Efficacy Of Electrical Pudendal Nerve Stimulation And Sacral Neuromodulation In Treating Non-obstructive Neurogenic Urinary Retention:A Comparative Study

Objective To Observe the clinical effects and make a comparative study between efficacy of electrical pudendal nerve stimulation(EPNS)and sacral neuromodulation(SNM),objectively evaluate the advantages of electrical pudendal nerve stimulation(EPNS)in the treatment of neurogenic non-obstructive urinary retention,and provide a new method for the treatment of the disease.Methods According to the place of treatment,70 patients with non-obstructive neurogenic urinary retention who met the inclusion criteria were divided into group EPNS and SNM.All patients signed the informed consent.In the electro-acupuncture group,four sacrococcygeal points will be needled with long needles to stimulate the pudendal nerve.Sacral nerve stimulator was used in sacral nerve regulation group to stimulate sacral nerve.Baseline assessment was performed before treatment in both groups.After 4 weeks of treatment,the bladder residual urine volume,ICIQ-LUTS score and ICIQ-LUTSqol score were compared to analyze the differential efficacy between the two different treatments on non-obstructive neurogenic urinary retention.Data analysis is conducted using SPSS 21.0.Result1.Contradistinction of the bladder residual urine volume: In group of electrical pudendal nerve stimulation(EPNS)the bladder residual urine volume of the of pre-treatment and after 4-week-treatment were 200.00(150.00-400.00),66.50(15.00-126.00)respectively;In group of sacral neuromodulation the bladder residual urine volume of the of pre-treatment of pre-treatment,after4-week-treatmentafter were 260.00(181.00-332.00)and 100.00(66.85-180.50)respectively.There was significant difference in bladder residual urine volume between the two groups after treatment(P<0.05).2.Comparison of ICIQ-LUTS score between two groups:In group of electrical pudendal nerve stimulation(EPNS),the scores of male patients before treatment and after 4-week-treatment were 32.87±7.38 and 19.07±11.32 respectively.the scores of female patients before treatment and after 4-week-treatment were 17.50(13.00-23.50)and 9.50(7.00-12.50)respectively.In group of sacral neuromodulation(SNM),the scores of male patients before treatment and after 4-week-treatment were 30.65±8.61 and 26.59±8.45 respectively.the scores of female patients before treatment and after4-week-treatment were 16.50(14.00-19.00)and 12.50(10.00-15.00)respectively.After treatment,there were statistical differences in the ICIQ-LUTS scores between the two groups(P<0.05).The ICIQ-LUTS scores of the two groups decreased with the increase of the number of treatments.3.Comparison of ICIQ-LUTSqol score between two groups : In group of electrical pudendal nerve stimulation(EPNS),the ICIQ-LUTSqol score of the of pre-treatment and after 4-week-treatment were 49.49±11.13 and 31.29±10.16 respectively.In group of sacral neuromodulation(SNM)the ICIQ-LUTSqol score of the of pre-treatment and after 4-week-treatmentafter were 50.86±6.59 and 41.74±9.47 respectively.After 4 weeks of treatment,there were significant differences in the ICIQ-LUTSqol scores between the two groups and within the group(P<0.05).4.Compare the effective rate of the bladder residual urine volume reduction between two groups: After 4-week-treatment,clinical efficacy rate was 82.85% in group of electrical pudendal nerve stimulation(EPNS),while clinical efficacy rate was 65.71% in group of sacral neuromodulation(SNM).There was no significant difference in clinical efficacy between the two groups after 4 weeks of treatment(P>0.05).5.Compare the effective rate of the clinical symptom score reduction after 4weeks between two groups: After 4-week-treatment,clinical efficacy rate was 60.00%in group of electrical pudendal nerve stimulation(EPNS),while clinical efficacy rate was 31.42% in group of sacral neuromodulation(SNM).After 4 weeks of treatment,there was a significant difference in the clinical efficacy between the two groups(P<0.05).6.Compare the effective rate of the comprehensive score reduction rate after 4weeks between two groups: After 4-week-treatment,clinical efficacy rate was 77.14%in group of electrical pudendal nerve stimulation(EPNS),while clinical efficacy rate was 37.14% in group of sacral neuromodulation(SNM).There was statistical difference in the total effective rate of comprehensive improvement index between the two groups.Conclusion1.The electrical pudendal nerve stimulation(EPNS)therapy and the sacral neuromodulation(SNM)therapy all can reduce the patients' bladder residual urine volume,ICIQ-LUTS score and ICIQ-LUTSqol scores.The scores of each index decreased with the increase of treatment time.2.After 4 weeks of treatment,the bladder residual urine volume,ICIQ-LUTS score and ICIQ-LUTSqol score decreased in the group of electrical pudendal nerve stimulation(EPNS)were greater than those in the group of sacral neuromodulation(SNM).3.After 4 weeks of treatment,the effective rate of clinical symptom score reduction and comprehensive score reduction rate in the group of electrical pudendal nerve stimulation(EPNS)were better than those in the group of sacral neuromodulation(SNM).4.The efficacy of electrical pudendal nerve stimulation(EPNS)therapy is better than that of sacral neuromodulation(SNM)therapy.