Published online Jun 26, 2020. doi: 10.12998/wjcc.v8.i12.2494
Peer-review started: February 5, 2020
First decision: April 21, 2020
Revised: May 8, 2020
Accepted: May 23, 2020
Article in press: May 23, 2020
Published online: June 26, 2020
Processing time: 139 Days and 16.1 Hours
Dysuria without urinary retention or obvious inducement is a clinically difficult problem to diagnose and treat. In the past, patients suffering from non-neurogenic, non-obstructive dysuria could only rely on intermittent catheterization, transurethral indwelling catheters, or suprapubic cystostomy to drain urine. These treatment methods significantly affected the patients’ quality of life. In 1999, sacral neuromodulation (SNM) was approved by the United States Food and Drug Administration for idiopathic urinary retention. China officially introduced SNM therapy into clinical practice in 2012, providing a new treatment method for non-neurogenic, non-obstructive dysuria.
The traditional treatment methods for non-neurogenic, non-obstructive dysuria are often ineffective, and the best treatment method is still controversial. As its third-line treatment, SNM has been widely used to treat dysuria in China in recent years. This study is the first retrospective, multicenter study of this treatment method in China, reflecting the clinical effect of SNM in the treatment of patients with non-neurogenic, non-obstructive dysuria.
The main purpose of this study was to summarize the experience of SNM in the treatment of non-neurogenic, non-obstructive dysuria.
The clinical data of 54 patients with non-neurogenic, non-obstructive dysuria treated with SNM in ten Chinese medical centers from January 2012 to December 2016 were collected retrospectively, and the paired-samples t-test and two-related sample test were used to compare the differences before and after treatment.
Eight patients refused to implant an implanted pulse generator because of the unsatisfactory effect. The conversion rate was 85.2% (46/54). There were significant differences between baseline and the test period in urgency score, quality of life score, and voiding diary. Only the urgency score and residual urine showed significant differences between the latest follow-up time and the test period.
SNM is a safe and effective, minimally invasive treatment for non-neurogenic, non-obstructive dysuria. The duration of continuous stimulation may be positively correlated with the improvement of residual urine.
Our study reflects the present clinical effects of SNM in the treatment of non-neurogenic, non-obstructive dysuria patients in China. However, this study is limited by its retrospective study design. Therefore, we look forward to a future prospective study on the use of SNM for lower urinary tract dysfunction to draw a conclusion with a higher level of evidence and further guide clinical diagnosis and treatment.