Long-term outcome of sacral neuromodulation in patients with idiopathic nonobstructive urinary retention: Single-center experience
Objective: The objective of this study was to determine the safety and efficacy of sacral neuromodulation (SNM) in patients with idiopathic nonobstructive urinary retention. Materials and Methods: We retrospectively reviewed the files of patients who underwent staged neuromodulation for idiopathic n...
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Wolters Kluwer Medknow Publications
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doaj-ba6487ebfad34c6f96ce5b501f102db12020-11-24T22:12:38ZengWolters Kluwer Medknow PublicationsUrology Annals0974-77960974-78342017-01-019324424810.4103/UA.UA_165_16Long-term outcome of sacral neuromodulation in patients with idiopathic nonobstructive urinary retention: Single-center experienceShahbaz MehmoodWaleed Mohammad AltaweelObjective: The objective of this study was to determine the safety and efficacy of sacral neuromodulation (SNM) in patients with idiopathic nonobstructive urinary retention. Materials and Methods: We retrospectively reviewed the files of patients who underwent staged neuromodulation for idiopathic nonobstructive urinary retention from 2004 to 2016 at our hospital. Patients who had a 50% improvement in symptoms after 1 week of stage 1 procedure were qualified for permanent device implantation. Patient data were assessed on efficacy and need for intermittent self-catheterization, complications, and operative revision rates. Results: Twenty-seven female patients who underwent SNM therapy were analyzed. The mean age of the patients was 32.5 ± 10.8 years. The mean duration of urinary retention was 3.2 ± 1.7 years. All patients were doing intermittent self-catheterization, but few were able to void <100 ml. Twenty-four (88.8%) of the 27 patients demonstrated a >50% improvement in symptoms and underwent permanent device placement. At a median follow-up of 5.7 ± 3.2 years, 20 (83.3%) of the 24 patients demonstrated sustained improvement rates of >50%. Seventeen (70.83%) of 24 patients could void spontaneously with a mean residual urine of 28.1 ± 24.4 ml (P < 0.001). Three (12.5%) were voiding with significant mean decreasing number of catheterizations from 5.6 ± 2.4 to 1.4 ± 2.1 (P < 0.001). Four (16.6%) had their device explanted. Ten (41.6%) of the 24 patients underwent surgical revision. Most of the adverse events were managed by device reprograming. Conclusion: SNM is a highly effective and safe procedure in this subset of the female population with idiopathic refractory nonobstructive urinary retention.http://www.urologyannals.com/article.asp?issn=0974-7796;year=2017;volume=9;issue=3;spage=244;epage=248;aulast=MehmoodFowler's syndromeidiopathic urinary retentionInterStim devicesacral neuromodulationurodynamic study |
collection |
DOAJ |
language |
English |
format |
Article |
sources |
DOAJ |
author |
Shahbaz Mehmood Waleed Mohammad Altaweel |
spellingShingle |
Shahbaz Mehmood Waleed Mohammad Altaweel Long-term outcome of sacral neuromodulation in patients with idiopathic nonobstructive urinary retention: Single-center experience Urology Annals Fowler's syndrome idiopathic urinary retention InterStim device sacral neuromodulation urodynamic study |
author_facet |
Shahbaz Mehmood Waleed Mohammad Altaweel |
author_sort |
Shahbaz Mehmood |
title |
Long-term outcome of sacral neuromodulation in patients with idiopathic nonobstructive urinary retention: Single-center experience |
title_short |
Long-term outcome of sacral neuromodulation in patients with idiopathic nonobstructive urinary retention: Single-center experience |
title_full |
Long-term outcome of sacral neuromodulation in patients with idiopathic nonobstructive urinary retention: Single-center experience |
title_fullStr |
Long-term outcome of sacral neuromodulation in patients with idiopathic nonobstructive urinary retention: Single-center experience |
title_full_unstemmed |
Long-term outcome of sacral neuromodulation in patients with idiopathic nonobstructive urinary retention: Single-center experience |
title_sort |
long-term outcome of sacral neuromodulation in patients with idiopathic nonobstructive urinary retention: single-center experience |
publisher |
Wolters Kluwer Medknow Publications |
series |
Urology Annals |
issn |
0974-7796 0974-7834 |
publishDate |
2017-01-01 |
description |
Objective: The objective of this study was to determine the safety and efficacy of sacral neuromodulation (SNM) in patients with idiopathic nonobstructive urinary retention.
Materials and Methods: We retrospectively reviewed the files of patients who underwent staged neuromodulation for idiopathic nonobstructive urinary retention from 2004 to 2016 at our hospital. Patients who had a 50% improvement in symptoms after 1 week of stage 1 procedure were qualified for permanent device implantation. Patient data were assessed on efficacy and need for intermittent self-catheterization, complications, and operative revision rates.
Results: Twenty-seven female patients who underwent SNM therapy were analyzed. The mean age of the patients was 32.5 ± 10.8 years. The mean duration of urinary retention was 3.2 ± 1.7 years. All patients were doing intermittent self-catheterization, but few were able to void <100 ml. Twenty-four (88.8%) of the 27 patients demonstrated a >50% improvement in symptoms and underwent permanent device placement. At a median follow-up of 5.7 ± 3.2 years, 20 (83.3%) of the 24 patients demonstrated sustained improvement rates of >50%. Seventeen (70.83%) of 24 patients could void spontaneously with a mean residual urine of 28.1 ± 24.4 ml (P < 0.001). Three (12.5%) were voiding with significant mean decreasing number of catheterizations from 5.6 ± 2.4 to 1.4 ± 2.1 (P < 0.001). Four (16.6%) had their device explanted. Ten (41.6%) of the 24 patients underwent surgical revision. Most of the adverse events were managed by device reprograming.
Conclusion: SNM is a highly effective and safe procedure in this subset of the female population with idiopathic refractory nonobstructive urinary retention. |
topic |
Fowler's syndrome idiopathic urinary retention InterStim device sacral neuromodulation urodynamic study |
url |
http://www.urologyannals.com/article.asp?issn=0974-7796;year=2017;volume=9;issue=3;spage=244;epage=248;aulast=Mehmood |
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