Ms. Li, a 46-year-old from Yunfu, Guangdong, suffered from worsening dysuria, frequent urination and urgency, and even had to go to the toilet within ten minutes, which seriously affected her life and work.
Recently, she came to the clinic of Professor Huang Hai of the Department of Urology at Sun Yat-sen Memorial Hospital of Sun Yat-sen University, hoping to improve the “stubborn disease” through further treatment.
Figure 1: Bladder Diagram 39 Health Supplement
Professor Huang Hai learned through consultation that Ms. Li 13 years ago, there was no obvious incentive for frequent urination and urgency, accompanied by dysuria, and he went to the local hospital for repeated visits. He was considered for cystitis and treated with drugs, but the symptoms did not improve significantly. Later, the symptoms worsened significantly and he was hospitalized. He was diagnosed as “interstitial cystitis”. He underwent bladder water expansion + botulinum toxin injection, postoperative oral medication and bladder instillation, and the symptoms were relieved slightly.
But two months later, the symptoms worsened again, and in addition to repeated lower abdominal and perineal pain, the more depressing need to urinate every ten minutes . After that, I sought medical treatment for many times, but the symptoms did not get better. The symptoms even worsened, and my spirit was close to collapse…
“I heard that Professor Huang Hai is an expert in this field, so I came to try it with the last hope.” Ms. Li came to Guangzhou with the last glimmer of expectation.
Picture 2: Professor Huang Hai patiently answering the patient’s questions Photo: Xiang Wanqi
patiently listening to Ms. Li’s painful experience and seeing a doctor History, detailed review of the relevant diagnosis and treatment records, Professor Huang Hai explained that the current treatment goal of this disease is mainly to relieve symptoms and improve the quality of life.
What is interstitial cystitis?
Professor Huang Hai explained: “It is a type of chronic pelvic pain syndrome, which refers to pain and discomfort in the bladder area accompanied by at least one symptom, such as pain during storage, frequent urination during the day. Urinary tract infection and other pathological lesions are excluded at the same time.”
“At present, the etiology of interstitial cystitis is still unclear, and there are still many hypotheses. , such as occult infection, genetic factors, neurogenic inflammatory response, autoimmune disease, bladder mucosal barrier destruction, urinary toxicity, etc. Therefore, the current treatment goals mainly reduce symptoms and improve quality of life /strong>, pain control needs to be done throughout.”
In response to Ms. Li’s frequent urination, urgency and pain in urination and the ineffectiveness of conservative drug treatment , Professor Huang Hai had in-depth communication with Ms. Li and her family, and decided to implement sacral nerve stimulator implantation for her, mainly to relieve pain and discomfort, and then combined with bladder exercise to further improve the frequency and urgency of urination symptom.
What is sacral nerve stimulator implantation?
Professor Huang Hai further explained that sacral nerve stimulator implantation is a method of placing sacral nerve regulating electrodes into the contact nerve through a tiny incision in the buttocks, and regulating nerve conduction through electric current to achieve the treatment goal. kind of surgery.
Sacral nerve modulation is continuously applied to specific sacral nerves through low-frequency electrical pulses, artificially activating excitatory or inhibiting neural pathways, and modulating abnormal sacral nerve reflex arcs, which affect and regulate bladder, urethra/anal sphincter muscles , pelvic floor and other sacral nerves innervate the function of target organs to achieve therapeutic effect.
This treatment method is especially suitable for overactive bladder symptoms such as urge incontinence, frequency and urgency of urination, non-obstructive chronic urinary retention, interstitial cystitis with pain associated with bladder filling, neurogenic Patients with bladder and other urination-related diseases for whom conservative treatment is not satisfactory.
This therapy is divided into two treatment phases.
The first stage is experiential therapy: experiential therapy can allow patients to experience the actual improvement of the treatment before the pacemaker is implanted. Record the urination diary and evaluate the improvement of symptoms. If the patient can achieve symptom relief during the experience treatment and the effect is significant, the second stage of permanent implantation can be considered.
The therapy using sacral nerve stimulator has its own characteristics compared with the previous conservative therapy and drug therapy:
1. The therapy can be experienced, and the patient can experience the therapeutic effect in the temporary implantation stage;
2. As a minimally invasive surgery, the treatment is reversible, does not damage the human body, and does not cause bodily harm; 3. The treatment is controllable, and the stimulator can be adjusted according to the condition by means of special devices; 4. Clinical efficacy is widely documented.
After thorough communication, Professor Huang Hai performed a one-stage sacral nerve stimulator implantation for Ms. Li. Three days after the operation, Ms. Li said that the pain in the lower abdomen and perineum was significantly relieved, and combined with the bladder The interval between exercising and urinating can already be extended to an hour.
A week later, Ms. Li came to the outpatient clinic for a follow-up visit, indicating that the pain has basically disappeared, and the interval between urination has reached about one and a half. Hours later, I can finally go out for normal activities. And strongly demanded further two-stage sacral nerve stimulator implantation treatment.
When she came to the outpatient clinic again after the second-stage sacral nerve stimulator was implanted, Ms. Li was very happy. She said, “I have a new life and my life is finally back on track…”
< p>Professor Huang Hai finally appealed to the public: prevention is more important than cure, and you should actively practice a healthy lifestyle.It is necessary to seek medical attention as soon as possible and treat as soon as possible, so as not to delay the disease and increase the burden of disease.
Experts instructing this article:
Professor Huang Hai Deputy Director of Surgery, Sun Yat-sen Memorial Hospital of Sun Yat-sen University, Secretary of the Party Branch of Urology Department, Prostate and Lower Urinary Tract Associate Director of Disease Specialties