Department of Urology, Radboud University, Nijmegen Medical Centre, Geert Grooteplein Zuid, Nijmegen, The Netherlands.
Neurourol Urodyn. 2013 Jun;32(5):472-5. doi: 10.1002/nau.22322. Epub 2012 Oct 15.
Electrical stimulation of the posterior tibial nerve (PTN) is an established therapy for the treatment of refractory overactive bladder syndrome (OAB). The Urgent-SQ™ is an implant that is surgically placed near the PTN and activated by an external pulse generator, allowing for "on demand" PTN stimulation, without the need for needle insertion. The current study presents results of a 9-year, open-label, follow-up of eight patients to address the long term safety and efficacy of the implant.
In 2003, eight patients with refractory OAB received a Urgent-SQ™ implant and were systematically followed up for 1 year. After that, the follow up continued as open-label study. The seven patients who still had the implant were contacted after 9 years and evaluated with an interview, physical exam, ankle X-ray, voiding diaries, and completed questionnaires about adverse events, performance, efficacy, safety, and quality of life (validated iQoL).
Six of the seven patients still had sensory and loco-motor responses on stimulation at 9-year follow-up. Three of four patients who had a successful treatment response at 1 year, still use the device. The fourth patient restarted therapy. The implants are intact with no migration and/or displacement. All patients reported easy handling of the Urgent-SQ™. One patient reported sporadic spontaneous sensory responses. One patient reported occasional localized ankle discomfort.
After 9 years of clinical experience, we demonstrated that implant driven PTNS with the Urgent-SQ™ is a safe therapy for OAB. The implant has a long lifespan and is well tolerated by patients.
胫后神经电刺激(PTN)是治疗难治性过度活跃膀胱综合征(OAB)的一种既定疗法。Urgent-SQ™是一种植入物,通过外部脉冲发生器激活,放置在 PTN 附近,允许“按需”进行 PTN 刺激,无需插入针头。本研究介绍了对 8 名患者进行的 9 年开放性、随访研究的结果,以解决植入物的长期安全性和疗效问题。
2003 年,8 名难治性 OAB 患者接受了 Urgent-SQ™植入物治疗,并接受了为期 1 年的系统随访。此后,继续作为开放性研究进行随访。9 年后,联系了仍保留植入物的 7 名患者,并通过访谈、体格检查、踝 X 光、排尿日记以及有关不良事件、性能、疗效、安全性和生活质量(经 iQoL 验证)的完整问卷进行评估。
7 名患者中有 6 名在 9 年随访时仍有刺激的感觉和运动反应。4 名在 1 年时治疗反应成功的患者中有 3 名仍在使用该设备。第 4 名患者重新开始治疗。植入物完整,无迁移和/或移位。所有患者报告说 Urgent-SQ™易于操作。1 名患者报告间歇性自发性感觉反应。1 名患者报告偶尔出现局部踝关节不适。
经过 9 年的临床经验,我们证明了 Urgent-SQ™驱动的 PTNS 植入物是治疗 OAB 的一种安全疗法。该植入物具有较长的使用寿命,并且患者耐受性良好。