Percutaneous Nerve Evaluation in Women

Crites-Bachert, Melanie; Mukati, Marium; Sorial, Andrew; Ghoniem, Gamal M.

doi:10.1097/spv.0b013e318239b57d

Cited by 5 publications

(8 citation statements)

References 16 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…Of the 24 PNE nonresponders, 8 patients (33.3%) had either Parkinson's disease or unspecified dementia. These findings are supported by Crites‐Bachert et al, 18 who previously demonstrated that patients with an equivocal or failed PNE outcome were more likely to have a neurological insult, and Amundsen et al 20 who suggested that neurologic conditions may be associated with decreased cure rates. Patients with neurologic bladder disorders appear to benefit from a two‐staged SNM approach, as Wallace et al noted that 28 of 33 neurogenic patients (85%) proceeded to permanent implant following successful tined lead screening, including 4 of 6 patients (67%) with Parkinson's disease 21 .…”

Section: Discussionmentioning

confidence: 56%

“…The current study is limited by its retrospective design. Due to the small cohort with neurologic conditions, our results highlighting this comorbidity as predictive of PNE failure may be subject to type 1 statistical error; however, previous studies with comparable sample sizes have supported this claim 18,20 . Ultimately, larger studies investigating this patient population are necessary to fully confirm these findings.…”

Section: Discussionmentioning

confidence: 70%

“…Due to the small cohort with neurologic conditions, our results highlighting this comorbidity as predictive of PNE failure may be subject to type 1 statistical error; however, previous studies with comparable sample sizes have supported this claim. 18,20 Ultimately, larger studies investigating this patient population are necessary to fully confirm these findings. The availability of fluoroscopy may be a limiting factor for some clinical settings to replicate our results, yet this study did include an unselected group of patients with OAB syndrome that can be applicable to community practice.…”

Section: Discussionmentioning

confidence: 88%

“…Another study evaluating PNE with fluoroscopy in 112 patients reported 66% success and included 9 patients (8%) with UR 18 . While UR was not statistically significant as a characteristic in patients with an equivocal or failed trial of PNE, there was a strong trend toward UR as a potential cause of failure, and the authors advocated for a two‐stage procedure in this patient population 18 …”

Section: Discussionmentioning

confidence: 99%

“…Additionally, their cohort included 35 patients (37%) with chronic UR, and the proportion of patients with UR that underwent either PNE or staged implant was not specified, but it was noted that indication did not differ between these techniques 8 . Another study evaluating PNE with fluoroscopy in 112 patients reported 66% success and included 9 patients (8%) with UR 18 . While UR was not statistically significant as a characteristic in patients with an equivocal or failed trial of PNE, there was a strong trend toward UR as a potential cause of failure, and the authors advocated for a two‐stage procedure in this patient population 18 …”

Section: Discussionmentioning

confidence: 99%

See 4 more Smart Citations

Predictive factors of PNE success in a contemporary series: A single institution experience

Kocher

Derisavifard

Rueb

et al. 2020

Neurourology and Urodynamics

View full text Add to dashboard Cite

Peripheral nerve evaluation (PNE) permits a trial of sacral neuromodulation to determine candidates for single stage implant. Before routine fluoroscopy, PNE success rates were 40%-50% compared to approximately 77% with staged procedures. There are limited data on PNE success rates with the use of fluoroscopy and improved techniques. We evaluated a contemporary series of PNE patients to determine predictors of PNE success and persistent functional response following permanent implantation. Methods: A retrospective review of PNE patients at a large academic center from 2015 to 2019 was performed. Patients with urgency-frequency, urge incontinence, and/or fecal incontinence (FI) were included. Rates of permanent implant after successful PNE trial and continued improvement at ≥1 month were reviewed. Multivariable logistic regression determined predictors of PNE success and continued response at follow-up. Results: A total of 102 PNE patients were included. A total of 78 patients (76.5%) were PNE responders. Predictors of PNE success included younger age (p = .014), urgency incontinence (p = .021), FI (p = .017), absence of a neurologic diagnosis (p = .04), presence of bellows and toe responses (p = .038), and perineal sensation (p = .027). A total of 68 of 78 PNE responders (87.2%) maintained optimal responses at ≥1 month. Absence of a neurologic diagnosis was predictive of persistent success at follow-up (p = .013). Conclusions: This contemporary PNE series revealed screening success equivalent to a two-staged approach. A small proportion of patients demonstrate suboptimal responses following permanent implant. Conversion from testing to permanent implant may not be the ideal outcome as it may overestimate success, and evaluation for persistent improvement should be investigated further as a more reliable indicator of successful screening.

