Division of Urogynecology and Reconstructive Pelvic Surgery, University of Alabama at Birmingham, Birmingham, AL, USA.
Neurourol Urodyn. 2013 Jun;32(5):476-9. doi: 10.1002/nau.22319. Epub 2012 Nov 20.
To characterize the effect of sacral neuromodulation (SNM) on urethral neuromuscular function.
Following IRB approval, women with refractory overactive bladder (OAB) underwent standardized urethral testing prior to and after Stage 1 SNM implantation. Periurethral sensation was measured using current perception thresholds (CPT). Striated urethral sphincter activity was quantified using concentric needle electromyography (CNE) and Multi-Motor Unit Action Potential (MUP) analysis software. Nonparametric analyses were used to characterize pre/post changes with intervention. Baseline CPT and CNE findings were compared between SNM responders and non-responders.
Twenty-seven women were enrolled in this pilot study with a mean age of 61 ± 13 years. Twenty of 26 women (76.9%) responded to SNM and went to Stage 2 permanent implantation. Four (14.8%) withdrew after Stage 1 implantation; three of the four withdrawals had not had therapeutic responses to SNM. CPT and CNE parameters did not significantly differ from baseline 2 weeks after SNM. Pre-SNM urethral sensation was not significantly different between responders and non-responders. However, responders had larger amplitude, longer duration and more turns and phases at baseline approaching significance, reflecting more successful urethral reinnervation, than non-responders.
SNM does not alter urethral neuromuscular function 2 weeks post Stage 1 implantation.
描述骶神经调节（SNM）对尿道神经肌肉功能的影响。
在获得机构审查委员会（IRB）批准后，对患有难治性膀胱过度活动症（OAB）的女性在接受 1 期 SNM 植入术前和术后进行标准化的尿道测试。使用电流感知阈值（CPT）测量尿道周围感觉。使用同心针肌电图（CNE）和多运动单位动作电位（MUP）分析软件量化横纹尿道括约肌活动。使用非参数分析来描述干预前后的变化。SNM 应答者和无应答者之间比较基线 CPT 和 CNE 发现。
本初步研究共纳入 27 名平均年龄为 61±13 岁的女性。26 名女性中有 20 名（76.9%）对 SNM 有反应并进行了第 2 阶段永久性植入。4 名（14.8%）在 1 期植入后退出；其中 3 名退出者对 SNM 没有治疗反应。SNM 后 2 周 CPT 和 CNE 参数与基线相比没有显著差异。SNM 应答者和无应答者的术前尿道感觉没有显著差异。然而，与无应答者相比，应答者在基线时具有更大的振幅、更长的持续时间和更多的转弯和相位，接近显著水平，反映了更成功的尿道再神经支配。
第 1 阶段植入后 2 周，SNM 不会改变尿道神经肌肉功能。
