Implantable Neuromodulation for Neurogenic Lower Urinary Tract Dysfunction: A Single-Institution Retrospective Study
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Purpose: Neurogenic lower urinary tract dysfunction (NLUTD) is highly prevalent among patients with neurologic disorders. Some studies have demonstrated that implantable neuromodulation can improve symptoms of NLUTD. We seek to describe our experience with sacral and pudendal neuromodulation in patients with NLUTD. Methods: A retrospective chart review of patients with “neurogenic bladder” ICD-9/10 (International Classification of Diseases, Ninth Revision/10th Revision) code was performed at a single institution. This included patients from 2008 to 2020 who underwent stage 1 neuromodulation trial. Demographic and clinical information was collected, including neurologic diagnosis, the character of patients’ voiding symptoms, the presence or absence of fecal incontinence, the need for intermittent catheterization, and whether patients had sufficient (>50%) improvement in their symptoms to undergo stage 2 implantable pulse generator (IPG) placement. Results: We identified 82 patients with neurologic diagnoses who underwent stage 1 neuromodulation. The most common diagnoses were diabetic cystopathy (17.07%), spinal surgery (17.07%), and spinal cord injury (12.20%). The most commonly reported symptoms were urinary urgency, and urge urinary incontinence. Overall, 59 patients (71.95%) advanced to stage 2 IPG placement including 72% of patients with sacral leads and 76% with pudendal leads. Conclusions: Neuromodulation is feasible and effective in the treatment of NLUTD. Further investigation into its utilization is warranted.
Abstract
Purpose: Neurogenic lower urinary tract dysfunction (NLUTD) is highly prevalent among patients with neurologic disorders. Some studies have demonstrated that implantable neuromodulation can improve symptoms of NLUTD. We seek to describe our experience with sacral and pudendal neuromodulation in patients with NLUTD. Methods: A retrospective chart review of patients with “neurogenic bladder” ICD-9/10 (International Classification of Diseases, Ninth Revision/10th Revision) code was performed at a single institution. This included patients from 2008 to 2020 who underwent stage 1 neuromodulation trial. Demographic and clinical information was collected, including neurologic diagnosis, the character of patients’ voiding symptoms, the presence or absence of fecal incontinence, the need for intermittent catheterization, and whether patients had sufficient (>50%) improvement in their symptoms to undergo stage 2 implantable pulse generator (IPG) placement. Results: We identified 82 patients with neurologic diagnoses who underwent stage 1 neuromodulation. The most common diagnoses were diabetic cystopathy (17.07%), spinal surgery (17.07%), and spinal cord injury (12.20%). The most commonly reported symptoms were urinary urgency, and urge urinary incontinence. Overall, 59 patients (71.95%) advanced to stage 2 IPG placement including 72% of patients with sacral leads and 76% with pudendal leads. Conclusions: Neuromodulation is feasible and effective in the treatment of NLUTD. Further investigation into its utilization is warranted.
