Goh Meidee, Diokno Ananias C
Department of Urology, William Beaumont Hospital, Royal Oak, Michigan 48073, USA.
J Urol. 2007 Jul;178(1):197-9; discussion 199. doi: 10.1016/j.juro.2007.03.058. Epub 2007 May 17.
We investigated whether there are factors which can predict successful stage II (permanent) sacral nerve stimulator (InterStim) implantation for patients with nonobstructive urinary retention.
We retrospectively reviewed our sacral neuromodulation database from January 1, 1999 to January 1, 2006. A total of 29 patients were referred to the William Beaumont Hospital Department of Urology for nonobstructive urinary retention. All patients completed a 3-day voiding log followed by test stimulation. Patients underwent test stimulation for a 2-week trial period. Those who experienced 50% improvement in void volume and/or catheterization frequency subsequently underwent permanent implantation. We reviewed patient charts with respect to age, sex, duration of retention, underlying diagnosis for retention and voiding ability.
Of the 29 patients 15 were men and 14 were women. Mean patient age was 58.8+/-16 years (range 18 to 82). The mean age of the men in the study was 55.5+/-18 years while the mean age of the women was 62.3+/-14 years. Although all the patients performed intermittent self-catheterization 18 were able to void (more than 50 cc per void). The remaining 11 patients had minimal (50 cc or less) or no ability to void. Of the 18 patients who were able to void 12 (67%) underwent successful permanent implantation. However, voiding improved after test stimulation in only 2 of the 11 patients (18%) who had been unable to void. This difference was statistically significant (p=0.02) and suggests that pre-implantation ability to void can predict success of test stimulation.
Patient ability to void predicts success of first stage test stimulation. Although we would still offer a trial of sacral neuromodulation to those with nonobstructive urinary retention and the inability to void, this study would allow better counseling regarding the likelihood of successful outcome.
我们研究了是否存在能够预测非梗阻性尿潴留患者骶神经刺激器（InterStim）二期（永久性）植入成功的因素。
我们回顾性分析了1999年1月1日至2006年1月1日期间的骶神经调节数据库。共有29例非梗阻性尿潴留患者被转诊至威廉·博蒙特医院泌尿外科。所有患者均完成了一份为期3天的排尿记录，随后进行测试刺激。患者接受了为期2周的测试刺激试验期。那些排尿量和/或导尿频率改善50%的患者随后接受了永久性植入。我们查阅了患者病历，了解其年龄、性别、潴留持续时间、潴留的潜在诊断以及排尿能力。
29例患者中，15例为男性，14例为女性。患者平均年龄为58.8±16岁（范围18至82岁）。研究中男性的平均年龄为55.5±18岁，而女性的平均年龄为62.3±14岁。尽管所有患者都进行间歇性自我导尿，但18例患者能够排尿（每次排尿量超过50毫升）。其余11例患者排尿能力极小（50毫升或更少）或无排尿能力。在能够排尿的18例患者中，12例（67%）成功进行了永久性植入。然而，在11例无法排尿的患者中，只有2例（18%）在测试刺激后排尿得到改善。这种差异具有统计学意义（p = 0.02），表明植入前的排尿能力可以预测测试刺激的成功。
患者的排尿能力可预测第一阶段测试刺激的成功。尽管对于非梗阻性尿潴留且无法排尿的患者，我们仍会提供骶神经调节试验，但本研究有助于就成功结果发生的可能性提供更好的咨询。
