#23333 скачать в хорошем качестве

#23333

Two staged sacral neuromodulation procedure for the treatment of non-obstructive urinary retention: a multi-center study Coolen R1, Groen J1, Stillebroer A1, Scheepe J1, Witte L2, Blok B1 1. Erasmus MC, 2. Isala Clinics KEYWORDS: Detrusor Hypocontractility, Neuromodulation, Voiding Dysfunction , Underactive Bladder, Retrospective Study Non-obstructive urinary retention (NOUR) is a voiding disorder that affects millions of people worldwide. Patients may present with slow urinary stream, hesitancy, and straining to void with the feeling of incomplete bladder emptying, acute urinary retention, or recurrent urinary tract infections. Urodynamic studies may reveal a decreased contractility of the detrusor muscle. However, NOUR is especially clinically relevant in case of significant post-void residual, which necessitates regular drainage of the bladder. Most patients with NOUR use clean intermittent catheterization (CIC), or indwelling catheters to ensure timely drainage of the bladder and prevent complications. Sacral neuromodulation (SNM) can be offered to restore voiding (thereby decreasing or abolishing the necessity for catheterization), reduce catheter associated complications, and improve quality of life. A test phase with an external stimulator precedes the implantation of a neuromodulator to assess whether the patient’s symptoms improve sufficiently with SNM. In patients with NOUR physicians usually propose a tined lead test phase (1). A tined lead test phase (first stage SNM) consists of placement of the definite tined lead, which is connected to an external neuromodulator for a duration of two to four weeks. Since the test phase is an invasive procedure, it would be beneficial to predict which patients with NOUR would have the highest chance on a positive test result. Therefore, the aims of this study were to 1) determine the success rate of the tined lead test phase in patients with NOUR, 2) to determine predictive factors of a successful test phase in patients with NOUR, and 3) to determine long term efficacy and patient satisfaction of SNM in patients with NOUR.