使用长效可充电骶神经调节系统治疗膀胱过度活动症的两年安全性和疗效结果。

Two-year safety and efficacy outcomes for the treatment of overactive bladder using a long-lived rechargeable sacral neuromodulation system.

机构信息

Department of Urology, Erasmus MC, Rotterdam, The Netherlands.

Department of Urology, Maastricht University Medical Centre, Maastricht, The Netherlands.

出版信息

Neurourol Urodyn. 2020 Apr;39(4):1108-1114. doi: 10.1002/nau.24317. Epub 2020 Apr 3.

Abstract

AIMS

Sacral neuromodulation (SNM) therapy for overactive bladder (OAB) has proven long-term safety and efficacy. Historically, the only commercially available SNM device was nonrechargeable requiring replacement surgery due to battery depletion. The Axonics System is the first rechargeable SNM device and is qualified to last a minimum of 15 years in the body. The study objective was to evaluate the safety and efficacy of this rechargeable SNM system. This study reports 2-year outcomes.

METHODS

A total of 51 subjects were implanted with the Axonics System in a single nonstaged procedure. Subjects had OAB, confirmed on a 3-day voiding diary (≥8 voids/day and/or ≥2 incontinence episodes over 72 hours). Test Responders were defined as subjects that were responders at 1 month postimplant. The efficacy analysis included therapy responder rates, change in the quality of life, and subject satisfaction reported in Test Responders (n = 30) and all implanted subjects (n = 37) that completed the follow-up visits. Adverse events (AEs) are reported in all implanted subjects.

RESULTS

At 2 years, 90% of the Test Responders continued to respond to the therapy based on voiding diary criteria. Satisfaction with therapy was reported by 93% of subjects and 86% found their charging experience acceptable. Of the urinary incontinence Test Responders, 88% continued to be responders at 2 years, and 28% were completely dry. There were no unanticipated (AEs) or serious device-related AEs.

CONCLUSIONS

The Axonics System® provides sustained clinically meaningful improvements in OAB subjects at 2 years. There were no serious device-related AEs. Subjects reported continued satisfaction with their therapy.

摘要

目的

骶神经调节(SNM)疗法治疗膀胱过度活动症(OAB)已被证实具有长期安全性和有效性。从历史上看,唯一可商用的 SNM 设备为不可充电,由于电池耗尽需要进行更换手术。Axonics 系统是第一个可充电的 SNM 设备,其资格可保证在体内至少使用 15 年。本研究的目的是评估这种可充电 SNM 系统的安全性和有效性。本研究报告了 2 年的结果。

方法

共有 51 名受试者接受了 Axonics 系统的单次非分期植入手术。受试者患有 OAB,通过 3 天排尿日记(每天≥8 次排尿和/或 72 小时内≥2 次尿失禁发作)得到确认。测试应答者被定义为在植入后 1 个月时为应答者的受试者。疗效分析包括应答者的治疗应答率、生活质量的变化以及报告在测试应答者(n=30)和完成随访的所有植入受试者(n=37)中的满意度。报告了所有植入受试者的不良事件(AE)。

结果

在 2 年时,根据排尿日记标准,90%的测试应答者继续对治疗有反应。93%的受试者对治疗表示满意,86%的受试者认为充电体验可接受。在尿失禁测试应答者中,88%的人在 2 年内继续有应答,28%的人完全没有尿失禁。没有意外的(AE)或严重的与设备相关的 AE。

结论

Axonics 系统®在 2 年内为 OAB 受试者提供持续的具有临床意义的改善。没有与设备相关的严重 AE。受试者报告对其治疗持续满意。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/bcf6/7217215/238686bd71ba/NAU-39-1108-g001.jpg

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