SCOTTSDALE, AZ USA (UroToday.com) - Drs. Steven Siegel and Suzette Sutherland moderated the podium session for Neuromodulation/OAB. Notable presentations were:
“Pudendal neuromodulation after failed sacral stimulation” (Presented by Kenneth Peters, MD).
Dr. Peters’ group retrospectively reviewed 48 patients who underwent pudendal neuromodulation (PNM) after failing SNM. He compared them to 55 patients with no prior sacral neuromodulation (SNM). The most common indications for implantation included: Overactive bladder with urinary incontinence (37.5%) and then, interstitial cystitis/bladder pain syndrome (22.9%). There were no significant differences in baseline voiding patterns between the two groups.
At 24-months post implantation follow up, a similar and durable response was demonstrated in both groups. There was a non-significant difference in reoperation rates and lead migration rates (4% versus 5%). He noted that PNM is an off label use of InterStim®.
“Results of a prospective, multicenter study evaluating the efficacy and safety of sacral. neuromodulation through 36 months in subjects with symptoms of overactive bladder” (Presented by Steven Siegel, MD).
Inclusion criteria was defined as refractory idopathic overactive bladder where the patients had failed at least one anticholinergic.
Patients were excluded from the study if they were diagnosed with a neurologic overactive bladder, mixed urinary incontinence (symptoms of both stress urinary incontinence and overactive bladder, or the patient expereinced pain as a primary symptom.
Two hundred sixteen patients we included in the 36-month follow up.
Success was defined as a greater than 50% reduction in leaks per day, voids per day, or a return to normal ( < 8 voids per day).
Baseline patient characteristics included that ninety-one percent of patients were female and a mean age of 57 years. Patients had a baseline of 3.1 leaks per day and 13 voids per day.
The responder rate at 3 years was 83%. Urinary incontinence patients had a mean reduction from baseline of 2.3 incontinence episodes per day (p < 0.0001). Patients with urinary frequency experienced a reduction from baseline of 5.3 voids per day (p < 0.0001).
The most common adverse events were undesirable change in sensation (18%), pain at implantation site (12%), and lack of efficacy (7%). There was a 12% device explantation rate.
The authors concluded that SNM is safe and effective through 36-months of follow up. The study will continue to follow patients out to 5 years.
Moderated by Steven W. Siegel, MD and Suzette E. Sutherland, MD at the Society of Urodynamics, Female Pelvic Medicine and Urogenital Reconstruction (SUFU) Winter Meeting - February 24 - 28, 2015 - JW Marriott Camelback Inn Resort & Spa - Scottsdale, AZ USA
Reported for UroToday by Drew Freilich, MD. Dr. Freilich is a graduate of the University of Massachusetts Medical School and completed his urology residency at New York Medical College/Westchester Medical Center. He is currently a fellow in Female Urology, Neurourology and Reconstructive Urology at Medical University of South Carolina. He has authored more than 40 peer-reviewed articles, monographs, abstracts, and book chapters and abstracts. Dr. Freilich is a member of the American Urological Association and the Society for Urodynamics and Female Urology.