Reduction of nocturia after sacral neuromodulation therapy for overactive bladder

摘要: Objective: To examine whether improvements in nocturia are seen following sacral neuromodulation therapy in patients treated for other lower urinary tract symptoms such as urinary urgency/frequency or urge urinary incontinence.Methods: Eighty two patients (72 women, 10 men) underwent successful sacral nerve test stimulation followed by permanent implantable pulse generator (IPG) implantation from March 2000 to October 2009. The number of nocturia episodes was recorded between pre-and postoperative periods and were stratified by age and severity of preoperative nocturia. Use of anticholinergic medication was recorded.Results: When stratified by age (< 50, 50-69,≥ 70), all groups experienced a significant decrease in nocturia episodes per night (1.82, 2.39, 1.63, respectively, p< 0.01). Age≥ 70 predicted poorer response to neuromodulation with respect to nocturia (p< 0.01). Patients presenting with minimal nocturia were less likely to experience≥ 50% decrease in nocturia episodes. Success rates were 44.4%, 66.7%, and 69.2% for groups with< 3 voids, 3-5 voids, and> 5 voids per night, respectively (p< 0.05, p= 0.191, and p= 0.448).Conclusions: Reductions in nocturia were noted in each group studied. Patients aged≥ 70 and those with< 3 preoperative nocturia episodes were not as likely to see benefit after neuromodulation. Although no causal relationship can be proven due to the limitations of the study, it appears nocturia improves following sacral neuromodulation.