International Neurourology Journal

Korean Continence Society (대한배뇨장애요실금학회)
권호 표지
DOI QR코드

DOI QR Code

Predictors of Nerve Stimulator Success in Patients With Overactive Bladder

  • Stensland, Kristian D. (Lahey Hospital and Medical Center) ;
  • Sluis, Bennett (Tufts University School of Medicine) ;
  • Vance, Jay (Tufts University School of Medicine) ;
  • Schober, Jared P. (Tufts University School of Medicine) ;
  • MacLachlan, Lara S. (Lahey Hospital and Medical Center) ;
  • Mourtzinos, Arthur P. (Lahey Hospital and Medical Center)
  • Received : 2018.04.15
  • Accepted : 2018.07.09
  • Published : 2018.09.30
⟨ Previous Next ⟩

Abstract

Purpose: To identify factors associated with successful sacral nerve stimulator (SNS) trial after SNS implantation for the treatment of medication refractory overactive bladder (OAB). Methods: Patients undergoing treatment for OAB at Lahey Hospital and Medical Center between 2004 and 2016 were identified. Patients undergoing SNS placement were identified; SNS success was defined as permanent implantation of the SNS. Demographic, clinical and treatment data were extracted from patient charts; uni- and multivariate analyses were conducted to identify factors associated with SNS treatment success. Results: A total of 128 patients were included. On univariate analysis, male sex, prior diagnosis of benign prostatic hyperplasia, and lower volume at first urge on urodynamics (UDS) were associated with unsuccessful SNS trial. On multivariate analysis, male sex (odds ratio [OR], 0.145; 95% confidence interval [CI], 0.036-0.530) and lower volume at first urge on UDS (OR, 0.982; 95% CI, 0.967-0.995) were associated with unsuccessful SNS trial. A threshold value of 100 mL at first urge during preoperative UDS had a specificity of 0.86 in predicting SNS success in men. Conclusions: SNS is frequently successful at relieving OAB symptoms. Male patients and those with lower volumes at first urge on UDS, particularly below 100 mL, are more likely to have an unsuccessful SNS trial. Patients in these groups should be counseled on the lower likelihood of SNS success.

Keywords

References

  1. Eapen RS, Radomski SB. Review of the epidemiology of overactive bladder. Res Rep Urol 2016;8:71-6.
  2. Gormley EA, Lightner DJ, Faraday M, Vasavada SP; American Urological Association; Society of Urodynamics, Female Pelvic Medicine. Diagnosis and treatment of overactive bladder (non-neurogenic) in adults: AUA/SUFU guideline amendment. J Urol 2015;193:1572-80. https://doi.org/10.1016/j.juro.2015.01.087
  3. Herbison GP, Arnold EP. Sacral neuromodulation with implanted devices for urinary storage and voiding dysfunction in adults. Cochrane Database Syst Rev 2009;(2):CD004202.
  4. Robin X, Turck N, Hainard A, Tiberti N, Lisacek F, Sanchez JC, et al. pROC: an open-source package for R and S+ to analyze and compare ROC curves. BMC Bioinformatics 2011;12:77. https://doi.org/10.1186/1471-2105-12-77
  5. The R Project for Statistical Computing [Internet]. Vienna (Austria): The R Project for Statistical Computing; [cited 2018 Mar 15]. Available from: https://www.R-project.org/.
  6. Olivera CK, Meriwether K, El-Nashar S, Grimes CL, Chen CC, Orejuela F, et al. Nonantimuscarinic treatment for overactive bladder: a systematic review. Am J Obstet Gynecol 2016;215:34-57. https://doi.org/10.1016/j.ajog.2016.01.156
  7. Siddiqui NY, Amundsen CL, Visco AG, Myers ER, Wu JM. Costeffectiveness of sacral neuromodulation versus intravesical botulinum A toxin for treatment of refractory urge incontinence. J Urol 2009;182:2799-804. https://doi.org/10.1016/j.juro.2009.08.031
  8. van Balken MR, Vergunst H, Bemelmans BL. Prognostic factors for successful percutaneous tibial nerve stimulation. Eur Urol 2006; 49:360-5. https://doi.org/10.1016/j.eururo.2005.10.019
  9. Yazdany T, Bhatia N, Nguyen J. Determining outcomes, adverse events, and predictors of success after sacral neuromodulation for lower urinary disorders in women. Int Urogynecol J 2011;22:1549-54. https://doi.org/10.1007/s00192-011-1512-2

Cited by

  1. Deepening Knowledge Through Basic and Clinical Research vol.22, pp.3, 2018, https://doi.org/10.5213/inj.1820edi.006
  2. Management of Overactive Bladder After Treatment of Bladder Outlet Obstruction vol.14, pp.3, 2018, https://doi.org/10.1007/s11884-019-00527-6
  3. Seasonal Variation of Drug Prescription Rate for Overactive Bladder in Men Based on National Health Insurance Claims Data, 2012–2016 vol.24, pp.3, 2020, https://doi.org/10.5213/inj.2040030.015