Pham Cecile T, Parkin Cameron J, Kovacic James, Yeow Siying, Yang Yunzhi, Delaney Danielle, Chung Amanda
North Shore Urology Research Group, St Leonards, New South Wales, Australia.
Department of Urology, Northern Beaches Hospital, Frenchs Forest, New South Wales, Australia.
Curr Urol. 2025 Jul;19(4):280-285. doi: 10.1097/CU9.0000000000000201. Epub 2023 May 23.
Limited published data exist regarding the utility of sacral neuromodulation (SNM) for neurogenic lower urinary tract dysfunction (NLUTD), consisting of only small case series, and, to our knowledge, no Australian data have been published. The aim of this study was to evaluate the clinical outcomes of SNM for treatment of NLUTD in Australian patients.
A retrospective analysis was conducted of patients who received a permanent SNM implant between December 2014 and March 2021. Patients completed a urodynamic test preoperatively. They completed a 3-day bladder diary, uroflowmetry, and postvoid residual measurement preoperatively and at 6-month intervals postoperatively following SNM insertion. Urinary function, patient-reported outcome measures, and adverse events were assessed.
A total of 36 patients received a permanent SNM implant. The mean duration of follow-up was 25 ± 20 months, with the majority (89%, n = 32) of patients reporting a >50% improvement on bladder diary evaluation. There was a significant increase in void volume ( < 0.001), decrease in postvoid residual ( < 0.001), decrease in voiding frequency ( < 0.001), decrease in incontinence episodes ( = 0.002), and decrease in pad number ( < 0.001). There was no significant difference in peak flow ( = 0.21). There was no significant difference in SNM efficacy between patients with progressive or nonprogressive neurological conditions.
Sacral neuromodulation is a safe and effective therapy for NLUTD in the context of both progressive and nonprogressive neurological conditions. It should be offered more readily to patients with NLUTD as a minimally invasive treatment option with the potential to make clinically meaningful improvements in quality of life.
关于骶神经调节（SNM）治疗神经源性下尿路功能障碍（NLUTD）的效用，已发表的数据有限，仅包括一些小型病例系列，据我们所知，尚无澳大利亚的数据发表。本研究的目的是评估SNM治疗澳大利亚NLUTD患者的临床疗效。
对2014年12月至2021年3月期间接受永久性SNM植入的患者进行回顾性分析。患者术前完成尿动力学检查。他们在术前以及SNM植入术后每隔6个月完成一份为期3天的膀胱日记、尿流率测定和排尿后残余尿量测量。评估排尿功能、患者报告的结局指标和不良事件。
共有36例患者接受了永久性SNM植入。平均随访时间为25±20个月，大多数（89%，n = 32）患者在膀胱日记评估中报告改善>50%。排尿量显著增加（<0.001），排尿后残余尿量减少（<0.001），排尿频率降低（<0.001），尿失禁发作次数减少（=0.002），护垫使用数量减少（<0.001）。最大尿流率无显著差异（=0.21）。进展性或非进展性神经疾病患者之间的SNM疗效无显著差异。
在进展性和非进展性神经疾病背景下，骶神经调节是治疗NLUTD的一种安全有效的疗法。作为一种微创治疗选择，它应该更容易提供给NLUTD患者，有可能在临床上显著改善生活质量。
