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Title
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A supervised 3 weeks test phase in sacral neuromodulation with a 1-year followup
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Author
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Abstract
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| Purpose: We sought to determine whether prolonged interventional test phase increases cumulative success rate and compared success rates between early responders (ie within 1 week) and those in need for reprogramming (due to lack of efficacy) of sacral neuromodulation after 1-year followup. Materials and Methods: In a single tertiary center prospective study (August 2015 to November 2018) 90 patients refractory to first line treatment were eligible for sacral neuromodulation, including 48 overactive bladder wet (53%), 8 overactive bladder dry (9%) and 34 nonobstructive urinary retention (38%). Patients were evaluated at weekly intervals during test phase and those not successful were reprogrammed. This could be repeated after the second week. Primary outcome was success rate after 3-week test phase and after 1-year followup. Statistical analysis was done by nonparametric tests for numeric (Mann-Whitney U) and categorical (chi(2)) data. Results: After 3 weeks of test period 56 patients (62%) were considered successful. Prolonged interventional testing increased cumulative success. A 1-year followup showed no significant difference in success rate between early responders and those in need for reprogramming (chi(2), p = 0.562). There was no difference in age (Mann-Whitney U, p = 0.222), sex (chi(2), p = 0.952) or indication (chi(2), p = 0.975). Conclusions: A 3-week test phase with close followup increases cumulative success rate. During this supervised 3-week test phase 42% of the initial non-responders after the first week became successful candidates after reprogramming. Patients who required this additional programming did equally as well as those without need for reprogramming. A supervised 3-week test phase is therefore strongly recommended. |
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Language
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English
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Source (journal)
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The journal of urology. - Baltimore, Md
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Publication
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Baltimore, Md
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2021
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ISSN
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0022-5347
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DOI
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10.1097/JU.0000000000001317
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Volume/pages
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205
:1
(2021)
, p. 206-212
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ISI
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000597318700045
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Pubmed ID
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32716692
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Full text (Publisher's DOI)
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