Therapeutic effect of sacral nerve stimulation for neurogenic bladder / 中华神经医学杂志

Objective To observe the therapeutic effect of the sacral nerve stimulation (SNS)on the neurogenic bladder. Methods SNS was used to treat 94 patients with neurogenic bladder. The ICI-Q-SF scores, voiding diary (including urinary incontinence times, urinal pad test, urination times,nocturia times and urinary volume) and urine dynamics test (including bladder volume, pressure of detrusor, maximum urinary flow rate, average urinary flow rate, pressure of bladder neck, maximal urethral pressure, functional urethral length and residual urine volume) were observed before and 1 week after SNS. And the data was analyzed statistically. Results The ICI-Q-SF scores were 17.2±1.8 before the treatment of SNS and 8.3±1.6 after SNS (P＜0.05). The urinary incontinence times, urination times and nocturia times were significantly decreased (P＜0.05) compared with those before treatment. The weight of urinal pads was lessened significantly (P＜0.05), while the urinary volumes were increased significantly (P＜0.05). The bladder volume, the maximum urinary flow rate and the average urinary flow rate were increased significantly (P＜0.05) while the residual urine volumes were decreased significantly (P＜0.05). There were no differences in pressure of detrusor, pressure of bladder neck, maximal urethral pressure and functional urethral length (P＞0.05). No complication occurred in our study and total effective rate was 75.5%. Conclusions The therapeutic effect of SNS on the neurogenic bladder is sure, and the symptom of the neurogenic bladder is well improved with few complications. It should be widely used.

Transurethral resection of bladder tumor under block anesthesia of bilateral obturator nerves / 中国微创外科杂志

Objective To study the safety and efficacy of transurethral resection of bladder tumor(TURBt)under block anesthesia of bilateral obturator nerves.Methods Seventy-seven patients were chronologically divided into two groups.Forty-six of patients with lateral,bilateral or multiple tumors in the bladder,which underwent transurethral resection of bladder tumor under epidural anesthesia from April 2003 to October 2004,were chosen as the Control Group.Thirty-one patients whom were administrated with epidural anesthesia plus bilateral block of the obturator nerve from October 2004 to July 2005 served as the Study Group.Incidences of bladder perforation and obturator nerve reflex were compared between the two groups.Results In the Control Group,obturator nerve reflex occurred in 25 patients(including intense reflex in 11 patients),giving an incidence of 54.3%(25/46),and bladder perforation resulted from the reflex was observed in 8 patients,with an incidence of 17.3%(8/46).In the Study Group,slight obturator nerve reflex happened in 3 patients(9.9%,3/31)and bladder perforation was found in 1 patient(3.2%,1/31).A significant higher rate of obturator nerve reflex was noted in the Control Group than in the Study Group(?2=15.970,P=0.000),but no statistical difference was seen in bladder perforation rate between the two groups(?2=2.359,P=0.125).Conclusions Bilateral block of the obturator nerve can improve the safety remarkably during transurethral resection of bladder tumor,especially when the tumor was located in the lateral bladder wall.

DETERMINATION OF STRESS LEAK POINT PRESSURE IN THE DIAGNOSIS OF FEMALE STRESS URINARY INCONTINENCE / 解放军医学杂志

0 05). SLPP determation is helpful in the assessment of the type of genuine female stress urinary incontinence and is therefore valuable in its management.