Sacral Neuromodulation: Determining Predictors of Success.
Urology
; 153: 124-128, 2021 07.
Article
in En
| MEDLINE
| ID: mdl-32619594
ABSTRACT
OBJECTIVE:
To determine predictors of success for sacral neuromodulation in women with overactive bladder, urinary retention, and fecal incontinence.METHODS:
A retrospective chart review was performed on women who underwent a staged sacral neuromodulation implantation between 2007 and 2018. Clinical and procedural characteristics were recorded. Presence of intraoperative motor responses in either all 4 or <4 electrodes were used to group women. Endpoints included completion of stage II implant, tined lead revision, and patient-reported success.RESULTS:
In 198 women with a mean age of 62.9 years (SD+/- 14.7), completion of stage II implant occurred in 92.4% of women, and 83.3% of these women reported success at the first postoperative visit. Continued success at 6 months was reported in 70.3%. Lead revision was noted in 23.0%. Age >65 years (odds ratio [OR]â¯=â¯0.2, 95% confidence interval [CI]â¯=â¯0.06-0.8) and prior onabotulinumtoxinA (onaBoNT-A) (ORâ¯=â¯0.2, 95% CIâ¯=â¯0.06-0.9) were negative predictors for completion of stage II implant on multivariable analysis. Also, prior pelvic floor physical therapy was a significant negative predictor of postoperative patient-reported success on multivariable analysis (ORâ¯=â¯0.25, 95% CIâ¯=â¯0.1-0.6). There were no differences seen in women who had motor responses with either all 4 electrodes or <4 electrodes in any endpoint (P > .05).CONCLUSION:
Patient age >65 and history of prior onaBoNT-A were associated with failure to complete stage II implant. Women with prior pelvic floor physical therapy were less likely to report success after sacral neuromodulation. Motor responses in <4 electrodes during lead testing did not impact patient-reported success.
Full text:
1
Database:
MEDLINE
Main subject:
Transcutaneous Electric Nerve Stimulation
/
Pelvic Floor
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Urinary Bladder, Overactive
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Fecal Incontinence
Type of study:
Prognostic_studies
/
Risk_factors_studies
Limits:
Aged
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Female
/
Humans
/
Middle aged
Language:
En
Year:
2021
Type:
Article