Mehmood Shahbaz, Altaweel Waleed Mohammad
King Faisal Specialist Hospital and Research Center, Riyadh, Kingdom of Saudi Arabia.
Department of Urology, King Faisal Specialist Hospital and Research Centre, Riyadh, Kingdom of Saudi Arabia.
Urol Ann. 2017 Jul-Sep;9(3):244-248. doi: 10.4103/UA.UA_165_16.
The objective of this study was to determine the safety and efficacy of sacral neuromodulation (SNM) in patients with idiopathic nonobstructive urinary retention.
We retrospectively reviewed the files of patients who underwent staged neuromodulation for idiopathic nonobstructive urinary retention from 2004 to 2016 at our hospital. Patients who had a 50% improvement in symptoms after 1 week of stage 1 procedure were qualified for permanent device implantation. Patient data were assessed on efficacy and need for intermittent self-catheterization, complications, and operative revision rates.
Twenty-seven female patients who underwent SNM therapy were analyzed. The mean age of the patients was 32.5 ± 10.8 years. The mean duration of urinary retention was 3.2 ± 1.7 years. All patients were doing intermittent self-catheterization, but few were able to void <100 ml. Twenty-four (88.8%) of the 27 patients demonstrated a >50% improvement in symptoms and underwent permanent device placement. At a median follow-up of 5.7 ± 3.2 years, 20 (83.3%) of the 24 patients demonstrated sustained improvement rates of >50%. Seventeen (70.83%) of 24 patients could void spontaneously with a mean residual urine of 28.1 ± 24.4 ml ( < 0.001). Three (12.5%) were voiding with significant mean decreasing number of catheterizations from 5.6 ± 2.4 to 1.4 ± 2.1 ( < 0.001). Four (16.6%) had their device explanted. Ten (41.6%) of the 24 patients underwent surgical revision. Most of the adverse events were managed by device reprograming.
SNM is a highly effective and safe procedure in this subset of the female population with idiopathic refractory nonobstructive urinary retention.
本研究的目的是确定骶神经调节（SNM）治疗特发性非梗阻性尿潴留患者的安全性和有效性。
我们回顾性分析了2004年至2016年在我院因特发性非梗阻性尿潴留接受分期神经调节治疗的患者病历。在第1阶段治疗1周后症状改善50%的患者有资格植入永久性装置。评估患者数据的疗效、间歇性自我导尿的需求、并发症及手术翻修率。
分析了27例接受SNM治疗的女性患者。患者的平均年龄为32.5±10.8岁。尿潴留的平均持续时间为3.2±1.7年。所有患者均进行间歇性自我导尿，但很少有人能排出<100ml尿液。27例患者中有24例（88.8%）症状改善>50%并接受了永久性装置植入。在中位随访5.7±3.2年时，24例患者中有20例（83.3%）症状持续改善率>50%。24例患者中有17例（70.83%）能够自主排尿，平均残余尿量为28.1±24.4ml（<0.001）。3例（12.5%）排尿时导尿次数显著减少，从平均5.6±2.4次降至1.4±2.1次（<0.001）。4例（16.6%）患者的装置被取出。24例患者中有10例（41.6%）接受了手术翻修。大多数不良事件通过装置重新编程进行处理。
对于患有特发性难治性非梗阻性尿潴留的女性患者，SNM是一种高效且安全的治疗方法。
