Sacral Neuromodulation: Determining Predictors of Success

To determine predictors of success for sacral neuromodulation in women with overactive bladder, urinary retention, and fecal incontinence. A retrospective chart review was performed on women who underwent a staged sacral neuromodulation implantation between 2007 and 2018. Clinical and procedural cha...

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Bibliographic Details
Published in:Urology (Ridgewood, N.J.) N.J.), 2021-07, Vol.153, p.124-128
Main Authors: Morgan, Tara Nikonow, Pace, Natalie, Mohapatra, Anand, Ren, Dianxu, Kunkel, Gregory, Tennyson, Lauren, Shepherd, Jonathan P., Chermansky, Christopher J.
Format: Article
Language:English
Subjects:
Age Factors
Aged
Electrodes, Implanted
Fecal Incontinence - physiopathology
Fecal Incontinence - therapy
Female
Humans
Lumbosacral Plexus - physiology
Middle Aged
Patient Reported Outcome Measures
Pelvic Floor - physiopathology
Predictive Value of Tests
Sacrum
Transcutaneous Electric Nerve Stimulation - adverse effects
Transcutaneous Electric Nerve Stimulation - instrumentation
Transcutaneous Electric Nerve Stimulation - methods
Treatment Outcome
Urinary Bladder, Overactive - physiopathology
Urinary Bladder, Overactive - therapy
Urinary Retention - physiopathology
Urinary Retention - therapy
Women's Health
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Summary:To determine predictors of success for sacral neuromodulation in women with overactive bladder, urinary retention, and fecal incontinence. A retrospective chart review was performed on women who underwent a staged sacral neuromodulation implantation between 2007 and 2018. Clinical and procedural characteristics were recorded. Presence of intraoperative motor responses in either all 4 or 65 years (odds ratio [OR] = 0.2, 95% confidence interval [CI] = 0.06-0.8) and prior onabotulinumtoxinA (onaBoNT-A) (OR = 0.2, 95% CI = 0.06-0.9) were negative predictors for completion of stage II implant on multivariable analysis. Also, prior pelvic floor physical therapy was a significant negative predictor of postoperative patient-reported success on multivariable analysis (OR = 0.25, 95% CI = 0.1-0.6). There were no differences seen in women who had motor responses with either all 4 electrodes or .05). Patient age >65 and history of prior onaBoNT-A were associated with failure to complete stage II implant. Women with prior pelvic floor physical therapy were less likely to report success after sacral neuromodulation. Motor responses in
ISSN:0090-4295
1527-9995
DOI:10.1016/j.urology.2020.06.023