Usefulness of sacral nerve modulation in a series of multiple sclerosis patients with bladder dysfunction

被引:15
作者
Andretta, Elena [1 ]
Simeone, Claudio [2 ]
Ostardo, Edoardo [3 ]
Pastorello, Mauro [4 ]
Zuliani, Cristina [5 ]
机构
[1] Gen Hosp Dolo, Dept Urol, Venice, Italy
[2] Univ Brescia, Dept Urol, I-25121 Brescia, Italy
[3] Gen Hosp Sta Maria degli Angeli, Dept Urol, Pordenone, Italy
[4] Sacra Cuore Hosp Negrar, Dept Urol, Verona, Italy
[5] Gen Hosp Mirano, Dept Neurol, I-30035 Venice, Italy
关键词
Sacral nerve modulation; Multiple sclerosis; Neurogenic bladder; Bladder storage symptoms; Bladder voiding symptoms; Bladder mixed symptoms; URINARY URGE INCONTINENCE; DETRUSOR OVERACTIVITY; NEUROMODULATION; STIMULATION; MANAGEMENT; SYMPTOMS; MULTICENTER; INJECTIONS; RETENTION; EFFICACY;
D O I
10.1016/j.jns.2014.10.010
中图分类号
R74 [神经病学与精神病学];
学科分类号
摘要
Objective: Bladder dysfunctions are common in multiple sclerosis (MS) often causing the most distressing symptoms. The aim of this paper was to evaluate the effectiveness of sacral nerve modulation (SNM) in this disease. Methods: We conducted an observational retrospective survey in 17 patients treated with SNM in the north-east of Italy, all complaining of bladder symptoms (storage in 41%, voiding in 24%, mixed in 35%) unresponsive to conventional therapies, with a mean follow-up of 52 +/- 26 months and mean Expanded Disability Status Scale score of 5.8 +/- 1.8. Results: 75% of patients reported significant and lasting improvement in bladder symptoms and in quality of life. We observed a statistically significant improvement in frequency, urgency, number of pads, residual volumes, number of catheterizations and in the voided volumes. In 5 out of 6 cases with mixed symptoms the stimulation was discontinued (device totally explanted or turned off) after a mean time of 66 months (range 10-84 months) after the implant for disease progression or loss of efficacy. Conclusion: SNM could be an option in very selected cases of storage and voiding symptoms refractory to conservative treatments caused by a stable or slowly progressive MS considering its minimal invasiveness and reversibility. The poor results observed suggest avoiding this therapy in mixed symptoms and in cases of advanced disability. (C) 2014 Elsevier B.V. All rights reserved.
引用
收藏
页码:257 / 261
页数:5
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