Department of Urology, China Rehabilitation Research Centre, School of Rehabilitation, Capital Medical University, Beijing, China.
Department of Urology, The Second Affiliated Hospital of Xi'an Jiaotong University, Xi'an, Shaanxi, China.
Neuromodulation. 2021 Oct;24(7):1278-1283. doi: 10.1111/ner.13383. Epub 2021 Apr 28.
This retrospective study aimed to determine the effectiveness of sacral neuromodulation (SNM) on neurogenic lower urinary tract dysfunction (NLUTD) and analyze the predictive factors.
From January 2012 to January 2020, 152 subjects with NLUTD from four medical centers in China received SNM test stimulation. Subjects were assessed via bladder diaries, postvoid residual volumes (PRVs) and neurogenic bowel dysfunction (NBD) scores before and during the testing period. Patients who showed a minimum 50% improvement in symptoms through the SNM test phase were eligible for permanent SNM implantation.
The pooled success rate for chronic urinary retention was 31.0% (40/129), which was significantly lower (p < 0.05) than the rates for frequency-urgency (64.8%, 59/91), urinary incontinence (65.2%, 30/46), and NBD score (61.7%, 82/133). The results of the risk factor analysis showed that the urinary storage symptom was a statistically significant positive predictor (p = 0.001).
In conclusion, SNM is an effective and reliable method for treating NLUTD, especially in patients with urinary storage symptoms. Although not all of the symptoms in every patient can be resolve, SNM still might be a superior choice together with other treatment procedures.
本回顾性研究旨在确定骶神经调节(SNM)对神经源性下尿路功能障碍(NLUTD)的疗效,并分析其预测因素。
2012 年 1 月至 2020 年 1 月,来自中国四家医学中心的 152 名 NLUTD 患者接受了 SNM 测试刺激。在测试期间,通过膀胱日记、残余尿量(PRV)和神经源性肠功能障碍(NBD)评分对受试者进行评估。在 SNM 测试阶段症状至少改善 50%的患者有资格接受永久性 SNM 植入。
慢性尿潴留的总体成功率为 31.0%(40/129),显著低于(p<0.05)频率-急迫性(64.8%,59/91)、尿失禁(65.2%,30/46)和 NBD 评分(61.7%,82/133)。风险因素分析结果显示,储尿症状是一个具有统计学意义的阳性预测因素(p=0.001)。
总之,SNM 是治疗 NLUTD 的一种有效且可靠的方法,特别是对储尿症状的患者。尽管并非所有患者的所有症状都能得到缓解,但 SNM 仍然可能是一种优于其他治疗方法的选择。