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镍钛形状记忆合金全植入式胫骨神经刺激器治疗急迫性尿失禁型膀胱过度活动症的 12 个月耐用性:一项单臂前瞻性研究。

Twelve-month Durability of a Fully-implanted, Nickel-sized and Shaped Tibial Nerve Stimulator for the Treatment of Overactive Bladder Syndrome with Urgency Urinary Incontinence: A Single-Arm, Prospective Study.

机构信息

Tauranga Urology Research Ltd, Tauranga, New Zealand.

Roundhay Medical Centre, Nelson, New Zealand.

出版信息

Urology. 2021 Nov;157:71-78. doi: 10.1016/j.urology.2021.04.039. Epub 2021 May 26.

Abstract

OBJECTIVES

To evaluate the safety and efficacy of the eCoin - a nickel-sized, primary battery-powered, neuromodulation device for the treatment of urgency urinary incontinence which is implanted in the lower leg in a 20-minute procedure under local anesthesia. A feasibility clinical trial was conducted and the results after 1 year of treatment with the eCoin are presented.

METHODS

A total of 46 participants with refractory urgency urinary incontinence were included in this prospective, single-arm, open-label study. This study was conducted at 7 sites in the United States and New Zealand. Participants in this study were implanted with the eCoin in the lower leg over the tibial nerve and activated after 4 weeks. Bladder diary data and validated quality-of-life instruments, collected at 3, 6, and 12 months' post-activation, were compared to baseline values.

RESULTS

Responders were defined as those who had a ≥50% reduction in reported episodes of urgency urinary incontinence. At 12 months', 65% of participants were considered responders with 26% of participants achieving complete continence. The median number of urgency urinary incontinence episodes per day decreased from 4.2 at baseline to 1.7 at 12 months'. Seventy percent of participants reported feeling "better", "much better", or "very much better" on the Likert 7-point maximum scale. One participant experienced a related serious adverse event.

CONCLUSION

The eCoin is a safe and effective treatment for urgency urinary incontinence associated with overactive bladder syndrome, with significant reduction or complete resolution of symptoms and no significant safety concerns.

摘要

目的

评估 eCoin 的安全性和有效性,eCoin 是一种镍大小的、由主电池供电的、用于治疗急迫性尿失禁的神经调节设备,通过局部麻醉在 20 分钟的手术过程中植入小腿。进行了一项可行性临床试验,并呈现了 eCoin 治疗 1 年后的结果。

方法

共有 46 名难治性急迫性尿失禁患者参与了这项前瞻性、单臂、开放标签研究。这项研究在美国和新西兰的 7 个地点进行。研究参与者在小腿内的胫神经上植入了 eCoin,并在 4 周后激活。在激活后 3、6 和 12 个月收集膀胱日记数据和经过验证的生活质量工具,并与基线值进行比较。

结果

应答者被定义为那些报告的急迫性尿失禁发作减少≥50%的患者。在 12 个月时,65%的参与者被认为是应答者,其中 26%的参与者达到完全控制。每天急迫性尿失禁发作的中位数从基线时的 4.2 次减少到 12 个月时的 1.7 次。70%的参与者报告在 Likert 7 点最大量表上感觉“更好”、“好得多”或“非常好得多”。一名参与者出现了与治疗相关的严重不良事件。

结论

eCoin 是一种治疗与膀胱过度活动症相关的急迫性尿失禁的安全有效的方法,可显著减少或完全消除症状,且无明显安全性问题。

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