Influence of patient sex on the effectiveness of sacral neuromodulation: A cohort study from China. (December 2020)

• Record Type: Journal Article
• Authors: Meng, Lingfeng; Tian, Zijian; Zhang, Wei; Zhang, Yaoguang; Wang, Jianye; Liao, Limin; Ling, Qing; Zhang, Peng; Wei, Zhongqing; Zhong, Tie; Xu, Zhihui; Wen, Wei; Li, Jiayi; Luo, Deyi
• Is Part Of: International journal of surgery. Volume 84(2020)
• Page Start: 13
• Page End: 17
• Publication Date: 2020-12
• Subjects: Patient gender -- Pelvic floor dysfunction -- Lower urinary tract disease -- Sacral neuromodulation -- Clinical efficacy; Surgery -- Periodicals; Surgical Procedures, Operative -- Periodicals; 617.005
• DOI: 10.1016/j.ijsu.2020.10.007
• Languages: English
• ISSNs: 1743-9191

Abstract

Abstract: Background: Sacral neuromodulation (SNM) has been widely used to treat lower urinary tract dysfunction. Studies have shown a higher conversion rate among female patients than among male patients. However, the influence of gender on the clinical effectiveness of SNM remains unclear. We aimed to confirm whether patients of both genders show similar benefits after SNM treatment. Materials and methods: Clinical data of patients with lower urinary tract symptoms associated with pelvic floor dysfunction (overactive bladder, neurogenic bladder, interstitial cystitis/painful bladder syndrome, idiopathic urinary retention) treated with SNM in 10 medical centres in China between January 2012 and December 2016 were retrospectively collected. The patients were classified by gender. Variations in objective (voiding diary) and subjective scores in the baseline, testing, and last follow-up periods were compared. Data were analysed using statistical measures. Results: The study included 203 patients (93 males, 110 females). There were no statistical differences in baseline information between the two groups, both groups showed improvement over time. Unsatisfactory improvement was observed in the quality of life and sexual life scores of both groups over the entire treatment period (all p ＞0.05). Although there was a difference in the maximum voiding volume between the groups at baseline, no difference was observed at the last follow-up ( p = 0.004, p = 0.044, p = 0.124), unlike in the average volume where a difference was noted at the last follow-up ( p = 0.085, p = 0.964, p = 0.031). While there were no differences in quality of life, sexual life, or pelvic pain and urinary urgency frequency scores at baseline, a significant difference was observed at the last follow-up, and the degree of improvement was less among female patients ( p = 0.836, p = 0.131, p = 0.015; p = 0.294, p = 0.265, p = 0.013; p = 0.299, p = 0.087, p = 0.015). Conclusion: SNM treatment elicited a similar effect on patients of both gender; however, a significant difference was observed regarding patient satisfaction with the treatment. Further preoperative patient education, especially, for female patients with interstitial cystitis/painful bladder syndrome may improve patient satisfaction. Highlights: The number of Sacral neuromodulation (SNM) being performed in China is increasing each year. SNM treatment had a similar effect on patients of both genders. Strengthening of patient education is needed to improve patient satisfaction.