INTRODUCTION AND OBJECTIVES: To report our long term experience of sacral neuromodulation for various lower urinary tract dysfunction but with a focus on efficacy, safety, re-interventions and degree of success.
PATIENTS AND METHODS: This is a single tertiary referral centre study which included 217 patients (86% female) who received an implantable pulse generator (IPG) (Interstim™, Medtronic, Minneapolis, USA) between 1996 and 2010. Success was considered if the initial 50 % or more improvement in any of primary voiding diary variables persisted compared to baseline, but was further stratified.
RESULTS: Median length of follow-up was 46.88 months. Success and cure rates were approximately 70% and 20% for urgency incontinence, 68% and 33% for urgency frequency syndrome and 73% and 58% for idiopathic retention. In those patients with an unsuccessful therapy outcome, mean time to failure was 24.6 months after implantation. There were 88 (41%) patients who had at least 1 device or treatment related surgical re-intervention. Re-intervention rate was 1.7 per patient with most of them (47%) occurring within 2 years of follow-up.
CONCLUSIONS: SNM appears efficacious in the long term with a success rates after definitive IPG implant of approximately 70% and complete cure rates ranging between 20-58% depending on indication. Patients with idiopathic retention appear to do best. Re-intervention rate is high with the majority occurring within 2 years of implantation. It is likely that with the newer techniques employed, efficacy and re-intervention rates will improve.
Written by:
Peeters K, Sahai A, de Ridder D, van der Aa F. Are you the author?
Department of Urology, University Hospitals Leuven, Belgium; Department of Development and Regeneration, KU Leuven, Belgium.
Reference: BJU Int. 2013 Nov 15. Epub ahead of print.
doi: 10.1111/bju.12571
PubMed Abstract
PMID: 24238278
UroToday.com Overactive Bladder (OAB) Section
