Oakland University William Beaumont School of Medicine, Rochester, Michigan, USA.
Neurourol Urodyn. 2013 Jan;32(1):30-6. doi: 10.1002/nau.22268. Epub 2012 Jun 5.
We evaluated whether patients stratified by age have the same level of risks/benefits after a staged neuromodulation procedure for refractory voiding symptoms.
Urologic diagnosis, complications, and revisions were collected from medical records of adults enrolled in our prospective observational study. Symptoms were assessed over 2 years with diaries, Interstitial Symptom-Problem Indices (ICSI-PI), and the Overactive Bladder Questionnaire-SF (OAB-q SF). 12-item Short-Form Health Survey (SF-12v2®) mental (MCS) and physical (PCS) component summaries evaluated quality of life. Data were examined with Pearson Chi-square or Fisher's Exact test, Kruskal-Wallis tests, and repeated measures analyses.
Patients (83% female) were grouped by age (years): <40 (n = 46), 40-64 (n = 146), and ≥65 (n = 136). Urge incontinence was predominant in the older groups and more patients <40 had interstitial cystitis/painful bladder syndrome (IC/PBS). In the <40, 40-64, and ≥65 groups, respectively, generator implant (91%, 88%, and 89%) and explant (15%, 12%, and 10%) rates were similar. Complications (24%, 14%, and 9%; P = 0.031) and revisions (20%, 5%, and 6%; P = 0.0025) differed. For the three respective groups, urinary frequency (P < 0.0001 for all), nocturia (P < 0.0001 for all), incontinence episodes (P < 0.0001 for all), urgency (P = 0.0474, P < 0.0001, P = 0.0020), ICSI-PI (P = 0.0015, P < 0.0001, P < 0.0001), and OAB-q scores improved over time. Incontinence severity improved in those >65 (P = 0.0015). SF-12 PCS improved in those 40-64 (P = 0.0482) and MCS scores improved in the <40 and 40-64 age groups (P = 0.013 and P = 0.0440, respectively).
These data suggest that neuromodulation success is not age dependent, however continued study is needed to confirm findings.
我们评估了接受分期神经调节治疗难治性排尿症状的患者，其年龄分层后是否具有相同的风险/获益水平。
我们从参加前瞻性观察研究的成年人的病历中收集了泌尿科诊断、并发症和修订情况。通过日记、国际下尿路症状问卷（ICSI-PI）和膀胱过度活动症问卷-SF（OAB-q SF）在 2 年内评估症状。12 项简明健康调查问卷（SF-12v2®）心理（MCS）和生理（PCS）综合评分评估生活质量。使用 Pearson 卡方检验或 Fisher 确切概率检验、Kruskal-Wallis 检验和重复测量分析来检查数据。
患者（83%为女性）按年龄（岁）分组：<40（n=46）、40-64（n=146）和≥65（n=136）。急迫性尿失禁在年龄较大的组中更为常见，<40 岁的患者中更有间质性膀胱炎/疼痛性膀胱综合征（IC/PBS）。在<40、40-64 和≥65 组中，分别有 91%、88%和 89%的患者进行了发生器植入，分别有 15%、12%和 10%的患者进行了发生器取出。并发症（24%、14%和 9%；P=0.031）和修订（20%、5%和 6%；P=0.0025）不同。对于这三个相应的组，尿频率（所有 P<0.0001）、夜尿（所有 P<0.0001）、失禁发作（所有 P<0.0001）、尿急（P=0.0474，P<0.0001，P=0.0020）、ICSI-PI（P=0.0015，P<0.0001，P<0.0001）和 OAB-q 评分随时间改善。在年龄>65 岁的患者中，失禁严重程度改善（P=0.0015）。40-64 岁患者的 SF-12 PCS 改善（P=0.0482），<40 岁和 40-64 岁年龄组的 MCS 评分改善（P=0.013 和 P=0.0440）。
这些数据表明，神经调节的成功与年龄无关，但需要进一步研究来证实这些发现。