show abstract

Section: Discussionmentioning

confidence: 56%

Section: Discussionmentioning

confidence: 70%

Section: Discussionmentioning

confidence: 88%

Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

See 3 more Smart Citations

Predictive factors of PNE success in a contemporary series: A single institution experience

Kocher

Derisavifard

Rueb

et al. 2020

Neurourology and Urodynamics

View full text Add to dashboard Cite

show abstract

Prospective, multicenter study to evaluate performance and safety of a re‐engineered temporary lead for InterStim™ therapy evaluation

Michaels¹,

Margolis

Harris-Hicks

et al. 2022

Neurourology and Urodynamics

View full text Add to dashboard Cite

Aims The basic evaluation or percutaneous nerve evaluation (PNE) is a method to assess pre‐implantation therapeutic response in patients considering sacral neuromodulation for the treatment of refractory overactive bladder. A new PNE lead with a more robust design and greater distensibility designed to reduce the possibility of lead migration has recently been introduced to the market. The aim of this prospective, multicenter, global, postmarket study was to evaluate the clinical performance and safety of the new InterStim PNE lead with the foramen needle. Methods Patients with overactive bladder were enrolled in this study. The primary objective of this study was to determine the proportion of subjects who demonstrated motor or sensory response(s) during lead placement using the InterStim PNE lead. Additional measures included the Patient Global Impression of Improvement (PGI‐I), patient satisfaction at the end of therapy evaluation, and change in bladder symptoms from baseline to the end of therapy evaluation (1‐week follow‐up visit). Results One‐hundred and ten subjects met the inclusion and exclusion criteria and underwent a lead implant procedure. Of those, 108 had a successful procedure and 107 completed the 1‐week follow‐up visit. Ninety‐nine percent of subjects (109/110) had a motor or sensory response during needle placement (95% confidence interval [CI]: 95%–100%) and 97% of subjects (107/110) had a motor or sensory response during lead placement (95% CI: 92%–99%). The majority of subjects (88%, 95/108) reported their bladder condition was better at the follow‐up visit compared to before the PNE implant procedure, as reported in PGI‐I. Subjects reported being satisfied with how the therapy impacted their voiding symptoms (82%, 88/108) and that they would recommend this therapy (87%, 94/108) to other patients. Symptom improvement was demonstrated with urinary urge incontinence subjects having an average of 4.2 ± 3.4 urinary incontinence episodes/day at baseline and 2.2 ± 2.5 at follow‐up, and urinary frequency subjects having an average of 12.5 ± 4.4 voids/day at baseline and 10.5 ± 4.3 voids/day at follow‐up. Lead removal was deemed to be easy and safe by the implanting physician, with a total of three adverse device effects in 3/110 subjects. No event was categorized as serious and all were resolved without sequelae. Conclusions The updated InterStim PNE lead with a more robust design and greater distensibility designed to reduce migration was shown to have a high rate of motor or sensory response during lead placement. Furthermore, subjects reported high rates of global improvements and amelioration of symptoms, and the lead was easy to remove with minimal morbidity.

show abstract

Optimizing Neuromodulation Testing—Who, When, and How?

Rueb

Goldman

2020

Curr Bladder Dysfunct Rep

View full text Add to dashboard Cite

Percutaneous Nerve Evaluation in Women

Cited by 5 publications

References 16 publications

Predictive factors of PNE success in a contemporary series: A single institution experience

Predictive factors of PNE success in a contemporary series: A single institution experience

Prospective, multicenter study to evaluate performance and safety of a re‐engineered temporary lead for InterStim™ therapy evaluation

Optimizing Neuromodulation Testing—Who, When, and How?

Contact Info

Product

Resources

About