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Efficacy of sacral neuromodulation in treatment of bladder pain syndrome: Long‐term follow‐up
Author(s) -
Ghazwani Yahya Q.,
Elkelini Mohamed S.,
Hassouna Magdy M.
Publication year - 2011
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.21037
Subject(s) - medicine , visual analogue scale , surgery , sacral nerve stimulation , urinary retention , refractory (planetary science) , percutaneous , astrobiology , physics
Aims This study was sought to evaluate the efficacy and durability of sacral neuromodulation in the treatment of bladder pain syndrome (BPS) patients. Methods A retrospective chart review was performed of patients who had unilateral sacral nerve stimulator (InterStim®) for refractory BPS between June 2002 and December 2004. Patients were qualified for permanent implantation by showing ≥50% improvement in their bladder pain and voiding symptoms 1‐week post‐percutaneous nerve evaluation (PNE). Voiding diary was completed at pre‐implantation, 1 year, and on the last visit. Urinary distress inventory short form was completed pre‐implantation and on the last visit. Bladder pain was evaluated by visual analogue scale. Primary outcome was improvement in bladder pain. Differences among groups were compared by one‐way ANOVA and t ‐test. Statistical significance was set at P ≤ 0.05. Results Twenty‐one female patients diagnosed with BPS had PNE; 11 patients (52%) showed ≥50% improvement in their bladder pain and voiding symptoms and they consider candidates for permanent implantation (Table I), while 10 patients (48%) failed to show 50% improvement in their voiding symptoms or bladder pain (Table II). In those 11 patients who underwent permanent implantation, the average patient's age was 44.3 ± 8.9 years; average time since diagnosis was 3 ±0.8 years; the average follow‐ up was 71.5 ± 9.3 months (Table III). There was significant improvement in the bladder pain and voiding parameters at 1‐year follow‐up, which was maintained at 5‐year follow‐up. There was continuous improvement in urgency (1.2 ± 0.68) at 1‐year follow‐up, and (0.98 ± 0.72) at the last visit. Average voided volume was also continuously improved from 242 ± 62.7 ml at 1‐year follow‐up to 276 ± 64.7 ml on the last visit. Conclusion Sacral neuromodulation as part of multimodal treatment provides an effective long‐term treatment option for sub‐group of refractory BPS. Neurourol. Urodynam. 30:1271–1275, 2011. © 2011 Wiley‐Liss, Inc.