Maxwell Kelly M, Clemens J Quentin, Mazzenga Laura, Kielb Stephanie J
Department of Urology, Northwestern University Feinberg School of Medicine, Chicago, Illinois, USA.
J Urol. 2008 Feb;179(2):549-51. doi: 10.1016/j.juro.2007.09.071.
Recent publications support sacral nerve stimulator implantation in patients with interstitial cystitis. To our knowledge the reprogramming requirements for all patients following stimulator implantation has not been described and it is unknown whether the number of sessions required vary by pre-implantation diagnosis. We determined overall reprogramming requirements following nerve stimulator implantation and whether requirements vary based on preoperative indication.
After obtaining institutional review board approval we retrospectively reviewed the records of all patients who underwent sacral nerve stimulator implantation at our institution between June 2002 and October 2004. The preoperative indication and number of reprogramming sessions during the initial test period (stage 1) and following permanent implantation (stage 2) were compared.
The 17 patients proceeding to stage 2 with a minimum 12-month followup during the study period were included. Mean age was 43 years (range 26 to 78) and all patients except 1 were female. Patients were separated by diagnosis for evaluation purposes, including urgency/frequency/incontinence in 8, urinary retention in 2 and interstitial cystitis in 7. The average number of reprogramming sessions during stage 1 was 0.9, 3.5 and 2.3 for urgency/frequency/incontinence, urinary retention and interstitial cystitis, respectively. The average number of reprogramming sessions after stage 2 was 2.8, 3.0 and 6.9 at 12-month followup for urgency/frequency/incontinence, urinary retention and interstitial cystitis, respectively. No patient had the stimulator removed for reprogramming failure.
Patients in urinary retention appear to require more frequent reprogramming during stage 1, while patients with interstitial cystitis require more sessions after stage 2 implantation.
近期的出版物支持在间质性膀胱炎患者中植入骶神经刺激器。据我们所知，尚未描述刺激器植入后所有患者的重新编程要求，并且尚不清楚所需的疗程数量是否因植入前诊断而异。我们确定了神经刺激器植入后的总体重新编程要求，以及要求是否因术前指征而异。
获得机构审查委员会批准后，我们回顾性地审查了2002年6月至2004年10月在我们机构接受骶神经刺激器植入的所有患者的记录。比较了术前指征以及初始测试期（第1阶段）和永久植入后（第2阶段）的重新编程疗程数量。
纳入了在研究期间进入第2阶段且至少随访12个月的17例患者。平均年龄为43岁（范围26至78岁），除1例患者外均为女性。为评估目的，患者按诊断分类，包括8例尿急/尿频/尿失禁、2例尿潴留和7例间质性膀胱炎。在第1阶段，尿急/尿频/尿失禁、尿潴留和间质性膀胱炎的平均重新编程疗程数分别为0.9、3.5和2.3。在第2阶段后，尿急/尿频/尿失禁、尿潴留和间质性膀胱炎在12个月随访时的平均重新编程疗程数分别为2.8、3.0和6.9。没有患者因重新编程失败而取出刺激器。
尿潴留患者在第1阶段似乎需要更频繁的重新编程，而间质性膀胱炎患者在第2阶段植入后需要更多疗程。
