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Unilateral versus bilateral stage I neuromodulator lead placement for the treatment of refractory voiding dysfunction
Author(s) -
Pham Khanh,
Guralnick Michael L.,
O'Connor R. Corey
Publication year - 2008
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.20577
Subject(s) - medicine , refractory (planetary science) , stage (stratigraphy) , sacral nerve stimulation , surgery , lead (geology) , neuromodulation , retrospective cohort study , stimulation , paleontology , physics , geomorphology , astrobiology , biology , geology
Aims To determine if bilateral S3 lead placement during the stage I trial period improves the “success” rate for advancing to stage II (permanent) sacral neuromodulator placement. Methods A retrospective chart review of 124 (20 male and 104 female) patients undergoing stage I sacral neuromodulation (InterStim®, Medtronic, Minneapolis, Minnesota) implantation for the treatment of refractory voiding dysfunction was performed. Patients were divided into two cohorts based on unilateral versus bilateral stage I lead placement in the S3 foramina. Both groups were then evaluated and compared with regards to overall “success”, defined as progression from stage I to stage II placement. Results Fifty‐five (44%) patients underwent unilateral stage I lead placement and 69 (56%) received bilateral S3 leads. Successful stage I trials were reported in 32/55 (58%) and 53/69 (76%) of unilateral and bilateral cohorts, respectively (P = 0.03). Five wound infections were reported—2 (3.6%) following unilateral and 3 (4.3%) after bilateral stage I lead placement. No other complications were encountered. Conclusions Bilateral stage I neuromodulation trial provides a significantly higher rate of improvement in refractory voiding symptoms to allow for the progress to stage II implantation. Neurourol. Urodynam. 27:779–781, 2008, © 2008 Wiley‐Liss, Inc.