Female UrologyIncidence and Predictors of Complications With Sacral Neuromodulation
Section snippets
Material and Methods
After obtaining institutional review board approval, a prospective, longitudinal, observational study was performed to define the incidence and predictors of complications associated with SNS. All patients presented with subjective complaints of refractory urinary urgency and frequency, urge incontinence, or urinary retention. Patients underwent a complete history and physical examination, urinalysis, and urine culture. A 1-week voiding log was obtained, and the patients were subsequently
Results
From September 13, 2001 to March 1, 2008, 221 patients were evaluated and deemed appropriate candidates for SNS. The indication for intervention in the 188 women and 33 men was refractory urinary urgency/frequency (n = 121), urge incontinence (n = 63), and refractory urinary retention (n = 37). The mean age of the cohort was 48.77 years (range 18-88). The mean BMI was 28.61 kg/m2 (range 15.9-52.7). Of the 221 patients, 8 were confined to a wheelchair. Of the 221 patients, 83 were commercially
Comment
Tanagho and Schmidt5 first reported on the use of SNS for the treatment of refractory lower urinary tract dysfunction in 1981. Nearly 16 years later, the Food and Drug Administration approved the first commercially available SNS device (InterStim) for the treatment of refractory urinary urgency/frequency and urge incontinence. Two years later, InterStim was approved for the treatment of nonobstructive urinary retention. Since its approval, numerous retrospective studies and prospective trials
Conclusions
Sacral neuromodulation is an effective treatment option for select patients with refractory voiding dysfunction. Although complications and revisions should be expected, improved patient selection could help to avoid many of these untoward events. Future multicenter trials are needed to corroborate these findings and should address not only objective outcomes and overt complications, but also quality-of-life indexes as markers of success.
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Cited by (0)
C. Dobmeyer-Dittrich is a nonpaid educator for Medtronic.