骶神经调节治疗慢性排尿功能障碍的临床初步探讨

目的：探讨骶神经调节治疗慢性排尿功能障碍病人的疗效与安全性。方法：骶神经测试治疗6例慢性排尿功能障碍病人．其中4例为神经源性膀胱尿道功能障碍．6例中，有2例接受了永久性植入术．通过排尿日记、尿动力学检查及症状评价疗效。结果：骶神经调节测试的效果显示，6例中有5例的重要客观和／或主观指标均改善50％以上，另1例症状改善不明显接受永久性植入术的2例术后的客观和／或主观指标较术前得到显著改善。6例随访15～26个月，平均21．8个月．未发现明显不良反应和并发症结论：骶神经调节是一种创伤小、安全、有效的治疗慢性排尿功能障碍的方法，对某些神经源性膀胱尿道功能障碍有一定的疗效。

Primary Experience in the Treatment of Chronic Voiding Dysfunction by Sacral Nerve Neuromodulation

Objective:To explore the efficacy and safety of sacral nerve neuromodulation (SNN) in the treatment of chronic voiding dysfunctions. Methods: Six patients with chronic voiding dysfunction, 4 of which were neurogenic, received sacral nerve test stimulation. Of the 6 patients, 2 further received the implantation of the permanent electrode and neurostimulator. The therapeutic efficacy and safety were evaluated by means of the symptoms, voiding diaries and the results of urodynamics. Results: During the test stimulation period, there were significant improvements (greater than 50%) in the objective findings and/or subjective symptoms in 5 of the 6 patients, and no significant improvement in the remaining one. The two patients who received permanent electrode and neurostimulator implantation continued to keep significant improvement in objective findings and symptoms. All the patients have been followed-up for 15 to 26 months, with an average of 21.8 months, and no significant complications were found. Conclusions: SNN is a safe, effective and minimally invasive therapy for chronic voiding dysfunction. It is also effective in some neurogenic dysfunctions of the bladder and urethra.