根据适应症分层的骶神经调节治疗难治性特发性逼尿肌过度活动的结果：抗胆碱能药物疗效缺乏与不耐受情况对比
Sacral neuromodulation outcomes for the treatment of refractory idiopathic detrusor overactivity stratified by indication: Lack of anticholinergic efficacy versus intolerability.
作者信息
Davis Tanya, Makovey Iryna, Guralnick Michael L, O'Connor R Corey
机构信息
Department of Urology, Medical College of Wisconsin, Milwaukee, Wisconsin.
出版信息
Can Urol Assoc J. 2013 May-Jun;7(5-6):176-8. doi: 10.5489/cuaj.11251.
INTRODUCTION
Patients may fail oral overactive bladder therapies due to either poor drug efficacy or intolerability. We determined if the success of sacral neuromodulation varies if performed secondary to lack of anticholinergic efficacy versus drug intolerability.
METHODS
A retrospective review was performed on 152 patients undergoing staged sacral neuromodulation from 2004 to 2010 for refractory idiopathic detrusor overactivity with or without urge incontinence. Outcomes following sacral neuromodulation trials were compared based on the primary indication for anticholinergic failure: lack of drug efficacy versus intolerable side effects.
RESULTS
Overall, successful sacral neuromodulation trials were reported in 70% (106/152) of patients. Successful outcomes were noted in 70% (89/128) and 71% (17/24) of patients with poor anti-cholinergic efficacy and drug intolerability, respectively (p = NS).
CONCLUSIONS
We found no significant difference in outcome success in patients undergoing sacral neuromodulation trials for refractory detrusor overactivity due to lack of anticholinergic efficacy versus intolerability.
引言
患者可能因药物疗效不佳或不耐受而导致口服膀胱过度活动症治疗失败。我们确定了在因抗胆碱能药物疗效不佳与药物不耐受而进行骶神经调节时，其成功率是否存在差异。
方法
对2004年至2010年间因难治性特发性逼尿肌过度活动症（伴或不伴有急迫性尿失禁）而接受分期骶神经调节的152例患者进行回顾性研究。根据抗胆碱能药物治疗失败的主要原因（药物疗效不佳与难以耐受的副作用），比较骶神经调节试验后的结果。
结果
总体而言，70%（106/152）的患者骶神经调节试验成功。抗胆碱能药物疗效不佳和药物不耐受的患者中，成功结果分别为70%（89/128）和71%（17/24）（p=无显著性差异）。
结论
我们发现，因抗胆碱能药物疗效不佳与不耐受而接受骶神经调节试验治疗难治性逼尿肌过度活动症的患者，其治疗成功率无显著差异。
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