(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
To assess the outcome of two-stage sacral neuromodulation (SNM) in men with idiopathic dysuria during short follow-up.
From January 2012 to December 2016, 26 male patients with idiopathic dysuria treated with SNM were recruited in multiple medical centers across the country in this retrospective study. The average age was 45.2（1986）years old. The clinical symptoms included the frequency of urination, urgency, urinary retention, etc., which may exist in one or a mixture of them. All patients received two or more conservative treatments（Behavior therapy, oral therapy, etc.）, even surgical treatments and so on did not have a good effect on the patients. The data of voiding diary ,urgency score and the quality of life score 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 in order to observe the improvement of relevant symptoms.
22 patients choose embedding IPG at the end of stage I. Of all these patients, the conversion rate of stage I to stage II is 84.6% (22/26). The average follow-up time was 19.2 months. The data of residual urine, voiding frequency, average voiding amount, nocturia, maximum voiding amount and urgency score between baseline (before stage I) and at the test period were [5（0-137.5）] ml vs [0（0-40）]ml, 14.6±6.1 vs 9.1±2.8, [100（80-135）] ml vs[190（150-210）]ml, [3（2-5）] vs [1.5（1-3）], [180（140-210）] ml vs [260（200-300）] ml, [4（2-4）] vs[2（1-2）], respectively. And there were significant differences(P＜0.05).The daily urination volume and quality of life (QoL) had no significant differences(P＞0.05). In addition, during an average follow-up time of 19.2 months after the permanent implantation in 22 patients, the proportion of people whose residual urine volume improved more than 50% increased from 55.6% in the test period to 80% after the permanent implantation, suggesting that the improvement of residual urine may be positively correlated with the duration of regulation. There was no other significant finding when looking at other parameters studied. No adverse event, such as wound infection, electrode dislocation was detected.
SNM is an effective, safe and minimally invasive procedure for male patients with idiopathic dysuria. The medium-term curative effect is stable, and had high transfer rate. In addition, the duration of regulation may be positively correlated with the improvement of residual urine.