The Impact of Baseline Functional Bladder Capacity on Short Term Neuromodulation Outcomes

• Published in: Urology (Ridgewood, N.J.) N.J.), 2017-04, Vol.102, p.68-72
• Main Authors: Killinger, Kim A, Gupta, Priyanka, Gilleran, Jason P, Bartley, Jamie, Ehlert, Michael, Boura, Judith A, Peters, Kenneth M
• Format: Article
• Language: English
• Subjects: Electric Stimulation Therapy; Female; Humans; Male; Middle Aged; Prospective Studies; Time Factors; Urinary Bladder - physiopathology; Urinary Bladder Diseases - physiopathology; Urinary Bladder Diseases - therapy; Urodynamics; Urology
• ISSN: 0090-4295; 1527-9995
• DOI: 10.1016/j.urology.2017.01.008

Abstract Objectives To evaluate the impact of functional bladder capacity (FBC) on clinical outcomes after a staged neuromodulation procedure. Methods Adults in our prospective neuromodulation database were evaluated. Data were collected from medical records, voiding diaries (FBC defined as average volume per void), Interstitial Cystitis Symptom/Problem Indices (ICSI−PI), Overactive Bladder Questionnaires (OAB-q), and Global Response Assessments over 3 months. Descriptive statistics, Pearson's Chi-square tests, Wilcoxon rank sum tests, logistic regression, repeated measures analyses and Spearman Correlation Coefficients were performed. Results Of 216 patients (mean age 59 years; 84% female), most had urinary urgency/frequency with/without urge incontinence (71%), a sacral lead placed (82%) and implantable pulse generator (IPG) implantation (92%). Baseline FBC was similar between implanted/not implanted patients (p=0.17), however implanted patients had a median 19 ml increase in FBC after lead placement compared to a 2.7 ml decrease in explanted patients (p=0.0014). There was a strong association between percent change in FBC after lead placement and IPG implantation (p=0.021; C-statistic 0.68) but baseline FBC (ml) was not associated. Baseline FBC (ml), or percent change in FBC after lead placement, was not related to symptom improvement. When grouped by baseline FBC