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

Abstract

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.

Impact of bladder dysfunction in the management of post radical prostatectomy stress urinary incontinence—a review

“…At this stage there are relatively few data about SNM in post RP population. For DO generally, SNM has a success rate of 53% to 80% (44-46). SNM does not cause retention and may treat the other forms of bladder dysfunction that can be found in association with DO, in particular DU, with success rates of 66.7% to 87.4% (47).…”