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Does patient age impact outcomes of neuromodulation?
Author(s) -
Peters Kenneth M.,
Killinger Kim A.,
Gilleran Jason,
Boura Judith A.
Publication year - 2013
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.22268
Subject(s) - medicine , nocturia , overactive bladder , urology , interstitial cystitis , quality of life (healthcare) , observational study , prospective cohort study , urinary incontinence , gynecology , urinary system , pathology , alternative medicine , nursing
Aims We evaluated whether patients stratified by age have the same level of risks/benefits after a staged neuromodulation procedure for refractory voiding symptoms. Methods Urologic diagnosis, complications, and revisions were collected from medical records of adults enrolled in our prospective observational study. Symptoms were assessed over 2 years with diaries, Interstitial Symptom‐Problem Indices (ICSI‐PI), and the Overactive Bladder Questionnaire‐SF (OAB‐q SF). 12‐item Short‐Form Health Survey (SF‐12v2®) mental (MCS) and physical (PCS) component summaries evaluated quality of life. Data were examined with Pearson Chi‐square or Fisher's Exact test, Kruskal‐Wallis tests, and repeated measures analyses. Results Patients (83% female) were grouped by age (years): <40 (n = 46), 40–64 (n = 146), and ≥65 (n = 136). Urge incontinence was predominant in the older groups and more patients <40 had interstitial cystitis/painful bladder syndrome (IC/PBS). In the <40, 40–64, and ≥65 groups, respectively, generator implant (91%, 88%, and 89%) and explant (15%, 12%, and 10%) rates were similar. Complications (24%, 14%, and 9%; P = 0.031) and revisions (20%, 5%, and 6%; P = 0.0025) differed. For the three respective groups, urinary frequency ( P < 0.0001 for all), nocturia ( P < 0.0001 for all), incontinence episodes ( P < 0.0001 for all), urgency ( P = 0.0474, P < 0.0001, P = 0.0020), ICSI‐PI ( P = 0.0015, P < 0.0001, P < 0.0001), and OAB‐q scores improved over time. Incontinence severity improved in those >65 ( P = 0.0015). SF‐12 PCS improved in those 40–64 ( P = 0.0482) and MCS scores improved in the <40 and 40–64 age groups ( P = 0.013 and P = 0.0440, respectively). Conclusions These data suggest that neuromodulation success is not age dependent, however continued study is needed to confirm findings. Neurourol. Urodynam. 32: 30–36, 2013. © 2012 Wiley Periodicals, Inc.