Sacral neuromodulation in urological indications: The Finnish experience

Vaarala, Markku H.; Tammela, Teuvo L.J.; Perttilä, Ilkka; Luukkonen, Pekka; Hellström, Pekka

doi:10.3109/00365599.2010.523013

Cited by 7 publications

(4 citation statements)

References 20 publications

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“…Our series is consistent with most retrospective studies reporting on a global SNM experience, which included a predominant population of refractory OAB patients and fewer patients with urinary retention or BPS/IC ( 9 , 10 ).…”

Section: Discussionsupporting

confidence: 87%

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

et al. 2016

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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.

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Section: Discussionsupporting

confidence: 87%

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

et al. 2016

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“…Several authors have demonstrated that advanced patient age, male gender, increased duration of symptoms and the presence of concomitant medical comorbidities decrease the likelihood of success following SNM. [13][14][15][16] The two cohorts examined in our study were similar in age, gender distribution and overall health. As a result, we do not believe that sampling error contributed to our results.…”

Section: Discussionmentioning

confidence: 64%

Sacral neuromodulation outcomes for the treatment of refractory idiopathic detrusor overactivity stratified by indication – lack of anticholinergic efficacy versus intolerability

Davis

Makovey

Guralnick

et al. 2013

CUAJ

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Introduction: Patients may fail oral overactive bladder therapies due to either poor drug efficacy or intolerability. We determined if the success of sacral neuromodulation varies if performed secondary to lack of anticholinergic efficacy versus drug intolerability. Methods: A retrospective review was performed on 152 patients undergoing staged sacral neuromodulation from 2004 to 2010 for refractory idiopathic detrusor overactivity with or without urge incontinence. Outcomes following sacral neuromodulation trials were compared based on the primary indication for anticholinergic failure: lack of drug efficacy versus intolerable side effects. Results: Overall, successful sacral neuromodulation trials were reported in 70% (106/152) of patients. Successful outcomes were noted in 70% (89/128) and 71% (17/24) of patients with poor anticholinergic efficacy and drug intolerability, respectively (p = NS). Conclusions: We found no significant difference in outcome success in patients undergoing sacral neuromodulation trials for refractory detrusor overactivity due to lack of anticholinergic efficacy versus intolerability.

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“…2,[24][25][26][27] Studies on sacral neuromodulation demonstrated that all improvement of quality of life and subjective symptoms. 2,[28][29][30][31] The FDA has already approved injection of intradetrusor onabotulinumtoxinA (100U) as a third-line treatment in nonneurogenic OAB patients. 2 Indwelling catheters remain the last treatment option and are not recommended for OAB.…”

Section: Discussionmentioning

confidence: 99%

A survey on the management of overactive bladder by Indonesian urologists

Tirtayasa

Rahardjo

2015

Med J Indones

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Background: Overactive bladder (OAB) is a clinical syndrome consisting of symptom complex of urgency, with or without incontinence which has significant effects on quality of life and has to be managed properly. The aim of this study was to review the management of OAB by Indonesian urologists.Methods: A self-constructed questionnaires containing diagnostic and treatment options of OAB patients were distributed to Indonesian urologists. This was a cross-sectional study and descriptive analysis method was used to analyze the data.Results: 129 Indonesian urologists participated in this study. Most of them faced more than 20 OAB cases per year with the most common type was OAB without incontinence or dry OAB (57.4%). Most urologists (34.1%) ordered at least three diagnostic tools to determine OAB. They were bladder diary, urinalysis and scoring system. The most used scoring system (48.9%) was the overactive bladder symptoms score (OABSS). Thirty-five point seven percents (35.7%) of urologists used antimuscarinic and behavioral therapy as initial therapy. Solifenacin 5 mg/day was the most common antimuscarinic prescribed as the first line therapy (48%). Most common items commonly evaluated for follow-up: symptoms (96.9%), bladder diary (72.9%); and drug’s side effect (58.1%). When initial therapy had failed, most of the urologists (54.3%) chose to increase the dose of antimuscarinic. None of them chose bladder botulinum toxin injection as their additional therapy.Conclusion: OAB is a frequent disorder which remains a challenge for urologists. The management of patients with OAB by Indonesian urologists has been suitable with the previous studies and guidelines.

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Sacral neuromodulation in urological indications: The Finnish experience

Cited by 7 publications

References 20 publications

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

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

Sacral neuromodulation outcomes for the treatment of refractory idiopathic detrusor overactivity stratified by indication – lack of anticholinergic efficacy versus intolerability

A survey on the management of overactive bladder by Indonesian urologists

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