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Clinical outcomes of sacral neuromodulation in non-neurogenic, non-obstructive dysuria: A 5-year retrospective, multicentre study in China

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单位: [1]Beijing Hosp, Natl Ctr Gerontol, Dept Urol, 1 Dahua Rd, Beijing 100730, Peoples R China [2]Capital Med Univ, Beijing Chaoyang Hosp, Inst Urol, Dept Urol, Beijing 100000, Peoples R China [3]Capital Med Univ, China Rehabil Res Ctr, Dept Urol, Rehabil Sch, Beijing 100000, Peoples R China [4]Shanghai Jiao Tong Univ, Renji Hosp, Dept Urol, Sch Med, South Campus, Shanghai 200000, Peoples R China [5]Huazhong Univ Sci & Technol,Tongji Hosp,Dept Urol,Wuhan 430000,Hubei,Peoples R China [6]Nanjing Med Univ, Affiliated Hosp 2, Dept Urol, Nanjing 210000, Jiangsu, Peoples R China [7]Xi An Jiao Tong Univ, Dept Urol, Affiliated Hosp 2, Xian 710000, Shaanxi, Peoples R China [8]Zhejiang Prov Peoples Hosp, Dept Urol, Hangzhou 310000, Zhejiang, Peoples R China [9]Shanghai Jiao Tong Univ, Shanghai Gen Hosp, Dept Urol, Sch Med, Shanghai 200000, Peoples R China [10]Sichuan Univ, West China Hosp, Dept Urol, Chengdu 610000, Sichuan, Peoples R China
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关键词: Dysuria Implanted pulse generator Non-neurogenic Non-obstructive Sacral neuromodulation

摘要:
BACKGROUND Management of non-neurogenic, non-obstructive dysuria represents one of the most challenging dilemmas in urological practice. The main clinical symptom is the increase in residual urine. Voiding dysfunction is the main cause of dysuria or urinary retention, mainly due to the decrease in bladder contraction (the decrease in contraction amplitude or duration) or the increase in outflow tract resistance. Sacral neuromodulation (SNM) has been used for > 10 years to treat many kinds of lower urinary tract dysfunction. It has become increasingly popular in China in recent years. Consequently, studies focusing on non-neurogenic, non-obstructive dysuria patients treated by SNM are highly desirable. AIM To assess the outcome of two-stage SNM in non-neurogenic, non-obstructive dysuria. METHODS Clinical data of 54 patients (26 men, 28 women) with non-neurogenic, non-obstructive dysuria treated by SNM from January 2012 to December 2016 in ten medical centers in China were retrospectively analyzed. All patients received two or more conservative treatments. The voiding diary, urgency score, and quality of life score before operation, after implantation of tined lead in stage I (test period), and during short-term follow-up (latest follow-up) after implantation of the implanted pulse generator in stage II were compared to observe symptom improvements. RESULTS Among the 54 study patients, eight refused to implant an implanted pulse generator because of the unsatisfactory effect, and 46 chose to embed the implanted pulse generator at the end of stage I. The conversion rate of stage I to stage II was 85.2%. The average follow-up time was 18.6 mo. There were significant differences between baseline (before stage I) and the test period (after stage I) in residual urine, voiding frequency, average voiding amount, maximum voiding amount, nocturia, urgency score, and quality of life score. The residual urine and urgency score between the test period and the latest follow-up time (after stage II) were also significantly different. No significant differences were observed for other parameters. No wound infection, electrode breakage, or other irreversible adverse events occurred. CONCLUSION SNM is effective for patients with non-neurogenic, non-obstructive dysuria showing a poor response to traditional treatment. The duration of continuous stimulation may be positively correlated with the improvement of residual urine.

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出版当年[2019]版:
大类 | 4 区 医学
小类 | 4 区 医学:内科
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Q3 MEDICINE, GENERAL & INTERNAL
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Q3 MEDICINE, GENERAL & INTERNAL

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第一作者单位: [1]Beijing Hosp, Natl Ctr Gerontol, Dept Urol, 1 Dahua Rd, Beijing 100730, Peoples R China
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