Résultats de la neuromodulation des racines sacrées postérieures sur les troubles mictionnels et impact sur la sexualité à partir d’une étude monocentrique

Abstract

The objective of this study was to evaluate the results of S3 sacral neuromodulation on certain voiding disorders (overactive bladder and chronic retention) and its impact on the sexuality of these patients.A S3 sacral root neuromodulator was implanted in 41 patients with a mean of age of 53 years between January 1999 and March 2004. This study comprised two groups: one group composed of patients with overactive bladder (32 subjects) and the other composed of patients with chronic retention without obstruction (nine subjects).The mean follow-up of this study was 34 months (range: 12 to 72 months). In the group of patients with overactive bladder, after the operation, the daily voiding frequency decreased from 20.8 to 7.8 (p<0.0001), episodes of incontinence decreased from 3.7 to 1.4 per day (p<0.0001), the number of pads decreased from 2.5 to 1 per day (p<0.001) and 72% of these patients reported an improvement of their continence time. In the group with chronic retention, the number of intermittent self-catheterizations decreased from 4.77 to 0.44 per day (p=0.0169) and 72% of these patients resumed spontaneous voiding (7/9). Among this patient population, 41.5% reported sexual problems, which were improved after implantation of the neurostimulator in 41.2% of cases.In the light of these results, sacral neuromodulation appears to be an effective treatment for certain refractory chronic voiding disorders such as overactive bladder and chronic retention without obstructive syndrome. This study showed that improvement of clinical signs could have a positive impact on the sexuality of these patients, especially for patients with chronic retention without obstruction.