A prospective, single-blind, randomized crossover trial of sacral vs pudendal nerve stimulation for interstitial cystitis

被引:110
作者
Peters, Kenneth M. [1 ]
Feber, Kevin M. [1 ]
Bennett, Richard C. [1 ]
机构
[1] William Beaumont Hosp, Dept Urol, Minist Program Urol Res & Educ MPURE, Royal Oak, MI 48073 USA
关键词
neuromodulation; urinary symptoms; sacral stimulation; interstitial cystitis;
D O I
10.1111/j.1464-410X.2007.07082.x
中图分类号
R5 [内科学]; R69 [泌尿科学(泌尿生殖系疾病)];
学科分类号
1002 ; 100201 ;
摘要
Objective To compare sacral nerve stimulation (SNS) with pudendal nerve stimulation (PNS) for interstitial cystitis (IC). Patients and Methods Twenty-two patients with well-documented, refractory IC had a tined lead placed at S3 and a second electrode implanted at the pudendal nerve via a posterior approach. In a blinded, randomized design, each lead was tested for 7 days. The best lead was implanted to a pulse generator and patients were followed at 1, 3 and 6 months. Results The time required to place a sacral lead was 27.4 min, and a pudendal lead 19.6 min (P = 0.039). Of the 22 patients, 17 (77%) responded and had a permanent implant placed. PNS was chosen as the better lead in 77% and SNS in 24%. The order in which the lead was stimulated had no effect on the final lead implanted and there was no 'carry-over' effect. The overall reduction in symptoms was 59% for PNS and 44% for SNS (P = 0.05). At 6 months after implantation, voids improved by 41% (PNS) and 33% (SNS), and mean voided volume increased 95% and 21%, respectively; validated IC questionnaires improved markedly and complications were minimal. Conclusion This is the first 'blinded' study of SNS vs PNS for IC. A pudendal lead was implanted successfully in all patients, and most chose PNS as better than SNS; the improvement was sustained over time.
引用
收藏
页码:835 / 839
页数:5
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