Parnell Brent A, Howard James F, Geller Elizabeth J
Division of Female Pelvic Medicine and Reconstructive Surgery, Department of Obstetrics and Gynecology, University of North Carolina-Chapel Hill, Chapel Hill, North Carolina.
Department of Neurology, University of North Carolina-Chapel Hill, Chapel Hill, North Carolina.
Neurourol Urodyn. 2015 Jun;34(5):456-60. doi: 10.1002/nau.22579. Epub 2014 Feb 24.
To quantify changes in pudendal nerve function with sacral neuromodulation (SNM). To understand the relationship of pudendal nerve function to SNM treatment response for overactive bladder. To assess the relationship between female sexual function and pudendal nerve function after SNM.
Women undergoing SNM between January 2010 and May 2011 were enrolled. Baseline pudendal nerve terminal motor latencies (PNTML) were measured bilaterally. Subjects underwent peripheral nerve evaluation (PNE) prior to SNM therapy. PNTML was measured at 1 and 6 weeks after sacral neuromodulator implant. Women who did not undergo permanent implantation were reassessed at the end of the 1-week PNE testing phase. Pelvic floor and sexual function questionnaires were administered at baseline and follow-up to assess pelvic floor and sexual function.
Of 34 women enrolled, 31 were evaluated. Mean age was 67.4 ± 14.2 years with 29/34 (85.3%) treated for refractory overactive bladder. Thirty of 31 (96.7%) went on to a permanent implant. PNE success rate was 73.5% (25/33). Mean PNTML changed from 2.74 ± 0.52 msec at baseline to 2.57 ± 0.50 msec at 6 weeks postop (P = 0.198). Baseline amplitude remained stable at 1 and 6 weeks. At 6 weeks PISQ-12 scores showed improved sexual function (P = 0.034) and PFDI-20 and PFIQ-7 scores showed improved pelvic floor, colorectal and urinary symptoms (P < 0.05).
Women with refractory overactive bladder and non-obstructive urinary retention have abnormal pudendal nerve function, which showed a non-significant trend toward improvement after SNM. Sexually active women undergoing sacral neuromodulation experienced improvement in sexual function. Quality of life improved due to improvement in urinary and colorectal function.
量化骶神经调节（SNM）对阴部神经功能的改变。了解阴部神经功能与SNM治疗膀胱过度活动症反应之间的关系。评估SNM后女性性功能与阴部神经功能之间的关系。
纳入2010年1月至2011年5月期间接受SNM的女性。双侧测量基线阴部神经终末运动潜伏期（PNTML）。受试者在SNM治疗前接受周围神经评估（PNE）。在植入骶神经调节器后1周和6周测量PNTML。未进行永久植入的女性在1周PNE测试阶段结束时重新评估。在基线和随访时进行盆底和性功能问卷调查，以评估盆底和性功能。
纳入的34名女性中，31名接受了评估。平均年龄为67.4±14.2岁，其中29/34（85.3%）因难治性膀胱过度活动症接受治疗。31名中的30名（96.7%）继续进行永久植入。PNE成功率为73.5%（25/33）。平均PNTML从基线时的2.74±0.52毫秒变为术后6周时的2.57±0.50毫秒（P = 0.198）。基线振幅在1周和6周时保持稳定。在6周时，PISQ - 12评分显示性功能改善（P = 0.034），PFDI - 20和PFIQ - 7评分显示盆底、结肠和泌尿系统症状改善（P < 0.05）。
患有难治性膀胱过度活动症和非梗阻性尿潴留的女性存在阴部神经功能异常，SNM后有改善但未达显著水平。接受骶神经调节的性活跃女性性功能得到改善。由于泌尿系统和结肠功能的改善，生活质量提高。
