Effect analysis of sacral neuromodulation in the treatment of incomplete spinal cord injured patients suffering from neurogenic lower urinary tract symptoms
10.3760/cma.j.cn431274-20190927-01122
- VernacularTitle:骶神经调控治疗不完全性脊髓损伤患者下尿路症状的疗效分析
- Author:
Mengliang XIE
1
;
Yuansong XIAO
;
Jun LYU
;
Xiaoming ZHANG
;
Wei WANG
;
Haibo NIE
Author Information
1. 广东医科大学研究生学院，湛江 524023；中国人民解放军南部战区总医院泌尿外科，广州 510010
- From:
Journal of Chinese Physician
2020;22(5):727-730
- CountryChina
- Language:Chinese
-
Abstract:
Objective:To determine the efficacy and safety of sacral neuromodulation (SNM) in incomplete spinal cord injured (SCI) subjects affected by neurogenic lower urinary tract symptoms.Methods:Clinical data of 36 patients with incomplete spinal cord injury who underwent SNM from February 2015 to April 2019 were retrospectively analyzed and were divided into group NUR (16 cases neurogenic urinary retention group) and group NOAB (20 cases of neurogenic bladder overactive group). If at least 50% clinical improvement occurred, the patient would undergo a permanent SNM procedure. The patients were evaluated by using bladder diary, postvoid residual volume measurement, frequency of clean catheterization and urodynamic parameters before and during the test, and after the permanent SNM.Results:Among the 36 patients, 21 cases (58.3%) were tested effectively and received permanent stimulator implantation, 7(19.4%) in NUR group and 14(38.9%) in NOAB group. The residual urine volume of bladder, the average number of catheterization and the average number of urination in NUR group were improved in different degrees. After operation, the symptoms of frequent urination, urgency of urination and incontinence in NOAB group were relieved to varying degrees. During the follow-up, 2 patients with urinary retention failed the treatment. After the Ⅰ phase of the contralateral S3, the curative effect was recovered. A patient were infected after operation, and the wound healed after removal of the infection.Conclusions:The SNM is safe and effective in the treatment of neurogenic lower urinary tract symptoms in some incomplete spinal cord injury patients, and is helpful to protect renal function in patients with spinal cord injury. SNM can not improve all symptoms at times, but the SNM can be considered in patients with ineffective or intolerant traditional treatment.
