University of Toronto, Toronto, Ontario, Canada.
Minnesota Urology, Fridley, Minnesota, USA.
Neurourol Urodyn. 2021 Mar;40(3):920-928. doi: 10.1002/nau.24648. Epub 2021 Mar 1.
The aim of this study is to evaluate the effect of sub-sensory amplitude settings of sacral neuromodulation therapy on overactive bladder symptoms in subjects with urinary urge incontinence.
Subjects who qualified for a neurostimulator device implant were randomized to one of three amplitude settings (50% of sensory threshold [ST], 80% of ST, and ST). Subjects completed urinary voiding diaries (3-day), International consultation on incontinence modular questionnaire-overactive bladder symptoms quality of life questionnaire, and patient global impression of improvement (PGI-I) to assess change in voiding symptoms and quality of life (QoL) from baseline through 12 weeks.
Forty-eight subjects had a successful test stimulation, 46 were implanted with a neurostimulator device and 43 completed the 12-week follow-up visit. The change from baseline to 12 weeks is -3.0 urinary incontinence (UI) episodes/day (95% confidence interval [CI]: -4.4 to -1.7) for the 50% of sensory threshold group, -2.9 UI episodes/day (95% CI: -4.7 to -1.2) for 80% of sensory threshold group, and -3.6 UI episodes/day (95% CI: -5.2 to -1.9) for the sensory threshold group. In each randomized group, improvements were observed in health-related QoL, its subscales, and symptom interference. Subjects across all three randomization groups reported on the PGI-I that their bladder condition was better at 12 weeks compared to before they were treated with InterStim therapy.
These findings provide insights into possible advancements in the postimplantation phase of therapy with potential for improved patient comfort and increased device longevity.
本研究旨在评估骶神经调节治疗的亚感觉幅度设置对伴有尿急的逼尿肌过度活动症状的影响。
符合神经刺激器装置植入条件的受试者被随机分为三组幅度设置(感觉阈值 [ST] 的 50%、80%和 ST)之一。受试者完成排尿日记(3 天)、国际尿失禁咨询委员会-逼尿肌过度活动症状生活质量问卷和患者总体印象改善(PGI-I),以评估从基线到 12 周时排尿症状和生活质量(QoL)的变化。
48 名受试者进行了成功的测试刺激,46 名受试者植入了神经刺激器装置,43 名受试者完成了 12 周的随访。与基线相比,50%感觉阈值组的变化为-3.0 次尿失禁(UI)发作/天(95%置信区间 [CI]:-4.4 至-1.7),80%感觉阈值组为-2.9 UI 发作/天(95% CI:-4.7 至-1.2),感觉阈值组为-3.6 UI 发作/天(95% CI:-5.2 至-1.9)。在每个随机分组中,健康相关 QoL 及其子量表和症状干扰均有改善。所有三组随机分组的受试者均报告称,与接受 InterStim 治疗前相比,他们的膀胱状况在 12 周时更好。
这些发现为治疗后植入阶段的可能进展提供了深入了解,可能提高患者舒适度和增加设备寿命。