Sacral Neuromodulation in Patients With Neurogenic Lower Urinary Tract Dysfunction: A Multicenter Retrospective Study From China
Sacral Neuromodulation in Patients With Neurogenic Lower Urinary Tract Dysfunction: A Multicenter Retrospective Study From China
复制标题
神经源性下尿路功能障碍患者的骶神经调节：来自中国的多中心回顾性研究
DOI：
10.1111/ner.13383
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发表时间：
2021-04-28
期刊：
影响因子：
2.8
通讯作者：
Liao, Limin
中科院分区：
文献类型：
--
作者：
Masood, Ifrah;Chen, Qi;Liao, Limin
目的回顾性研究骶神经调节（SNM）治疗神经源性下尿路功能障碍（NLUTD）的疗效，并分析其预测因素。材料与方法2012年1月至2020年1月，来自中国4个医疗中心的152例NLUTD患者接受SNM测试刺激。在测试前和测试期间，通过膀胱日记、膀胱后残留体积（PRVs）和神经源性肠功能障碍（NBD）评分对受试者进行评估。通过SNM试验阶段症状改善至少50%的患者有资格进行永久性SNM植入。结果慢性尿潴留的总成功率为31.0%(40/129)，显著低于尿频急症（64.8%,59/91）、尿失禁（65.2%,30/46）和NBD评分（61.7%,82/133）。危险因素分析结果显示，尿潴留症状是具有统计学意义的阳性预测因子（p = 0.001）。结论SNM是治疗NLUTD的一种有效、可靠的方法，尤其适用于有尿潴留症状的患者。虽然不是每个患者的所有症状都可以解决，但SNM与其他治疗方法一起可能是一个更好的选择。
Objectives This retrospective study aimed to determine the effectiveness of sacral neuromodulation (SNM) on neurogenic lower urinary tract dysfunction (NLUTD) and analyze the predictive factors.Materials and Methods 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.Results 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).Conclusions 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.