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骶神经调节改善难治性急迫性尿失禁患者的肠道功能障碍

Improvement of bowel dysfunction with sacral neuromodulation for refractory urge urinary incontinence.

作者信息

Gill Bradley C, Swartz Mia A, Rackley Raymond R, Moore Courtenay K, Goldman Howard B, Vasavada Sandip P

机构信息

Cleveland Clinic Lerner College of Medicine, Case Western Reserve University, Cleveland, OH, USA.

出版信息

Int Urogynecol J. 2012 Jun;23(6):735-41. doi: 10.1007/s00192-011-1553-6. Epub 2011 Sep 9.

Abstract

INTRODUCTION AND HYPOTHESIS

Sacral nerve stimulation (SNS) is approved for urologic indications in the USA and, recently, fecal incontinence. This study described concomitant bowel dysfunction and improvements in bowel and urinary symptoms and quality of life (QOL) in women with refractory urge urinary incontinence (UUI) receiving SNS.

METHODS

Women (N = 36) with refractory UUI receiving SNS were prospectively enrolled. Surveys and exams were completed at baseline and follow-up, with symptom and QOL scores measured using validated scales (0-100, none-worst).

RESULTS

A total 24 women were followed up at a median of 4.0 months post-implantation. Of these, 20 (83%) had bowel dysfunction, 13 (54%) used bowel medications at baseline, and 11 (45%) continued them after SNS. The mean/median urinary (54.8 to 32.6) and bowel (23.4 to 14.1) symptom scores improved significantly, as did urinary (64.2 to 14.3) but not bowel (2.4 to 0.0) QOL scores.

CONCLUSIONS

Bowel dysfunction is common in women with refractory UUI. SNS improves urinary symptoms and QOL, but improvement in bowel symptoms does not translate into significant QOL changes.

摘要

引言与假设

骶神经刺激(SNS)在美国已被批准用于泌尿外科适应症,最近也被批准用于治疗大便失禁。本研究描述了接受SNS治疗的难治性急迫性尿失禁(UUI)女性患者伴随的肠道功能障碍以及肠道和泌尿系统症状及生活质量(QOL)的改善情况。

方法

前瞻性纳入了36例接受SNS治疗的难治性UUI女性患者。在基线和随访时完成调查和检查,使用经过验证的量表(0 - 100,无 - 最差)测量症状和生活质量评分。

结果

总共24名女性在植入后中位4.0个月时接受了随访。其中,20例(83%)有肠道功能障碍,13例(54%)在基线时使用肠道药物,11例(45%)在SNS治疗后仍继续使用。泌尿系统(从54.8降至32.6)和肠道(从23.4降至14.1)症状评分显著改善,泌尿系统生活质量评分(从64.2降至14.3)也显著改善,但肠道生活质量评分(从2.4降至0.0)未显著改善。

结论

肠道功能障碍在难治性UUI女性中很常见。SNS可改善泌尿系统症状和生活质量,但肠道症状的改善并未转化为生活质量的显著变化。

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