Vandoninck Vera, van Balken Michael R, Finazzi Agrò Enrico, Heesakkers John P F A, Debruyne Frans M J, Kiemeney Lambertus A L M, Bemelmans Bart L H
Department of Urology, University Medical Center Nijmegen, PO Box 9101, NL-6500 HB Nijmegen, The Netherlands.
Neurourol Urodyn. 2004;23(3):246-51. doi: 10.1002/nau.10158.
To determine urodynamic changes and predictive factors in patients with voiding dysfunction who underwent 12 percutaneous tibial nerve stimulations.
Thirty nine patients with chronic voiding dysfunction were enrolled in a prospective multicenter trial in the Netherlands (n = 19) and in Italy (n = 20). A 50% reduction in total catheterised volume per 24 hr was taken as a primary objective outcome measure. Patients' request for continuation of treatment was regarded as subjective success. Objective urodynamic parameters and bladder indices were determined. Odds ratios and their 95% confidence interval were computed as a measure for predictive power in order to reveal predictive factors (Pdet at Qmax, Qmax, BVE, and BCI).
Primary outcome measure was obtained in 41%, an additional 26% reduced their 24 hr residuals with more than 25%. Fifty nine percent of patients chose to continue treatment. Detrusor pressure at maximal flow, cystometric residuals, and bladder indices improved significantly for all patients (P < 0.05). Patients with minor voiding dysfunction were more prone to notice success (Odds ratio: 0.73; 95% CI: 0.51-0.94).
PTNS is a young treatment modality, minimally invasive, and easily accessible. It might be an attractive first line option for patients with (minor) voiding dysfunction.
确定接受12次经皮胫神经刺激的排尿功能障碍患者的尿动力学变化及预测因素。
39例慢性排尿功能障碍患者纳入荷兰（n = 19）和意大利（n = 20）的一项前瞻性多中心试验。以每24小时导尿总量减少50%作为主要客观结局指标。患者要求继续治疗视为主观成功。测定客观尿动力学参数和膀胱指标。计算比值比及其95%置信区间作为预测能力的指标，以揭示预测因素（最大尿流率时的逼尿肌压力、最大尿流率、膀胱容积和膀胱顺应性指数）。
41%的患者达到主要结局指标，另外26%的患者24小时残余尿量减少超过25%。59%的患者选择继续治疗。所有患者的最大尿流率时逼尿肌压力、膀胱测压残余尿量和膀胱指标均有显著改善（P < 0.05）。轻度排尿功能障碍患者更容易取得成功（比值比：0.73；95%置信区间：0.51 - 0.94）。
经皮胫神经刺激是一种新兴的治疗方式，微创且易于实施。对于（轻度）排尿功能障碍患者，它可能是一个有吸引力的一线治疗选择。
