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대한배뇨장애요실금학회 International Neurourology Journal International Neurourology Journal 제20권 제3호
발행연도
2016.1
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250 - 254 (5page)

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Purpose: InterStim device is an U.S. Food and Drug Administration approved minimal invasive therapy for sacral neuromodulation for lower urinary tract dysfunction. Before InterStim implantation, a trial with the appropriate screening tests is required to determine patient therapy eligibility. There are two different techniques for patient screening: percutaneous nerve evaluation (PNE) test and staged test. Few studies have reported success and failure rates for each technique. However, test sensitivity and predictive values of either test have not been studied. The aim of our study was to determine the sensitivity and specificity of each test and to establish a decision algorithm for the most appropriate testing method to be used as a screening test. Methods: This cross-sectional study was conducted from August 2009 to February 2012 and included patients with lower urinary tract dysfunction who participated in the stimulation test trial. Patients underwent PNE as the first stimulation test, while those who encountered technical difficulty during PNE or electrode migration underwent staged testing. Results: A total of 213 patients, including 172 female and 41 male subjects, underwent PNE. The patients’ diagnoses included refractory overactive bladder (47.9%), nonobstructive urinary retention (29.6%), and frequency urgency syndrome (22.1%). A total of 202 patients were screened with PNE and 10 patients with staged testing. Overall sensitivity of PNE was 87.3%, and it was 90% for staged test. PNE specificity was 98.5% as compared to 92.9% for staged test. Positive and negative predictive values for PNE were 99% and 82.1% and for staged test were 90% and 92.9%, respectively. Conclusions: PNE test has high specificity and positive predictive value. We recommend PNE, a simple office-based, less expensive procedure as the first option for screening.
#Sacral Nerve Stimulation #Sacral Neuromodulation #Screening #Staged #Percutaneous Nerve Evaluation Test

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참고문헌 (11)

참고문헌 신청
Hassouna MM / 2000 / Sacral neuromodulation in the treatment of urgency-frequency symptoms: a multicenter study on efficacy and safety / J Urol 163:1849~1854 google schola Abrams P / 2010 / Fourth International Consultation on Incontinence Recommendations of the International Scientific Committee: Evaluation and treatment of urinary incontinence, pelvic organ prolapse, and fecal incontinence / Neurourol Urodyn 29:213~240 google schola Shaker HS / 1998 / Sacral root neuromodulation in idiopathic nonobstructive chronic urinary retention / J Urol 159:1476~1478 google schola Al-Shaiji TF / 2011 / Pelvic electrical neuromodulation for the treatment of overactive bladder symptoms / Adv Urol 2011:757454 google schola Banakhar MA / 2012 / Sacral neuromodulation and refractory overactive bladder: an emerging tool for an old problem / Ther Adv Urol 4:179~185 google schola

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