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Master Thesis

Évaluation rétrospective à long terme des patients porteurs d’un neurostimulateur de Brindley suivis au CHU de Bordeaux : évolution de la place du dispositif dans l’arsenal thérapeutique des vessies neurogènes spinales

Abstract : Introduction: Brindley’s device is an implanted anterior sacral roots stimulator for patients with complete spinal cord injury. It allows obtaining triggered micturitions with an external box. Objective: after a review of the literature, the objective was to evaluate the long-term use of Brindley’s device in patients who had been implanted in Bordeaux University Hospital (BUH) between 1987 and 2016. Secondary objectives were to identify technical failures and their resolution, and to evaluate patients’ general satisfaction after a long-term use. Materials and Methods: this is a descriptive retrospective study. Data were collected from electronic or archived medical files in BUH. Patients’ satisfaction was evaluated with a questionnaire performed by telephone. Analyses were performed with Excel® and survey analyses were performed according to the Kaplan-Meier method with R® software. Results: 49 patients were implanted in BUH between 1987 and 2016. Eleven patients are deceased (22.4%), 5 were lost to follow-up (10.5%), and the remaining 32 patients were contacted by telephone. The mean follow-up duration was 16 years. Of the 33 alive patients, 18 (54.5%) are still using the device as a daily voiding way. The mean duration of use for the entire cohort was 14.5 years. General satisfaction for interviewed patients was 87.5%. Paraplegic women and quadriplegic men were the most satisfied groups (89.1% and 95%, respectively). Conclusion: Brindley’s device has already proven itself clinically, for urodynamics and for the quality of life of spinal cord injury patients. This study confirmed the benefits it could provide for these patients, with a mean follow-up duration of 16 years. However, the device is less and lessoffered, for multiple reasons: epidemiology, new therapeutics, economics, medical and surgery practices. Neurostimulator indications are delicate because it’s definitive and mutilating. Research on optimization of surgical procedures for implantation is ongoing.
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Master Thesis
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https://dumas.ccsd.cnrs.fr/dumas-01653724
Contributor : Bu Carreire Université de Bordeaux <>
Submitted on : Friday, December 1, 2017 - 6:07:36 PM
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Louise Debergé. Évaluation rétrospective à long terme des patients porteurs d’un neurostimulateur de Brindley suivis au CHU de Bordeaux : évolution de la place du dispositif dans l’arsenal thérapeutique des vessies neurogènes spinales . Médecine humaine et pathologie. 2017. ⟨dumas-01653724⟩

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