Ghazi Abdullah Ahmed, Abuzgaya Malak, Banakhar Mai, Hassouna Magdy
Department of Urology, Toronto Western Hospital, University of Toronto, Toronto, Canada.
Department of Urology, King Abdulaziz University, Faculty of Medicine, Jeddah, Saudi Arabia.
Turk J Urol. 2018 Jan;44(1):70-74. doi: 10.5152/tud.2017.81592. Epub 2017 Dec 19.
The aim of the current research project was to study the role of the Neurometer as a tool to predict responders to sacral neuromodulation therapy (SNM).
This was a prospective, open study in male and female patients, aged 18 and over with voiding dysfunction [non-obstructive retention and/or frequency/ urgency syndrome]. The first group underwent a screening test to evaluate percutaneous nerve functions (PNE) and to determine whether they are candidates for SNM with the InterStim. Prior to PNE testing, all patients were evaluated with the pain tolerance test (PTT) using the electro-diagnostic Neurometer CPT/C device. An InterStim implant was placed in patients who were responders to PNE testing underwent. On the other hand, non-responders underwent a staged implant placement. The second group consisted of patients who already had InterStim implanted for voiding dysfunction. During the routine office follow-up, the patients implanted with Interstim underwent a PTT using the Neurometer CPT/C device. All the testing using the Neurometer CPT/C was performed on the day of the PNE for the first group, and the day of the routine follow-up visit for the second group. All of the results for the Neurometer testing were kept blinded from the PNE results, and those of the outcome of the follow-up visit. The study received approval by the Research Ethics Board of the University Health Network (No. 14-8196).
We recruited a total of 123 patients. The results presented here include 110 patients who completed the study, 48 of whom were in the first group, and 62 in the second group. The statistical analysis used was as follows: Group 1: Simple linear regression analysis and the linear discriminate analysis were preformed. It was found that for patients without the InterStim implant with a combined CPT/CPD of 800 and above, the Neurometer could predict the test screening results with an accuracy of 71%. Group 2: Same analysis and tests were conducted for patients with the InterStim implant, and the results showed that if the patient had a combined CPT/CPD of 600 and above, the Neurometer could predict the patients satisfaction or dissatisfaction with an accuracy of 72%.
Neurometer may play a role in predicting test trial positive responders and patient satisfaction after the placement of InterStim implant.
当前研究项目的目的是研究神经仪作为预测骶神经调节疗法（SNM）反应者的工具的作用。
这是一项针对18岁及以上患有排尿功能障碍[非梗阻性尿潴留和/或尿频/尿急综合征]的男性和女性患者的前瞻性开放性研究。第一组患者接受了一项筛查测试，以评估经皮神经功能（PNE），并确定他们是否是使用InterStim进行骶神经调节的候选者。在进行PNE测试之前，所有患者均使用电诊断神经仪CPT/C设备进行疼痛耐受测试（PTT）。对PNE测试有反应的患者植入了InterStim。另一方面，无反应者接受了分阶段植入。第二组由已经因排尿功能障碍植入InterStim的患者组成。在常规门诊随访期间，植入InterStim的患者使用神经仪CPT/C设备进行了PTT。第一组在PNE当天，第二组在常规随访当天使用神经仪CPT/C进行了所有测试。神经仪测试的所有结果对PNE结果以及随访结果均保持盲态。该研究获得了大学健康网络研究伦理委员会的批准（编号14 - 8196）。
我们共招募了123名患者。此处呈现的结果包括110名完成研究的患者，其中第一组48名，第二组62名。所使用的统计分析如下：第一组：进行了简单线性回归分析和线性判别分析。发现对于未植入InterStim且CPT/CPD总和为800及以上的患者，神经仪能够以71%的准确率预测测试筛查结果。第二组：对植入InterStim的患者进行了相同的分析和测试，结果表明，如果患者的CPT/CPD总和为600及以上，神经仪能够以72%的准确率预测患者的满意度或不满意度。
神经仪可能在预测测试试验阳性反应者以及InterStim植入后的患者满意度方面发挥作用。
