White Wesley M, Dobmeyer-Dittrich Cindy, Klein Frederick A, Wallace Lorraine S
Department of Urology, University of Tennessee Medical Center, Knoxville, Knoxville, Tennessee 37920, USA.
Urology. 2008 Jan;71(1):71-4. doi: 10.1016/j.urology.2007.08.034.
To examine the long-term efficacy and durability of sacral nerve stimulation (SNS) for the treatment of refractory, nonobstructive urinary retention.
A retrospective study of all patients who underwent SNS with the InterStim device for refractory, nonobstructive urinary retention was performed. All patients had their history taken, underwent physical examination and urodynamic study, and completed a voiding diary before treatment with staged SNS. Patients with greater than 50% improvement in symptoms underwent implantable program device placement. Patients were followed up for evidence of postoperative complications, device failure, and treatment efficacy. Statistical analyses were performed.
From June 1, 2000 to February 1, 2007, 40 patients were treated with SNS for refractory, nonobstructive urinary retention. Of the 40 patients, 29 had complete urinary retention (using clean intermittent catheterization), and 11 demonstrated incomplete retention (elevated postvoid residual urine volume). Of the 40 patients, 28 (70%) demonstrated greater than 50% improvement in symptoms and underwent implantable program device placement. At a mean follow-up of 40.03 +/- 19.61 months, 24 (85.7%) of 28 patients demonstrated sustained improvement of greater than 50%. Of the 28 patients, 4 (14.3%) had their InterStim device removed and 6 (21.4%) required revision. Among those with complete retention, significant improvement occurred in the number of catheterizations/day and the volume/catheterization (P <0.001). Among those with incomplete retention, significant improvement occurred in the postvoid residual urine volume (P <0.001).
At a mean follow-up of 40 months, 85.7% of patients with refractory, nonobstructive urinary retention demonstrated greater than 50% improvement in symptoms with SNS. For 911 patients, a statistically significant improvement in voiding parameters resulted.
探讨骶神经刺激（SNS）治疗难治性、非梗阻性尿潴留的长期疗效和持久性。
对所有使用InterStim装置接受SNS治疗难治性、非梗阻性尿潴留的患者进行回顾性研究。所有患者在接受分期SNS治疗前均进行了病史采集、体格检查和尿动力学研究，并完成了排尿日记。症状改善超过50%的患者接受了植入式程控装置置入。对患者进行随访，观察术后并发症、装置故障和治疗效果。进行了统计学分析。
2000年6月1日至2007年2月1日，40例患者接受SNS治疗难治性、非梗阻性尿潴留。40例患者中，29例有完全性尿潴留（采用清洁间歇性导尿），11例表现为不完全性尿潴留（排尿后残余尿量升高）。40例患者中，28例（70%）症状改善超过50%，并接受了植入式程控装置置入。平均随访40.03±19.61个月时，28例患者中有24例（85.7%）症状持续改善超过50%。28例患者中，4例（14.3%）移除了InterStim装置，6例（21.4%）需要进行翻修。在完全性尿潴留患者中，每日导尿次数和每次导尿量有显著改善（P<0.001）。在不完全性尿潴留患者中，排尿后残余尿量有显著改善（P<0.001）。
平均随访40个月时，85.7%的难治性、非梗阻性尿潴留患者经SNS治疗后症状改善超过50%。对于911例患者，排尿参数有统计学意义的改善。
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