Copyright
©The Author(s) 2020. Published by Baishideng Publishing Group Inc. All rights reserved.
Clinical outcomes of sacral neuromodulation in non-neurogenic, non-obstructive dysuria: A 5-year retrospective, multicentre study in China
Ling-Feng Meng, Wei Zhang, Jian-Ye Wang, Yao-Guang Zhang, Peng Zhang, Li-Min Liao, Jian-Wei Lv, Qing Ling, Zhong-Qing Wei, Tie Zhong, Zhi-Hui Xu, Wei Wen, Jia-Yi Li, De-Yi Luo
Ling-Feng Meng, Wei Zhang, Jian-Ye Wang, Yao-Guang Zhang, Department of Urology, Beijing Hospital, National Center of Gerontology, Beijing 100730, China
Peng Zhang, Department of Urology, Beijing Chaoyang Hospital, Institute of Urology, Capital Medical University, Beijing 100000, China
Li-Min Liao, Department of Urology, China Rehabilitation Research Centre, Rehabilitation School of Capital Medical University, Beijing 100000, China
Jian-Wei Lv, Department of Urology, South Campus, Renji Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai 200000, China
Qing Ling, Department of Urology, Tongji Hospital, Huazhong University of Science and Technology, Wuhan 430000, Hubei Province, China
Zhong-Qing Wei, Department of Urology, The Second Affiliated Hospital of Nanjing Medical University, Nanjing 210000, Jiangsu Province, China
Tie Zhong, Department of Urology, The Second Affiliated Hospital of Xi’an Jiaotong University, Xi’an 710000, Shaanxi Province, China
Zhi-Hui Xu, Department of Urology, Zhejiang Provincial People’s Hospital, Hangzhou 310000, Zhejiang Province, China
Wei Wen, Department of Urology, Shanghai General Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai 200000, China
Jia-Yi Li, Department of Urology, Renji Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai 200000, China
De-Yi Luo, Department of Urology, West China Hospital, Sichuan University, Chengdu 610000, Sichuan Province, China
Author contributions: Meng LF developed the protocol, analyzed the data, and wrote and edited the manuscript; Zhang W analyzed the data and wrote and edited the manuscript; Wang JY and Zhang YG developed the protocol and collected the data; Zhang P, Liao LM, Lv JW, Ling Q, Wei ZQ, Zhong T, Xu ZH, Wen W, Li JY, and Luo DY collected the data. All authors reviewed the manuscript.
Supported by National Key Research and Development Program of China, No. 2018YFC2002202.
Institutional review board statement: This study was reviewed and approved by the Ethics Committee of the Beijing Hospital.
Informed consent statement: Patients were not required to give informed consent to the study because the analysis used anonymous clinical data that were obtained after each patient agreed to treatment by written consent.
Conflict-of-interest statement: We have no financial relationships to disclose.
Data sharing statement: No additional data are available.
Open-Access: This article is an open-access article that was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution NonCommercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/
Corresponding author: Yao-Guang Zhang, MD, Doctor, Department of Urology, Beijing Hospital, National Center of Gerontology, No. 1, Dahua Road, Dongdan, Dongcheng District, Beijing 100730, China. zhang003887@sina.com
Received: February 5, 2020
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
ARTICLE HIGHLIGHTS
Research background
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.
Research motivation
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.
Research objectives
The main purpose of this study was to summarize the experience of SNM in the treatment of non-neurogenic, non-obstructive dysuria.
Research methods
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.
Research results
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.
Research conclusions
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.
Research perspectives
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.
