开发非神经源性膀胱过度活动综合征骶神经调控中期成功预测工具

IF 1.8 3区 医学 Q3 UROLOGY & NEPHROLOGY
Samy Hafez, Morgane Pere, Louise Olivier, Benjamin Carolus, Marie-Liesse De Guerry, Jérôme Rigaud, Xavier Biardeau, Marie-Aimée Perrouin-Verbe
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引用次数: 0

摘要

目的:根据术前临床和尿动力学数据,确定可预测难治性非神经源性膀胱过度活动综合征(nnOAB)骶神经调节(SNM)试验阶段和中期成功的因素。材料和方法:我们进行了一项双中心回顾性研究,纳入了所有在2005年至2021年期间接受了测试阶段的nnOAB患者,随后植入或不植入SNM装置。仅纳入术前尿动力学评估数据的患者。SNM成功定义为膀胱日记参数之一改善≥50%,与症状改善≥50%相关。个体在2年后接受随访评估。结果:共纳入191人(163名女性),其中69%接受了SNM装置植入。在术前尿动力学检查中,115例患者出现逼尿肌过度活动(DO)。测试阶段的成功与较年轻的年龄相关(p = 0.009)。24个月SNM成功与基线时最大逼尿肌压力(Pdet max DO)较低相关(p = 0.045)。2年成功的其他预测因素为女性(p = 0.03)、压力性尿失禁手术史(p = 0.01)、最大尿道闭合压力(MUCP)低(p = 0.04)、初始DO容量低(VFDO) (p = 0.03)和最大膀胱容量(MCC)高(p = 0.03)。我们开发了一个工具来预测2年的成功。以下阈值与治疗成功显著相关:MUCP 2O, VFDO 254 mL。结论:年龄预测试验阶段的成功。Pdet max DO、性别、失禁手术史、高MUCP、MCC和VFDO预测了nnOAB患者SNM的中期成功。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
Development of a Predictive Tool for Midterm Success of Sacral Neuromodulation in Non-Neurogenic Overactive Bladder Syndrome.

Objectives: To identify factors that can predict both test phase and midterm success of sacral neuromodulation (SNM) in refractory non-neurogenic overactive bladder syndrome (nnOAB) based on preoperative clinical and urodynamic data.

Materials and methods: We conducted a two-center retrospective study and included all individuals with nnOAB who underwent a test phase between 2005 and 2021, with or without subsequent implantation of an SNM device. Only those with preoperative urodynamic assessment data were included. SNM success was defined as $\ge $  50% improvement in one of the bladder diary parameters, associated with $\ge $  50% symptom improvement. Individuals underwent follow-up evaluation at 2 years.

Results: In total, 191 individuals were included (163 women), 69% of whom underwent SNM device implantation. At the preoperative urodynamic exam, 115 individuals had detrusor overactivity (DO). Test phase success was associated with younger age (p = 0.009). 24-month SNM success was associated with lower maximal detrusor pressure at DO (Pdet max DO) at baseline (p = 0.045). Other predictive factors for success at 2 years were female (p = 0.03), a history of stress incontinence surgery (p = 0.01), a low maximum urethral closure pressure (MUCP) (p = 0.04), a low volume at first DO (VFDO) (p = 0.03), and a high maximum cystometric capacity (MCC) (p = 0.03). We developed a tool to predict success at 2 years. The following threshold values were significantly associated with treatment success: MUCP < 58 cmH2O, VFDO < 170 mL, and MCC > 254 mL.

Conclusion: Age predicted test phase success. Pdet max DO, gender, history of incontinence surgery, high MUCP, MCC, and VFDO predicted midterm success of SNM in people with nnOAB.

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来源期刊
Neurourology and Urodynamics
Neurourology and Urodynamics 医学-泌尿学与肾脏学
CiteScore
4.30
自引率
10.00%
发文量
231
审稿时长
4-8 weeks
期刊介绍: Neurourology and Urodynamics welcomes original scientific contributions from all parts of the world on topics related to urinary tract function, urinary and fecal continence and pelvic floor function.
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