Number of active electrodes at time of staged tined lead interstim implant does not impact clinical outcomes

Gilleran, Jason; Killinger, Kim A.; Boura, Judith; Peters, Kenneth M.

doi:10.1002/nau.22766

Cited by 20 publications

(39 citation statements)

References 16 publications

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“…Many subsequent series have shown excellent symptom benefit before the concept of lead optimization was widely suggested. However, it is unknown if the overall degree of symptom relief could potentially have been greater, and the rate of screen failure, re‐operation, or eventual therapy abandonment might have been reduced within these study populations, had lead optimization been a standard . Another unknown is whether the demands for precise lead placement may differ for various indications.…”

Section: Implant Techniquementioning

confidence: 99%

International Continence Society best practice statement for use of sacral neuromodulation

Goldman

Lloyd

Noblett

et al. 2018

Neurourology and Urodynamics

137

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Section: Implant Techniquementioning

confidence: 99%

International Continence Society best practice statement for use of sacral neuromodulation

Goldman

Lloyd

Noblett

et al. 2018

Neurourology and Urodynamics

137

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show abstract

“…Sensory, levator ani and foot/big toe movement were used to indicate an appropriate electrode position. Number of electrodes per stimulation at stage implant did not make a difference in the outcome, despite a higher voltage needed for a <4 electrode stimulation [15]. Most of the implanters in this survey consider a 2-4 electrode position as being required for a good position.…”

Section: Discussionmentioning

confidence: 67%

Sacral Neuromodulation: A Worldwide Survey Conducted Among Surgeons

Ghazi¹

2017

JURNOA

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Aim and Objectives: The purpose of this study was to conduct a pre-guideline survey of surgeons involved in InterStim® therapy for Sacral Neuromodulation (SNM). The data gathered from the survey may serve as an important baseline in the development of a guideline for SNM implantation.Methods: Surgeons implanting SNM were surveyed using an Internet-based program between November and April of 2016. The survey was posted on the included a questionnaire.We used a questionnaire that covered various clinical aspects involved in the delivery of SNM. The questionnaire was posted on-line via Survey Monkey for a period of 5 months. The entire process was under the auspices of the Neurourology Promotion Committee of the International Continence Society (ICS).Results: 49 surgeons who are involved in SNM implant filled out the survey. We searched the literature about the best practices in those areas of interest in the delivery of SNM. We found a discrepancy in the surgical approach for SNM. Based on the results of the survey, we found discrepancies in the following areas: preoperative evaluation: voiding diary, X-ray of sacrum, uroflowmetry, urodynamic study and cystoscopic evaluation. Screening: percutaneous nerve evaluation versus stage implant. Surgical technique: anesthesia used position of electrode in sacral foramina, type of stylet and number of optimum electrodes used for stimulation. Postoperative: duration of antibiotic and number of programs given to the patient. Those differences were not based on any scientific basis in the literature rather on individual practice. Conclusion:In the current manuscript, we described the different nuances in the standard of practice for surgeons involved in the delivery of SNM therapy.As evidenced by the discrepancy in the responses, we think that this is the initial step in the preparation for a guideline describing the best policy to deliver the SNM.

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“…According to Gilleran, the number of active electrodes at the time of staged tined‐lead InterStim implantation does not affect clinical outcomes . However, in our clinical practice, we believed that more sensitive electrode contacts could provide more options for electrode combinations and extend the length of therapy.…”

Section: Discussionmentioning

confidence: 94%

Evaluation of sacral neuromodulation system with new six‐contact points electrode in pigs

Wang

Liu

Cong

et al. 2019

Neurourology and Urodynamics

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Aims We investigated the effects of sacral neuromodulation using the new six‐contact electrode vs the four‐contact electrode in pigs. Methods Randomly, a six‐contact electrode was implanted in eight pigs in one side of the third sacral (S3) foramen, and a four‐contact electrode was implanted in the other side using the same method. Using an external neurostimulator, the number of contact points (sensitive voltage ≤ 2 V) of both electrodes (SacralStim and InterStim systems) was calculated. Cystometry was performed by infusing normal saline or acetic acid. Then sacral neuromodulation with the SacralStim and InterStim systems was induced at a voltage at which we could observe perianal and/or tail movement. Multiple cystometrograms were performed to determine the effects of the two systems on the micturition reflex. Results The mean number of sensitive points of six‐contact electrodes of the SacralStim system (2.63 ± 0.32) was higher than that of the quadripolar‐lead electrodes of the InterStim system (1.38 ± 0.18), and the difference was statistically significant (P < 0.05). Acetic acid‐induced bladder overactivity significantly reduced bladder capacity to 54.89% ± 4.7% of the normal saline control level. During acetic acid infusion, sacral neuromodulation with the SacralStim system suppressed bladder overactivity and significantly increased bladder capacity to 70.41% ± 5.4% of the normal saline control level, compared with the acetic acid level ( P < 0.05). Moreover, sacral neuromodulation with the InterStim system also significantly increased bladder capacity to 69.63% ± 5.3% of the normal saline control level, compared with the acetic acid level ( P < 0.05). No significant differences were found in the results obtained using the two systems ( P > 0.05). Conclusions The six‐contact electrode of the SacralStim system had more sensitive points (<2 V) than that of the quadripolar‐lead electrode of InterStim system. Potentially, it has more postimplantation programming options and battery savings manifested by lower voltage will increase the longevity of the stimulator. Further studies of sacral neuromodulation with six‐contact electrodes in clinical practice are needed.

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Number of active electrodes at time of staged tined lead interstim implant does not impact clinical outcomes

Cited by 20 publications

References 16 publications

International Continence Society best practice statement for use of sacral neuromodulation

International Continence Society best practice statement for use of sacral neuromodulation

Sacral Neuromodulation: A Worldwide Survey Conducted Among Surgeons

Evaluation of sacral neuromodulation system with new six‐contact points electrode in pigs

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