Sacral neuromodulation for neurogenic lower urinary tract dysfunction: systematic review and meta-analysis.

Détails

ID Serval
serval:BIB_64E932E2B05B
Type
Article: article d'un périodique ou d'un magazine.
Collection
Publications
Titre
Sacral neuromodulation for neurogenic lower urinary tract dysfunction: systematic review and meta-analysis.
Périodique
European Urology
Auteur⸱e⸱s
Kessler T.M., La Framboise D., Trelle S., Fowler C.J., Kiss G., Pannek J., Schurch B., Sievert K.D., Engeler D.S.
ISSN
1873-7560 (Electronic)
ISSN-L
0302-2838
Statut éditorial
Publié
Date de publication
2010
Volume
58
Numéro
6
Pages
865-874
Langue
anglais
Notes
Publication types: Journal Article ; Meta-Analysis ; Research Support, Non-U.S. Gov't ; ReviewPublication Status: ppublish
Résumé
CONTEXT: Treatment of neurogenic lower urinary tract dysfunction (LUTD) is a challenge, because conventional therapies often fail. Sacral neuromodulation (SNM) has become a well-established therapy for refractory non-neurogenic LUTD, but its value in patients with a neurologic cause is unclear.
OBJECTIVE: To assess the efficacy and safety of SNM for neurogenic LUTD.
EVIDENCE ACQUISITION: Studies were identified by electronic search of PubMed, EMBASE, and ScienceDirect (on 15 April 2010) and hand search of reference lists and review articles. SNM articles were included if they reported on efficacy and/or safety of tested and/or permanently implanted patients suffering from neurogenic LUTD. Two reviewers independently selected studies and extracted data. Study estimates were pooled using Bayesian random-effects meta-analysis.
EVIDENCE SYNTHESIS: Of the 26 independent studies (357 patients) included, the evidence level ranged from 2b to 4 according to the Oxford Centre for Evidence-Based Medicine. Half (n=13) of the included studies reported data on both test phase and permanent SNM; the remaining studies were confined to test phase (n=4) or permanent SNM (n=9). The pooled success rate was 68% for the test phase (95% credibility interval [CrI], 50-87) and 92% (95% CrI, 81-98%) for permanent SNM, with a mean follow-up of 26 mo. The pooled adverse event rate was 0% (95% CrI, 0-2%) for the test phase and 24% (95% CrI, 6-48%) for permanent SNM.
CONCLUSIONS: There is evidence indicating that SNM may be effective and safe for the treatment of patients with neurogenic LUTD. However, the number of investigated patients is low with high between-study heterogeneity, and there is a lack of randomised, controlled trials. Thus, well-designed, adequately powered studies are urgently needed before more widespread use of SNM for neurogenic LUTD can be recommended.
Mots-clé
Adult, Electric Stimulation Therapy/adverse effects, Electric Stimulation Therapy/instrumentation, Evidence-Based Medicine, Female, Humans, Implantable Neurostimulators, Lumbosacral Plexus/physiopathology, Male, Middle Aged, Treatment Outcome, Urinary Tract/innervation, Urination, Urologic Diseases/physiopathology, Urologic Diseases/therapy, Young Adult
Pubmed
Web of science
Création de la notice
05/11/2014 12:13
Dernière modification de la notice
20/08/2019 14:21
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