A clinical observation for electric sacral neuromdulation in the treatment of secondary female overactive bladder

Abstract

Objectives To evaluate the efficacy of combined sacral nerve stimulation and Tolterodine treatments for patients with Secondary female idiopathic overactive bladder(SOAB).Methods A total of 200 Secondary female patients diagnosed with SOAB from August,2006 to August,2012 were included in the study and randomized into a solely Tolterodine treatment and a Tolterodine combined with sacral nerve stimulation group.Each group included 100 patients,which were further subdivided into 3 groups according to their symptoms of urinary frequency and urgency,urge incontinence,and both of them.In the treatment group,patients received percutaneous sacral nerve stimulation and tolterodine(2mg once daily),while in the control group,only tolterodine(2mg once daily) was administered in a course of 3 months.The voiding diary and urodynamics parameters were observed between the two groups,while patients' quality of life scores as well as their psychological depression and anxiety scores were monitored before and after the treatments.Results Though the urinary frequency as well as average urine and single urine outputs were ameliorated in the three sub-groups treated solely by tolterodine,there was no statistical significance.In contrast,the urinary frequency,average and single urine outputs in patients treated by tolterodine combined with sacral nerve stimulation were statistically significant improved (P ＜ 0.01).Particularly the conditions of first desire to void (FDV),and maximum cystometric capacity (MCBC),and maximum flow rate (Qmax) were superior and albeit the patients' urinary frequency was reduced,the daily average urine and maximum urine outputs were obviously increased with significant differences in the 3-month clinical symptoms and urodynamics parameters between the two groups(P ＜ 0.01).In addition,the results also showed that the self-rating depression scale (SDS) and self-rating anxiety scale (SAS) were reduced in both groups after the treatments (P ＜ 0.01),but with combined sacral nerve stimulation and tolterodine medication the patients' quality of life improved with statistical significance.Conclusions The combined treatment of tolterodine and sacral nerve stimulation can not only improve the voiding dysfunctions symptoms but also the concomitant depression and anxiety in patients with female SOAB,thus achieving improvement of patients'quality of life.The combined treatment efficacy is superior to a solely tolterodine medication with certain clinical significance. Key words: Urnary Bladder,Overactive; Electric Stimulation