Department of Urology, Beijing Hospital, National Center of Gerontology, Beijing, China.
Department of Urology, China Rehabilitation Research Centre, Rehabilitation School of Capital Medical University, Beijing, China.
Neuromodulation. 2020 Dec;23(8):1189-1195. doi: 10.1111/ner.13130. Epub 2020 Mar 20.
This study aimed to evaluate whether patients stratified by age have the same level of benefits after a sacral neuromodulation (SNM) procedure for refractory lower urinary tract dysfunction.
This retrospective study comprised 211 patients with refractory lower urinary tract dysfunction who had been treated with SNM and recruited from multiple medical centers across China. Patients were grouped according to age: <40 (n = 58), 40-64 (n = 94), and > 64 (n = 59) years. Data were compared using voiding diaries and subjective scores pre-operatively, post-implantation of a stage I tined lead, and during a short-term follow-up period postimplantation of a stage II implanted pulse generator.
In all groups, voiding diary data and subjective scores improved significantly over different periods. Residual urine improved in the 40-64 and > 64-year-old age groups. Quality of life scores improved in the <40-year-old age group. Voiding diary data among age groups varied at baseline; however, average urinary frequency did not differ at the last follow-up. Urgency and sexual life scores differed at baseline and these differences had resolved at the last follow-up. O'Leary-Sant and Pelvic Pain and Urgency/Frequency Symptoms Scale scores did not differ at baseline; however, significant differences were observed at the last follow-up.
SNM success is unrelated to age, and age alone should not be considered a limiting factor in SNM. For older patients, an overactive bladder appears a better indication for SNM treatment; however, further studies are required to confirm this finding.
本研究旨在评估接受骶神经调节（SNM）治疗难治性下尿路功能障碍的患者，按年龄分层后是否具有相同的获益水平。
本回顾性研究纳入了来自中国多家医疗中心的 211 例难治性下尿路功能障碍患者，这些患者均接受了 SNM 治疗。患者按年龄分组：<40 岁（n=58）、40-64 岁（n=94）和>64 岁（n=59）岁。使用排尿日记和术前、一期经皮刺激器植入后和植入脉冲发生器短期随访后的主观评分进行数据比较。
所有组别的排尿日记数据和主观评分在不同时间段均有显著改善。40-64 岁和>64 岁年龄组的残余尿量改善。<40 岁年龄组的生活质量评分改善。各组基线时排尿日记数据存在差异，但最后一次随访时平均排尿频率无差异。基线时尿急和性生活评分存在差异，最后一次随访时这些差异已解决。O'Leary-Sant 和骨盆疼痛与急迫/尿频症状量表评分在基线时无差异，但最后一次随访时存在显著差异。
SNM 的疗效与年龄无关，年龄本身不应成为 SNM 的限制因素。对于老年患者，膀胱过度活动症似乎是 SNM 治疗的更好适应证；然而，需要进一步的研究来证实这一发现。
