(1) Department Of Urology, Beijing Hospital, National Center Of Gerontology, Beijing, China, Beijing, China, (2) Department of Urology, China Rehabilitation Research Centre, Rehabilitation School of Capital Medical University, Beijing, China, Beijing, CN, (3) Department of Urology, Tongji Hospital, Huazhong University of Science and Technology, Wuhan, China, Wuhan, CN, (4) Department of Urology, Beijing Chaoyang Hospital, Institute of Urology, Capital Medical University, Beijing, China, Beijing, CN, (5) Department of Urology, The Second Affiliated Hospital of Nanjing Medical University, Nanjing , China, Nanjing, CN, (6) Department of Urology, The Second Affiliated Hospital of Xi’an Jiaotong University, Xi’an, China, Xi‘an, CN
We evaluated whether patients stratified by age have the same level of benefits after a staged neuromodulation procedure for refractory lower urinary tract dysfunction.
From January 2012 to December 2016, 211 patients with refractory lower urinary tract dysfunction treated with SNM were recruited in multiple medical centers across the country in this retrospective study. Patients were grouped by age (years): ＜40 (n =58), 40–64(n =94), and ＞65 (n =59). The data of voiding diary and subjective scores before operation, after implantation of stage I tined lead, and during short-term follow-up after implantation of stage II implanted pulse generator（IPG）were compared. Data were examined with one-way ANOVA and repeated measurement analysis of variance.
In the＜40, 40–64, and＞65 groups, urinary frequency(P＜0.001 for all), nocturia(P＜0.001 for all), maximum voiding amount(P＜0.001 for all), average voiding amount(P＜0.001 for all), leakage episodes（P=0.0011，P=0.047，P=0.011）, average Urinary Emergency(P＜0.001 for all), VAS scores（P=0.0043，P＜0.001，P＜0.001）, O’Leary-Sant scores（P＜0.01，P＜0.001，P＜0.001）, and PUF scores （P＜0.01，P＜0.001，P＜0.001）improved over time. Residual urine improved in the 40-64 and >65 age groups(P＜0.001 for all). Quality of life（QoL） scores improved in those >65 (P =0.024). Most of the urination diary data of different age groups are different at baseline, and the residual urine was not different at the last follow-up（P=0.006，P=0.024，P=0.057）. The average urinary emergency and sexual life scores were different at baseline and disappeared at the last follow-up（P=0.029，P=0.107，P=0.304；P=0.01，P=0.082，P=0.087）. There was no difference in O-S score and PUF score at baseline, but there was significant difference at the last follow-up（P=0.059，P=0.008，P=0.031；P=0.14，P=0.032，P=0.024）.
These data suggest that the success of neuromodulation is not related to age, that is, the age of patients has no effect on the clinical efficacy of SNM, and age alone should not be regarded as a limiting factor in SNM treatment. For older patients with refractory lower urinary tract dysfunction, OAB is a better indication for SNM treatment, but further studies are needed to confirm these findings.