A new surgical method for the treatment of male lower urinary tract symptoms: pudendal neuromodulation (a report of 1 cases)

Gu Y1, Fang W1, Lv T1, Lv J1, Leng J1, Xue W1, Huang Y1

Research Type

Clinical

Abstract Category

Male Lower Urinary Tract Symptoms (LUTS) / Voiding Dysfunction

Abstract 758
Non Discussion Abstracts
Scientific Non Discussion Abstract Session 36
Voiding Dysfunction Surgery Voiding Diary Neuromodulation
1. Renji Hospital affiliated to Shanghai Jiao Tong Unitversity School of Medicine
Links

Abstract

Hypothesis / aims of study
we report a new surgical method for the treatment of male lower urinary tract symptoms. The operation is minimally invasive through percutaneous intervention, and the patient is conscious during the whole operation.
Study design, materials and methods
The location of the sacral CT and the MRI scan of sacral nerve and pudendal nerve were performed before surgery. The CT and MRI data were fused and 3D formed. On the 3D model, the percutaneous needle path was designed according to the shape of the nerve, and the puncture navigation template was designed according to the positioning patch. During the operation, the optimal lateral nerve implantation electrode was selected according to the puncture navigation template.According to sacral 3 nerve low frequency, sacral 3 nerve high frequency, pudendal nerve high frequency, pudendal nerve low frequency, bilateral nerve low frequency and pudendal nerve low frequency stimulation nerve.
Results
at the end of the patient, the pudendal nerve electrodes were implanted on the left side, and the sacral 3 nerve electrodes were implanted on the right side. Compared with the sacral 3 nerve stimulation and bilateral nerve stimulation, the vaginal stimulation of the pudendal nerve could reduce the frequency of urination and urgency (19 + 3.21vs32.78 + 1.56vs24.14 + 3.13). At the same time, the low frequency stimulation of the pudendal nerve was better than the high frequency stimulation of the pudendal nerve, the low frequency of the sacral 3 nerve and the high frequency of the sacral 3 nerve. (92.93 + 9.00vs54). .22 + 30.81vs22.86 + 11.00vs33.05 + 14.70)%, especially the low frequency stimulation of pudendal nerve is the best.
Interpretation of results
pudendal nerve as a branch of sacral 3 nerve can directly treat male lower urinary tract symptoms.
Concluding message
pudendal nerve as a branch of sacral 3 nerve can directly treat male lower urinary tract symptoms. However, the location of the pudendal nerve and electrode displacement need to be solved.
Figure 1
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Disclosures
Funding None Clinical Trial No Subjects Human Ethics Committee Renji Hospital affiliated to Shanghai Jiao Tong Unitversity School of Medicine Helsinki Yes Informed Consent Yes