Sacral neuromodulation therapy for urinary and defecatory disorders: experience in a Latin American public hospital.

Marcelo Mass-Lindenbaum, Diego Arévalo-Vega, Isidora Aleuanlli, Fernanda Santis-Moya, Andrea Maluenda, Eitan Dines, Miriam Cohen-Vaizer, Álvaro Saavedra, Trinidad Raby, Bernardita Blumel, Rodrigo Cuevas, Simone Pohlhammer, Gabriela Alarcon, Marco Arellano Albornoz, Javier Pizarro-Berdichevsky
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Abstract

Objective: To show the experience of a Latin American public hospital, with SNM in the management of either OAB, NOUR or FI, reporting feasibility, short to medium-term success rates, and complications.

Methods: A retrospective cohort was conducted using data collected prospectively from patients with urogynecological conditions and referred from colorectal surgery and urology services between 2015 and 2022.

Results: Advanced or basic trial phases were performed on 35 patients, 33 (94%) of which were successful and opted to move on Implantable Pulse Generator (GG) implantation. The average follow-up time after definitive implantation was 82 months (SD 59). Of the 33 patients undergoing, 27 (81%)reported an improvement of 50% or more in their symptoms at last follow-up. Moreover, 30 patients (90%) with a definitive implant reported subjective improvement, with an average PGI-I "much better" and 9 of them reporting to be "excellent" on PGI-I.

Conclusion: SNM is a feasible and effective treatment for pelvic floor dysfunction. Its implementation requires highly trained groups and innovative leadership. At a nation-wide level, greater diffusion of this therapy among professionals is needed to achieve timely referral of patients who require it.

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骶神经调节疗法治疗排尿和排便障碍:拉丁美洲一家公立医院的经验。
目的展示拉丁美洲一家公立医院在使用SNM治疗OAB、NOUR或FI方面的经验,报告可行性、中短期成功率和并发症:方法:利用2015年至2022年期间从结肠直肠外科和泌尿科转诊的泌尿妇科疾病患者中收集的前瞻性数据,进行回顾性队列研究:对35名患者进行了高级或基础试验阶段,其中33人(94%)成功选择了植入式脉冲发生器(GG)。最终植入后的平均随访时间为 82 个月(标准差为 59 个月)。在接受治疗的 33 名患者中,有 27 人(81%)在最后一次随访时报告症状改善了 50% 或更多。此外,30 名接受最终植入手术的患者(90%)报告主观症状有所改善,平均 PGI-I 为 "大为改善",其中 9 人报告 PGI-I 为 "极佳":SNM是治疗盆底功能障碍的一种可行而有效的方法。结论:SNM 是一种可行且有效的盆底功能障碍治疗方法,其实施需要训练有素的团队和创新的领导力。在全国范围内,需要在专业人员中更广泛地推广这种疗法,以便及时转诊需要治疗的患者。
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