항생제 요법에 반응하지 않는 여성요도증후군의 치료

초록

Purpose: In female urethral syndrome, if variable management fail, a antibiotic treatment seems to be the possible therapeutic approach. We tried to evaluate the long term results of antibiotic treatment with or without external sphincter relaxant and biofeedback with electrical stimulation therapy (EST) and the change of subjective symptoms in patients. Material and Method: From Mar. 1998 to Feb. 2000, 105 patients who complained of urinary frequency, urgency and suprapubic discomfort during more than 6 months were involved in this study. We assessed the patients medical records including, physical examination, laboratory result, the results of urodynamic study, cystoscopic finding, retrospectively. With regard to treatment, antibiotic therapy was done first and antibiotic therapy combined with muscle relaxant or biofeedback with EST was performed in recurrent or incurable urethral syndrome. The efficacy of treatment was evaluated by change of subjective symptoms with female urethral syndrome symptom scores and subjective satisfaction scale at biofeedback. Results: Average patients age was 47.69 yrs (range 26-77). Significant improvements in urinary frequency, urge, nocturia, residual urine sense and suprapubic discomfort were noted in most patients. Female urethral syndrome symptom scores changed 12.4 to 3.9 of 105 ptatients. Antibiotic therphy were performed in all patients (105) as first line. 33 (31.4%) of 105 patients were terminated with antibiotic alone and 7 (21.2%) of 33 patients were recurred. Antibiotics with muscle relaxant were applied in 31 (29.5%) of 105 patients and 5 (16.1%) among 31 patients were recurred. Biofeedback was done in 41 (39.0%) of 105 patients. For Biofeedback, mean voiding intervals changed 12.2 times to 7.7 time and nocturia changed 2.4 times to 0.6 time a night and the overall satisfaction rate for this treatment was 87.8%; 41.5% were very satisfactied, 46.3% satisfactied and 12.2% no response. Conclusion: A antibiotics the