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Clinical outcomes of sacral neuromodulation in non-neurogenic,non-obstructive dysuria:A 5-year retrospective,multicentre study in China

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World Journal of Clinical Cases 2020年第12期8卷 2494-2501页

作者： Ling-Feng Meng Wei Zhang Jian-Ye Wang Yao-Guang Zhang Peng Zhang Li-Min Liao Jian-Wei Lv Qing Ling Zhong-Qing Wei Tie Zhong Zhi-Hui Xu Wei Wen Jia-Yi Li De-Yi Luo Department of Urology Beijing HospitalNational Center of GerontologyBeijing 100730China Department of Urology Beijing Chaoyang HospitalInstitute of UrologyCapital Medical UniversityBeijing 100000China Department of Urology China Rehabilitation Research CentreRehabilitation School of Capital Medical UniversityBeijing 100000China Department of Urology South CampusRenji HospitalShanghai Jiao Tong University School of MedicineShanghai 200000China Department of Urology Tongji HospitalHuazhong University of Science and TechnologyWuhan 430000Hubei ProvinceChina Department of Urology The Second Affiliated Hospital of Nanjing Medical UniversityNanjing 210000Jiangsu ProvinceChina Department of Urology The Second Affiliated Hospital of Xi’an Jiaotong UniversityXi’an 710000Shaanxi ProvinceChina Department of Urology Zhejiang Provincial People’s HospitalHangzhou 310000Zhejiang ProvinceChina Department of Urology Shanghai General HospitalShanghai Jiao Tong University School of MedicineShanghai 200000China Department of Urology Renji HospitalShanghai Jiao Tong University School of MedicineShanghai 200000China Department of Urology West China HospitalSichuan UniversityChengdu 610000Sichuan ProvinceChina

BACKGROUND Management of non-neurogenic,non-obstructive dysuria represents one of the most challenging dilemmas in urological *** main clinical symptom is the increase in residual *** dysfunction is the main cause of dysuria or urinary retention,mainly due to the decrease in bladder contraction(the decrease in contraction amplitude or duration)or the increase in outflow tract *** neuromodulation(SNM)has been used for>10 years to treat many kinds of lower urinary tract *** has become increasingly popular in China in recent ***,studies focusing on nonneurogenic,non-obstructive dysuria patients treated by SNM are highly *** To assess the outcome of two-stage SNM in non-neurogenic,non-obstructive *** Clinical data of 54 patients(26 men,28 women)with non-neurogenic,nonobstructive dysuria treated by SNM from January 2012 to December 2016 in ten medical centers in China were retrospectively *** patients received two or more conservative *** voiding diary,urgency score,and quality of life score before operation,after implantation of tined lead in stage I(test period),and during short-term follow-up(latest follow-up)after implantation of the implanted pulse generator in stage II were compared to observe symptom *** Among the 54 study patients,eight refused to implant an implanted pulse generator because of the unsatisfactory effect,and 46 chose to embed the implanted pulse generator at the end of stage *** conversion rate of stage I to stage II was 85.2%.The average follow-up time was 18.6 *** were significant differences between baseline(before stage I)and the test period(after stage I)in residual urine,voiding frequency,average voiding amount,maximum voiding amount,nocturia,urgency score,and quality of life *** residual urine and urgency score between the test period and the latest follow-up time(after stage II)were also significantly different

关键词： Dysuria Implanted pulse generator non-neurogenic non-obstructive Sacral neuromodulation

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Very Low, Real-Time Rate of Urinary Retention after Intradetrusor Botox<sup>&reg</sup>for non-neurogenic Overactive Bladder

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Open Journal of Obstetrics and Gynecology 2017年第8期7卷 915-921页

作者： Kirin K. Syed Christopher S. Gomez Angelo E. Gousse Bladder Health and Reconstructive Urology Institute Miramar FL USA Female Urology Neurourology Voiding Dysfunction and Reconstruction Department of Urology University of Miami Miami FL USA

Introduction: According to the most recent AUA/SUFU guidelines, intradetrusor onabotulinumtoxinA (BTN/A) is a standard, evidence strength grade B, third line treatment option for refractory non-neurogenic overactive bladder (OAB). Urinary retention is the most common clinically significant reported side effect ranging from 5.4% to 43% in previous studies. The aim of this study was to investigate the real-time rate of urinary retention in patients treated with BTN/A for refractory non-neurogenic OAB in a multi-institutional study. Methods: Retrospective chart review identified 71 patients who were treated with 100U BTN/A for refractory non-neurogenic OAB from August 2011 to July 2015 at two institutions. Using a flexible cystoscope, 100U Botox® reconstituted with 10 ml normal saline was administered. Injections of 1 ml (10 units/ mL) were administered in 10 evenly distributed sites sparing the trigone. Pre and post BTN/A post-void residuals (PVR) were reviewed. Urinary retention was defined as PVR > 200 mL requiring clean intermittent catheterization (CIC). Results: After exclusion, the study group consisted of 66 patients with a mean age of 67 years and 30% were men. Mean pre and post-procedural PVR were 14.06 mL and 69.21 mL. Eight patients (12.12%) were noted to have elevated PVR > 200 mL post injection however only one patient (female) required initiation of CIC. The rate of urinary retention was 1.5% (N = 1). There was no correlation with age, history of previous radiation, diabetes or prior use of a neuromodulator device. Conclusions: To the best of our knowledge, this is the first study to demonstrate a very low risk of real-time urinary retention rates in appropriately selected patients treated with BTN/A for refractory non-neurogenic OAB outside of a clinical trial setting.

关键词： Intradetrusor OnabotulinumtoxinA Refractory non-neurogenic Overactive Bladder Urinary Retention OAB Urinary Retention Rate Botox®

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