참고문헌 (27)
- Gajewski JB, "An International Continence Society(ICS)report on the terminology for adult neurogenic lower urinary tract dysfunction(ANLUTD)", Neurourol Urodyn, 37, pp.1152~1161 (2018)
- Hohenfellner M, "Chronic sacral neuromodulation for treatment of neurogenic bladder dysfunction : long-term results with unilateral implants", Urology, 58, pp.887~892 (2001)
- Burks FN, "Neuromodulation and the neurogenic bladder", Urol Clin North Am, 37, pp.559~565 (2010)
- Liechti MD, "Sacral neuromodulation for neurogenic lower urinary tract dysfunction", NEJM Evid, 1, pp.EVIDoa2200071~ (2022)
- Dorsher PT, "Neurogenic bladder", Adv Urol, 2012, pp.1~16 (2012)
- Guitynavard F, "Percutaneous posterior tibial nerve stimulation(PTNS)for lower urinary tract symptoms(LUTSs)treatment in patients with multiple sclerosis(MS) : a systematic review and meta-analysis", Mult Scler Relat Disord, 58, pp.103392~ (2022)
- Zillioux J, "SUFU white paper on overactive bladder anticholinergic medications and dementia risk", Neurourol Urodyn, 41, pp.1928~1933 (2022)
- Cooley LF, "A review of botulinum toxin a for the treatment of neurogenic bladder", PM R, 11, pp.192~200 (2019)
- Nitti V, "Treatment of neurogenic detrusor overactivity and overactive bladder with Botox(onabotulinumtoxinA) : development, insights, and impact", Medicine(Baltimore), 102(S1), pp.e32377~ (2023)
- "Summary of Safety and effectiveness data: implantable electrical stimulator for incontinence" (2011)[URL]
- Wang CN, "Neuromodulation for lower urinary tract symptoms in special populations", Neurourol Urodyn, 41, pp.1948~1957 (2022)
- Sanford MT, "Neuromodulation in neurogenic bladder", Transl Androl Urol, 5, pp.117~126 (2016)
- Lombardi G, "Sacral neuromodulation for neurogenic non-obstructive urinary retention in incomplete spinal cord patients : a ten-year follow-up singlecentre experience", Spinal Cord, 52, pp.241~245 (2014)
- Chen G, "The effect of sacral neuromodulation in ambulatory spina bifida patients with neurogenic bladder and bowel dysfunction", Urology, 153, pp.345~350 (2021)
- Chaabane W, "Sacral neuromodulation for treating neurogenic bladder dysfunction : clinical and urodynamic study", Neurourol Urodyn, 30, pp.547~550 (2011)
- Engeler DS, "Sacral neuromodulation for the treatment of neurogenic lower urinary tract dysfunction caused by multiple sclerosis : a single-centre prospective series", BMC Urol, 15, pp.105~ (2015)
- Chen G, "Sacral neuromodulation for neurogenic bladder and bowel dysfunction with multiple symptoms secondary to spinal cord disease", Spinal Cord, 53, pp.204~208 (2015)
- Masood I, "Sacral neuromodulation in patients with neurogenic lower urinary tract dysfunction : a multicenter retrospective study from China", Neuromodulation, 24, pp.1278~1283 (2021)
- Wöllner J, "Sacral neuromodulation in patients with neurogenic lower urinary tract dysfunction", Spinal Cord, 54, pp.137~140 (2016)
- Seif C, "Findings with bilateral sacral neurostimulation : sixty-two PNEtests in patients with neurogenic and idiopathic bladder dysfunctions", Neuromodulation, 7, pp.141~145 (2004)
- Peters KM, "Clinical outcomes of sacral neuromodulation in patients with neurologic conditions", Urology, 81, pp.738~744 (2013)
- Banakhar MA, "Sacral neuromodulation for neurological diseaseinduced lower urinary tract symptoms in Saudi Arabia : a singlecentre experience", J Int Med Res, 50, pp.030006052211172~ (2022)
- Omri SG, "Feasibility of sacral neuromodulation in patients with underlying neurologic lower urinary tract dysfunction and fecal incontinence", Urology, 188, pp.54~62 (2024)
- Minardi D, "Sacral neuromodulation in patients with multiple sclerosis", World J Urol, 30, pp.123~128 (2012)
- Marinkovic SP, "Sacral neuromodulation for multiple sclerosis patients with urinary retention and clean intermittent catheterization", Int Urogynecol J, 21, pp.223~228 (2010)
- Wallace PA, "Sacral nerve neuromodulation in patients with underlying neurologic disease", Am J Obstet Gynecol, 197, pp.96~ (2007)
- van Ophoven A, "Systematic literature review and meta-analysis of sacral neuromodulation(SNM)in patients with neurogenic lower urinary tract dysfunction(nLUTD) : over 20 years’ experience and future directions", Adv Ther, 38, pp.1987~2006 (2021)