Department of Acupuncture and Moxibustion, The First Affiliated Hospital of Zhejiang Chinese Medical University, Hangzhou, China.
Clinical Research Section, Shanghai Research Institute of Acupuncture and Meridian, Shanghai, China.
BMC Urol. 2021 Mar 10;21(1):37. doi: 10.1186/s12894-021-00808-5.
Sacral neuromodulation (SNM) has become an effective therapy for patients with lower urinary tract dysfunction (LUTD) who do not respond to conservative treatment. However, an effective treatment strategy for patients who fail SNM has not yet been identified. An option for LUTD is needed when the clinical response to the SNM diminishes.
A 51-year-old Chinese man presented to an outpatient clinic complaining of difficulty in urination for > 3 years. The patient also complained of urinary frequency and urgency, accompanied by perineal discomfort. He was diagnosed with LUTD based on his symptoms and previous examinations. The patient underwent sacral neuromodulation with a permanent implantable pulse generator (IPG) (provided free of charge by Chengnuo Medical Technology Co., Ltd.; General Stim, Hangzhou, China) in the left buttock, as he participated in the company's clinical trial to test the long-term effects of IPG. He reported loss of efficacy of the device 3 months after the implantation. We performed bilateral electrical pudendal nerve stimulation (EPNS) therapy for him. After 2 weeks of treatment, he began to report smooth voiding within 2 h after EPNS, and a moderate improvement in urinary frequency, urgency, and perineal discomfort. After 4 weeks of EPNS, the patient reported > 50% improvement in his urination, evaluated with the short form of the International Consultation on Incontinence Questionnaire for Male Lower Urinary Tract Symptoms. He reported smooth voiding, moderate improvements in urinary frequency and urgency, and the disappearance of the perineal discomfort. He also reported improved sleep and erections. The patient was discharged after 8 weeks of EPNS treatment.
EPNS could be an option as an additional therapy for patients with LUTD who have failed SNM.
骶神经调节（SNM）已成为治疗对保守治疗无反应的下尿路功能障碍（LUTD）患者的有效方法。然而，对于 SNM 失败的患者，尚未确定有效的治疗策略。当 SNM 的临床反应减弱时，LUTD 需要一种选择。
一名 51 岁的中国男性因排尿困难>3 年就诊于门诊。患者还伴有尿频和尿急，伴有会阴部不适。根据症状和既往检查，患者被诊断为 LUTD。患者在左侧臀部接受了骶神经调节，使用了永久性可植入脉冲发生器（IPG）（由诚诺医疗科技有限公司免费提供；杭州，中国，通用刺激），因为他参加了该公司的临床试验，以测试 IPG 的长期效果。他报告称植入后 3 个月设备失效。我们为他进行了双侧阴部神经电刺激（EPNS）治疗。治疗 2 周后，他开始报告 EPNS 后 2 小时内排尿顺畅，尿频、尿急和会阴部不适有中度改善。EPNS 治疗 4 周后，患者报告称排尿>50%改善，用男性下尿路症状国际咨询尿失禁问卷短表进行评估。他报告说排尿顺畅，尿频和尿急有中度改善，会阴部不适消失。他还报告说睡眠和勃起改善。患者在 EPNS 治疗 8 周后出院。
EPNS 可以作为 SNM 失败的 LUTD 患者的附加治疗选择。
