Efficacy and safety of sacral neuromodulation variable-frequency stimulation in the treatment of refractory lower urinary tract dysfunction
10.3760/cma.j.cn112330-20210427-00231
- VernacularTitle:骶神经调控术变频刺激模式治疗难治性下尿路功能障碍疾病的疗效和安全性
- Author:
Lingfeng MENG
1
;
Qingwei WANG
;
Jianguo WEN
;
Wen ZHU
;
Yan WANG
;
Yan ZHANG
;
Miao WANG
;
Xiaodong LIU
;
Wei ZHANG
;
Jianye WANG
;
Yaoguang ZHANG
Author Information
1. 北京医院泌尿外科 国家老年医学中心 中国医学科学院老年医学研究院，北京 100730
- Keywords:
Urinary bladder, Overactive;
Sacral neuromodulation;
Variable-frequency stimulation;
Constant-frequency stimulation;
Overactive bladder;
Prospective
- From:
Chinese Journal of Urology
2021;42(6):472-474
- CountryChina
- Language:Chinese
-
Abstract:
This study prospectively collected the clinical data of patients who received sacral neuromodulation(SNM)variable-frequency stimulation (VFS) mode from June 2020 to December 2020, in order to explore the efficacy and safety of VFS mode in the treatment of refractory lower urinary tract dysfunction. The inclusion criteria were as follows: ①SNM was implanted; ②age ≥18 years old; ③The traditional constant-frequency stimulation (CFS) mode has poor therapeutic effect, and can not be improved after repeated adjustment of stimulation parameters; ④Patients with overactive bladder (OAB) symptoms, who fail to respond to conservative treatment or are intolerant to conservative treatment; ⑤The drugs that affect the lower urinary tract symptoms and pelvic function should not be increased or decreased during the trial; ⑥provision of informed consent. A total of six patients meeting the criteria were included in the study, with three males and three females. The age ranged from 47 to 74 years, with an average age of 55 years. Among those patients, three cases were diagnosed of OAB, two cases were diagnosed of interstitial cystitis, and one case was diagnosed of neurogenic bladder. All patients had received CFS-SNM for an average of 20.6 months before upgrading to VFS mode, and suffered from severe frequency of urination at the same time. Compared with the severity of symptoms during the baseline period and the CFS period, a trend of improvement was found among four patients during the VFS period. The severity of symptoms was mainly based on the average daily urination frequency and OAB-Q score. For the two patients with interstitial cystitis, OAB symptoms worsened during the VFS period, while the VAS score did not change significantly. In general, VFS-SNM is not inferior to CFS-SNM in improving the symptoms of frequent micturition. For patients with interstitial cystitis, multiple sets of VFS parameters can be tried under the premise of satisfactory pain management.
