-Q-SF score and I-QOL score between before treatment and after each course of treatment in the electroacupuncture group were lager than those in the Erbium laser group (P<0.01, P<0.05). The total effective rate was 61.8% (21/34) in the electroacupuncture group, which was superior to 19.4 (6/31) in the Erbium laser group (P<0.01).
Conclusion: Both electroacupuncture at "four points of sacral region" and transurethral Erbium laser can improve the clinical symptoms and the quality of life in patients of moderate to severe stress urinary incontinence after radical prostatectomy. The short-term efficacy and long-term efficacy of electroacupuncture are superior to the Erbium laser technology.
目的：比较电针“骶四穴”与经尿道铒激光治疗前列腺癌术后中重度压力性尿失禁的临床疗效。方法：将68例前列腺癌术后中重度压力性尿失禁患者根据就诊地点分为电针组（34例）和铒激光组（34例，脱落3例）。电针组予电针“骶四穴”（双侧骶尾关节旁开0.5寸点及会阳穴）治疗，连续波，频率2 Hz，每次60 min，隔日1次，每周3次，治疗12次为一疗程；铒激光组采用经尿道铒激光技术治疗，每4周治疗1次为一疗程。两组均治疗 5个疗程。分别于治疗前、治疗各个疗程及治疗后1、2个月随访时，观察两组患者国际尿失禁咨询委员会尿失禁问卷简表（ICI-Q-SF）及尿失禁生活质量问卷（I-QOL）评分，并于治疗后评定两组临床疗效。结果：与治疗前比较，两组患者治疗5个疗程及治疗后1、2个月随访时ICI-Q-SF评分降低、I-QOL评分升高（P<0.01）；与治疗5个疗程比较，铒激光组治疗后2个月随访时ICI-Q-SF评分升高（P<0.05）。治疗3、4、5个疗程及治疗后1、2个月随访时，电针组ICI-Q-SF评分低于铒激光组（P<0.05，P<0.01）；治疗2、3、4、5个疗程及治疗后1、2个月随访时，电针组I-QOL评分高于铒激光组（P<0.01）。电针组治疗各个疗程ICI-Q-SF及I-QOL评分较治疗前的变化幅度均大于铒激光组（P<0.01，P<0.05）。电针组总有效率为61.8%（21/34），高于铒激光组的19.4%（6/31， P<0.01）。结论：电针“骶四穴”与经尿道铒激光治疗均可改善前列腺癌术后中重度压力性尿失禁患者临床症状，提高其生活质量，电针治疗近期、远期疗效均优于铒激光技术。.
Keywords: Erbium laser; clinical efficacy; electroacupuncture; four points of sacral region; moderate to severe stress urinary incontinence; radical prostatectomy.