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Published on: April 25, 2017
Long term results of neuromodulation by sacral nerve stimulation for lower urinary tract symptoms: a retrospective
A C van Voskuilen1, D J A J Oerlemans, E H J Weil
1Department of Urology, University Hospital Maastricht, Maastricht, the Netherlands. Anco.vanvoskuilen@gmail.com
Objective:
To analyse the influence of technical improvements of Sacral Nerve Stimulation (SNS) on the incidence of surgical interventions and subjective long-term results of SNS.
Methods:
Retrospective, transversal study analyzing records of implanted patients at our department of Urology.
Results:
Of 149 patients analyzed, 107 had overactive bladder symptoms and 42 had urinary retention. Mean follow-up was 64,2 (sd = 38,5) months. In the whole group 194 adverse events occurred. 6 Patients had infection in their implanted system, one was explanted for infection. Most events could be solved by giving advice or by reprogramming the stimulator. 129 reoperations have been performed and 21 patients had their system explanted. Analysis of the data shows a striking difference in the incidence of reoperations, but small differences in subjective results in the groups of patients implanted before or after 1996, suggesting that a proactive approach towards adverse events is worthwhile.
Conclusions:
SNS gives lasting benefit in patients with refractory symptoms of overactive bladder and non-obstructive urinary retention. The differences in outcomes and incidence of reoperation can be attributed to the learning curve and technical and surgical improvements in the application of SNS.