确定女性下尿路疾病骶神经调节术后的治疗效果、不良事件及成功预测因素。
Determining outcomes, adverse events, and predictors of success after sacral neuromodulation for lower urinary disorders in women.
作者信息
Yazdany Tajnoos, Bhatia Narender, Nguyen John
机构信息
Division of Female Pelvic Medicine and Reconstructive Surgery, David Geffen UCLA School of Medicine, 1000 W. Carson St, Torrance, CA 90509, Box 489, USA.
出版信息
Int Urogynecol J. 2011 Dec;22(12):1549-54. doi: 10.1007/s00192-011-1512-2. Epub 2011 Jul 28.
INTRODUCTION AND HYPOTHESIS
The objective of this study was to determine the predictors of successful treatment of lower urinary tract disorders with sacral nerve stimulation (SNS) and the rate of adverse events and reoperations.
METHODS
A retrospective case series of patients who underwent SNS at a single institution was analyzed.
RESULTS
Seventy-six patients underwent stage I trial of SNS. Fifty-eight (76%) patients experienced improvement and underwent placement of an implantable pulse generator with a mean follow-up of 23.7 months (SD ± 22.3). Surgical revisions occurred in 14/58 (24%) patients and 15/58 (26%) patients had the device explanted after a mean of 2.8 years (SD ± 1.7). Patients with greater than ten incontinence episodes per day were more likely to have a successful stage I trial compared to those with less than five (OR = 10.3; 95% CI 2.1 to 50.60).
CONCLUSIONS
Although SNS is a safe and effective therapy for lower urinary tract disorders, it is associated with a high reoperation rate.
引言与假设
本研究的目的是确定骶神经刺激（SNS）成功治疗下尿路疾病的预测因素以及不良事件和再次手术的发生率。
方法
对在单一机构接受SNS治疗的患者进行回顾性病例系列分析。
结果
76例患者接受了SNS一期试验。58例（76%）患者病情改善并植入了植入式脉冲发生器，平均随访23.7个月（标准差±22.3）。14/58（24%）例患者进行了手术翻修，15/58（26%）例患者在平均2.8年（标准差±1.7）后取出了装置。与每天失禁发作少于5次的患者相比，每天失禁发作超过10次的患者更有可能在一期试验中取得成功（比值比=10.3；95%置信区间2.1至50.60）。
结论
尽管SNS是治疗下尿路疾病的一种安全有效的疗法，但它与较高的再次手术率相关。
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