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Influence of patient sex on the effectiveness of sacral neuromodulation: A cohort study from China

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单位: [1]Chinese Acad Med Sci, Beijing Hosp, Natl Ctr Gerontol, Inst Geriatr Med,Dept Urol, Beijing 100730, Peoples R China [2]Capital Med Univ, China Rehabil Res Ctr, Dept Urol, Rehabil Sch, Beijing 100068, Peoples R China [3]Huazhong Univ Sci & Technol,Tongji Hosp,Dept Urol,Wuhan 430030,Peoples R China [4]Capital Med Univ, Beijing Chaoyang Hosp, Inst Urol, Dept Urol, Beijing 100020, Peoples R China [5]Nanjing Med Univ, Dept Urol, Affiliated Hosp 2, Nanjing 210000, Peoples R China [6]Xi An Jiao Tong Univ, Dept Urol, Affiliated Hosp 2, Xian 710014, Peoples R China [7]Zhejiang Prov Peoples Hosp, Dept Urol, Hangzhou 310000, Peoples R China [8]Shanghai Jiao Tong Univ, Shanghai Gen Hosp, Dept Urol, Sch Med, Shanghai 200000, Peoples R China [9]Shanghai Jiao Tong Univ, Renji Hosp, Dept Urol, Sch Med, Shanghai 200000, Peoples R China [10]Sichuan Univ, West China Hosp, Dept Urol, Chengdu 610000, Peoples R China
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关键词: Patient gender Pelvic floor dysfunction Lower urinary tract disease Sacral neuromodulation Clinical efficacy

摘要:
Background: Sacral neuromodulation (SNM) has been widely used to treat lower urinary tract dysfunction. Studies have shown a higher conversion rate among female patients than among male patients. However, the influence of gender on the clinical effectiveness of SNM remains unclear. We aimed to confirm whether patients of both genders show similar benefits after SNM treatment. Materials and methods: Clinical data of patients with lower urinary tract symptoms associated with pelvic floor dysfunction (overactive bladder, neumgenic bladder, interstitial cystitis/painful bladder syndrome, idiopathic urinary retention) treated with SNM in 10 medical centres in China between January 2012 and December 2016 were retrospectively collected. The patients were classified by gender. Variations in objective (voiding diary) and subjective scores in the baseline, testing, and last follow-up periods were compared. Data were analysed using statistical measures. Results: The study included 203 patients (93 males, 110 females). There were no statistical differences in baseline information between the two groups, both groups showed improvement over time. Unsatisfactory improvement was observed in the quality of life and sexual life scores of both groups over the entire treatment period (all p > 0.05). Although there was a difference in the maximum voiding volume between the groups at baseline, no difference was observed at the last follow-up (p = 0.004, p = 0.044, p = 0.124), unlike in the average volume where a difference was noted at the last follow-up (p = 0.085, p = 0.964, p = 0.031). While there were no differences in quality of life, sexual life, or pelvic pain and urinary urgency frequency scores at baseline, a significant difference was observed at the last follow-up, and the degree of improvement was less among female patients (p = 0.836, p = 0.131, p = 0.015; p = 0.294, p = 0.265, p = 0.013; p = 0.299, p = 0.087, p = 0.015). Conclusion: SNM treatment elicited a similar effect on patients of both gender; however, a significant difference was observed regarding patient satisfaction with the treatment. Further preoperative patient education, especially, for female patients with interstitial cystitis/painful bladder syndrome may improve patient satisfaction.

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出版当年[2019]版:
大类 | 3 区 医学
小类 | 3 区 外科
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大类 | 2 区 医学
小类 | 2 区 外科
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Q1 SURGERY
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Q1 SURGERY

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第一作者单位: [1]Chinese Acad Med Sci, Beijing Hosp, Natl Ctr Gerontol, Inst Geriatr Med,Dept Urol, Beijing 100730, Peoples R China
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