Hypothesis / aims of study
Stress Urinary Incontinence (SUI) is defined as "the complaint of involuntary loss of urine on effort or physical exertion (e.g., sporting activities), or on sneezing or coughing" (1), and it is the most common type of urinary incontinence
Comparative effectiveness of Kelly plication plus local injection of autologous platelet-rich plasma (PRP) versus Kelly plication in women with stress urinary incontinence: a randomized clinical trial.
Study design, materials and methods
In this randomized clinical trial study, 60 consecutive women suffering from SUI were assigned to two groups by random block randomization: thirty patients were treated with Kelly plication, and 30 patients received PRP injection at the anterior vaginal wall where mid-urethra locates and Kelly plication. we used Urogenital Distress Inventory (UDI-6) questionnaire and International Consultation on Incontinence Questionnaire-Short Form (ICIQ-SF) to evaluate and compare the effectiveness of the two treatment procedures in pre-treatment, 1, 3, and 6months post-treatment.
Results
Among the 60 patients enrolled, the median age was 48.5 (range 27-72) years old. The median age in patients with Kelly plication and Kelly plication plus PRP treatments were 49.3(11.5) and 47(11.4), respectively. There was no statistical difference between the two treatment groups by age (p-value=0.772)
this study UDI-6 and ICIQ-SF scores showed incontinence improvement within both treatment groups during 1, 3, and 6months post-treatment. However, there was a statically significant difference between the two treatments by the UDI-6 questionnaire (p-value=0.012) but not by the ICIQ-SF questionnaire (p-value=0.112). The scores of both questionnaires revealed that Kelly plication and PRP procedure were more effective than Kelly plication alone.
Interpretation of results
Local injection of platelet-rich plasma seems safe, with a somewhat satisfactory response in treating female SUI at 1, 3, and 6months post-treatment. Yet how long the treatment effect could sustain remains unknown and awaits further studies.