Since the development of sacral neuromodulation (SNM) a large number of patients with lower urinary tract symptoms (LUTS) have been treated with SNM. A test stimulation is performed prior to implantation. In centres worldwide the duration of this test stimulation varies considerably since it is not certain when the onset of the therapy effect can be expected. The objective of this prospective study is to evaluate the average onset time of SNM in patients with LUTS.
All patients who were eligible for treatment with SNM were asked to participate. A voiding diary was filled out prior to and during test stimulation using an implanted tined lead. Success was defined as a ≥50% improvement in any of the main complaint parameters compared to baseline. The Mann Whitney U test was used to compare the mean time to success between OAB and NOR patients.
In total 45 patients, 24 with non-obstructive urinary retention (NOR) and 21 with overactive bladder syndrome (OAB) agreed and were included. Test stimulation was successful in 29 patients (64%). Mean time to success for all patients was 3.3 days (range 1-9). There was no significant difference in mean time to success between OAB and NOR patients (3.25 and 3.5, p=0.76).
The results implicate that a test stimulation of more than two weeks is not necessary if a cut off of ≥50% improvement is adopted. However, further improvement can be expected with prolonged test stimulation. This might be important since this might have implications for results on long term.
The Journal of urology. 2017 Dec 29 [Epub ahead of print]
R Jairam, J Drossaerts, T Marcelissen, G van Koeveringe, Ph Van Kerrebroeck
Department of Urology, Maastricht University Medical Centre (MUMC+), The Netherlands; School of Mental Health and Neuroscience (MHeNS), Maastricht University, The Netherlands. Electronic address: ., Department of Urology, Maastricht University Medical Centre (MUMC+), The Netherlands; School of Mental Health and Neuroscience (MHeNS), Maastricht University, The Netherlands., Department of Urology, Maastricht University Medical Centre (MUMC+), The Netherlands; School of Mental Health and Neuroscience (MHeNS), Maastricht University, The Netherlands; Pelvic Care Centre Maastricht, Maastricht University Medical Centre, Maastricht, The Netherlands.