Initial experience with sacral neuromodulation for the treatment of lower urinary tract dysfunction in Brazil

Abstract

Objectives:We report on the short-term outcomes of sacral neuromodulation (SNM) for treatment of idiopathic lower urinary tract dysfunction in Brazil (procedures performed before 2014).Materials and Methods:Clinical data and surgical outcomes of patients who underwent SNM staged procedures were retrospective evaluated. Urological assessment included a focused medical history and physical examination, measurement of postvoid residual volumes, urodynamics, and bladder diaries. A successful test phase has been defined by improvement of at least 50% of the symptoms, based on bladder diaries.Results:From January 2011 to December 2013, eighteen consecutive patients underwent test phase for SNM due to refractory overactive bladder (15 patients), non-obstructive chronic urinary retention (2 patients), and bladder pain syndrome/interstitial cystitis (1 patient). All patients underwent staged procedures at four outpatient surgical centers. Mean age was 48.3±21.2 (range 10-84 years). There were 16 women and 2 men. Median follow-up was 3 months. Fifteen patients (83.3%) had a successful test phase and underwent implantation of the pulse generator (IPG). Median duration of the test phase was 7 days (range 5–24 days). Mean age was 45.6±18.19 years in responders versus 61.66±34.44 years in non-responders (p=0.242). Mean operative time (test phase) was 99±33.12 min in responders versus 95±35 min for non-responders (p=0.852). No severe complications were reported.Conclusion:SNM is a minimally invasive treatment option for patients with refractory idiopathic lower urinary tract dysfunction. Our initial experience with staged technique showed that tined-lead electrodes yielded a high rate of responders and favorable clinical results in the short-term follow-up.

A comparative study between sacral neuromodulation and intravesical botulinum toxin injection for patients with refractory overactive bladder

“…The early response of our patients to both types of treatment was good, with statistically significant improvements in all the voiding diary variables, which is comparable to other studies [ 10 , 11 , 13 ].…”

“…Moreover, UDS are also helpful to diagnose other causes of UI (especially stress UI) [12]. The early response of our patients to both types of treatment was good, with statistically significant improvements in all the voiding diary variables, which is comparable to other studies [10,11,13].…”

Sacral neuromodulation treatment for urinary voiding dysfunctions: results of treatment with the largest single-center series in a tertiary referral center in Turkey

“…Rios et al reported no significant complications. However, they had 10.5% rate of infection rate in their series and 2% pain at IPG site [ 28 ]. In our series we also had no significant complications.…”