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In patients undergoing neuromodulation for intractable urge incontinence a reduction in 24‐hr pad weight after the initial test stimulation best predicts long‐term patient satisfaction
Author(s) -
Foster Raymond T.,
Anoia Elizabeth J.,
Webster George D.,
Amundsen Cindy L.
Publication year - 2007
Publication title -
neurourology and urodynamics
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.918
H-Index - 90
eISSN - 1520-6777
pISSN - 0733-2467
DOI - 10.1002/nau.20330
Subject(s) - medicine , sacral nerve stimulation , patient satisfaction , neuromodulation , physical therapy , logistic regression , surgery , stimulation
Aims To evaluate long‐term patient satisfaction of sacral neuromodulation and to correlate satisfaction with incontinence parameters. Methods Patients at least 1‐year remote from sacral neuromodulation were mailed a questionnaire to evaluate satisfaction and assess incontinence symptoms. Results Fifty‐two patients were consecutively enrolled in the study. Forty‐nine questionnaires (94.2%) were returned. The average interval between implantation and questionnaire completion was 27.2 (range 12–52) months. 83.7% of respondents were satisfied and 79.6% of patients would “do it all over again.” Compared to dissatisfied subjects during test stimulation, the satisfied patients had a significant decrease in 24‐hr pad weight (84.5% vs. 60.6%, P = 0.002) but did not differ in daily pad usage (4.5 fewer pads per day vs. 3.4, P = 0.190). At long‐term follow‐up, satisfied patients noted significantly greater improvement in their Incontinence Impact Questionnaire score versus dissatisfied patients (mean improvement 53 vs. 10 points, P = 0.0003). Using multiple logistic regression, change in 24‐hr pad weight, but not change in average daily pad usage, was correlated with long‐term satisfaction. Conclusions Eighty‐four percent of patients were satisfied with sacral neuromodulation at a mean of 27 months. An 84.5% reduction in 24‐hr pad weight correlated with long‐term patient satisfaction. In addition to lack of efficacy, device pain was a contributing factor to dissatisfaction. Neurourol. Urodynam. 26:213–217, 2007. © 2006 Wiley‐Liss, Inc.