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Long‐term follow‐up of sacral neuromodulation for lower urinary tract dysfunction
Author(s) -
Peeters Karlien,
Sahai Arun,
De Ridder Dirk,
Van Der Aa Frank
Publication year - 2014
Publication title -
bju international
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.773
H-Index - 148
eISSN - 1464-410X
pISSN - 1464-4096
DOI - 10.1111/bju.12571
Subject(s) - medicine , urinary retention , sacral nerve stimulation , implant , surgery , urinary system , psychological intervention , tertiary referral hospital , retrospective cohort study , psychiatry
Objective To report our long‐term experience of sacral neuromodulation ( SNM ) for various lower urinary tract dysfunctions but with a focus on efficacy, safety, re‐interventions and degree of success. Patients and Methods This is a single tertiary referral centre study that included 217 patients (86% female) who received an implantable pulse generator ( IPG ) ( I nterstim™, M edtronic, M inneapolis, USA ) between 1996 and 2010. Success was considered if the initial ≥50% improvement in any of primary voiding diary variables persisted compared with baseline, but was further stratified. Results The mean duration of follow‐up was 46.88 months. Success and cure rates were ≈70% and 20% for urgency incontinence, 68% and 33% for urgency frequency syndrome and 73% and 58% for idiopathic retention. In those patients with an unsuccessful therapy outcome, the mean time to failure was 24.6 months after implantation. There were 88 (41%) patients who had at least one device or treatment related surgical re‐intervention. The re‐intervention rate was 1.7 per patient with most of them (47%) occurring ≤2 years of follow‐up. Conclusions SNM appears effective in the long‐term with a success rate after definitive IPG implant of ≈70% and complete cure rates ranging between 20% and 58% depending on indication. Patients with idiopathic retention appear to do best. The re‐intervention rate is high with most occurring ≤2 years of implantation. It is likely that with the newer techniques used, efficacy and re‐intervention rates will improve.