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Published on: August 28, 2020
[Sacral neuromodulation as treatment of non-neurological vesical emptying disorders]
N Bakrim1, É Chabannes2, P Detree2
1Service d'urologie andrologie et transplantation rénale, CHRU Minjoz, Besançon, France; Université de Franche Comte, Besançon, France.
Goal:
The goal was to evaluate the results of sacral neuromodulation (SNM) in non-neurological vesical emptying disorders.
Patients And Methods:
From February 2010 to October 2017, 28 patients presenting voiding symptoms or a non-obstructive chronic urine retention without neurological cause have been operated for an SNM (test phase). The test was positive in case of decreased number of proper intermittent self-catheterization (SC) or post-voiding residual urine (PVR) of at least 50 %. A 100 % positive result meant the return to a spontaneous voiding without SC with a non-significative PVR (<100ml).
Results:
The median follow-up was of 53.2±21.2 months. Twenty-four (85.7%) tests were positive, from which twenty-two (78.6%) were 100% positive. 16 (84.2%) out of 19 patients with SC had spontaneous voiding without PVR. The number of daily SC decreased from 4.6±1.5 to 0.4±1.2 in post-operative (P<0.001). The PVR was of 287.1±170.4ml vs. 30.4±48.6ml in post-operative (P<0.001). Fourteen patients (58.3%) underwent at least one chirurgical revision or a removal of material ; mainly for loss of efficiency, end of battery, electrode migration and pain on material. At the end of the follow-up, 70.8% of the responding patients had their device still efficient.
Conclusion:
Results showed that SNM appears to be an efficient treatment of non-neurological emptying vesical troubles. Nevertheless, the re-operation rate was still significant.
Level Of Evidence:
3.
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