George Ene, Lane Felicia, Noblett Karen
From the Department of Obstetrics & Gynecology, University of California, Irvine, Orange, CA.
Female Pelvic Med Reconstr Surg. 2011 Mar;17(2):97-9. doi: 10.1097/SPV.0b013e31820e5cf3.
: The objectives of this study were to determine the number of patients implanted with sacral neuromodulation (SNM) for overactive bladder (OAB) who required supplemental or continued anticholinergic (ACH) therapy for improved response and to identify factors predictive of requiring supplemental ACH.
: This is a retrospective chart review of 148 patients who underwent SNM from 1999 to 2007. Patients included were those implanted for urgency, frequency, or urge incontinence. Eighty-eight patients were included in the analysis. A stepwise regression analysis was performed to identify factors predictive for restarting ACH medication.
: All patients underwent SNM implantation for frequency-urgency and urge incontinence. Of all patients, 16 (18%) required supplemental ACH therapy for improved symptom control. Overall, 26 patients (25%) either continued or were started on ACH therapy in addition to SNM for improved outcomes.
: A subset of patients had improved therapeutic response with combined SNM and ACH therapy. The only factor associated with supplemental ACH use was body mass index.
本研究的目的是确定因膀胱过度活动症（OAB）而接受骶神经调节（SNM）治疗的患者中，为改善疗效而需要补充或持续使用抗胆碱能药物（ACH）治疗的患者数量，并确定预测需要补充ACH治疗的因素。
这是一项对1999年至2007年期间接受SNM治疗的148例患者进行的回顾性病历审查。纳入的患者为因尿急、尿频或急迫性尿失禁而接受植入的患者。88例患者纳入分析。进行逐步回归分析以确定预测重新开始使用ACH药物的因素。
所有患者均因尿频-尿急和急迫性尿失禁接受SNM植入。所有患者中，16例（18%）需要补充ACH治疗以改善症状控制。总体而言，26例患者（25%）除SNM外还继续或开始使用ACH治疗以改善疗效。
一部分患者通过SNM和ACH联合治疗获得了更好的治疗反应。与补充使用ACH相关的唯一因素是体重指数。
