[Short-term outcome of sacral neuromodulation on refractory interstitial cystitis/pelvic pain syndrome]

Objective: To summarize the initial experiences of applying sacral neuromodulation (SNM) for refractory interstitial cystitis/pelvic pain syndrome (IC/PPS). Methods: From January 2013 to August 2016, 26 patients with refractory IC/PPS (including 5 males and 21 females) treated with SNM were recruited in Beijing Chaoyang Hospital and Hebei Yanda Hospital in this retrospective study. The data before operation, after implantation of stage Ⅰ tined lead, and during short-term follow-up after implantation of stage Ⅱ implanted pulse generator (IPG) were compared in order to observe the improvement of relevant symptoms, and to summarize the effectiveness and safety of SNM for IC/PPS. Results: All the 26 patients received stage Ⅰ tined lead implantation under local anesthesia, of whom 7 patients finally had the tined lead removed under local anesthesia because of poor testing effects. And 19 patients chose embedding of IPG at the end of stageⅠ, with the conversion rate from stage Ⅰto stage Ⅱ being 73.1%. The mean follow-up time after stage Ⅱ was 12.1 months. The data at the end of follow-up compared with those before treatment were: voiding frequency in 24 hours 24.3±9.6 vs 13.5±5.7, nocturia 4.6±2.2 vs 2.7±1.5, average voiding amount (109.4 ±45.3)vs(172.6±61.6) ml, O'leary-sant scale score 26.0±3.1 vs 17.0±3.8, quality of life (QOL) score 5.7±0.4 vs 3.3±1.3, sex rating 5.4±1.4 vs 2.9±1.6, and Numeric Pain Intensity Scale 8.4±1.7 vs 3.9±1.2 (all P<0.05). During the follow-up period for the 19 patients, 11 showed symptoms relieve without recurrence, 5 patients had slightly symptoms recurrence and 3 patients had severe recurrence of pelvic pain and frequent urination. About 42.1%(8/19) patients received reprogramming, the average reprogramming rate being 1.73/person. And 84.2% (16/19) patients had symptoms improvement greater than 50% after stage Ⅱ IPG implantation. Conclusions: SNM is an effective, safe and minimally invasive procedure for refractory IC/PPS. IC/PPS is a good indication for SNM with a high conversion rate from stage Ⅰ to stage Ⅱ. Patients should be followed up regularly after operation, and reprogramming should be arranged according to the degree of symptom improvement.