神经电生理监控下经皮穿刺电刺激阴部神经治疗前列腺癌根治术后顽固性压力性尿失禁的疗效观察

正压力性尿失禁是前列腺癌根治术后常见并发症,主要表现为腹压增加的情况下尿液不自主流出,严重影响患者生活质量,往往病情顽固,经保守治疗疗效多欠佳~(1])。目前临床上保守治疗方法主要有生物反馈、盆底肌锻炼~(2])等,而手术治疗的主要选择有男性尿道中段悬吊术~(3])及人工尿道括约肌植入术~(4])。前者手术失败率较高,多导致尿潴留,开展并不普遍~(5]);后者费用较高,同样存在异物排斥、感染等并发症~(6])。我们前期临床研究发现,经皮穿刺电针电刺激阴部神经治疗前列腺癌根治术后顽固性压力性尿失禁疗效满意,

The Effect of the Treatment of Refractory Stress Urinary Incontinence after Radical Prostatectomy with Percutaneous Electrical Stimulation of Pudendal Nerve under Neuroelectrophysiological Monitoring

Objective To observe the effect of the treatment of refractory stress urinary incontinence after radical prostatectomy with percutaneous electrical stimulation of pudendal nerve under neuroelectrophysiological monitoring. Methods We randomly assigned 20 patients with refractory stress urinary incontinence after radical prostatectomy admitted to our hospital from April 2016 through April 2019 to experimental group and control group equally. The mean age of the participants was 64.5±4.5 years old. In the experimental group, the vaginal nerve was stimulated by percutaneous puncture under neuroelectrophysiological monitoring, while the control group was not monitored by neurophysiological monitoring. The urine pad test leakage and urinary incontinence symptom score of the two groups were compared after one month. Results After treatment, the urine pad test leakage and urinary incontinence symptom scores of the two groups were significantly lower than those before treatment (P<0.05, P<0.01). After treatment, the urine pad test leakage and urinary incontinence symptom scores of the experimental group were significantly lower than that of the control group (P<0.05). Conclusion Percutaneous puncture of the pudendal nerve under neuroelectrophysiological monitoring is more accurate, and combining with electrical stimulation can significantly reduce the volume of urine leakage and urinary incontinence symptoms scores in patients with refractory stress urinary incontinence after radical prostatectomy. The long-term effect needs further observation.