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Sacral neuromodulation for nonobstructive urinary retention--is success predictable?
1Department of Urology, William Beaumont Hospital, Royal Oak, Michigan 48073, USA.
The Journal of Urology
|May 15, 2007
Summary
The ability to void before sacral nerve stimulation predicts successful outcomes for nonobstructive urinary retention. Patients who can void are more likely to benefit from permanent InterStim implantation.
Area of Science:
- Urology
- Neurology
- Neurosurgery
Background:
- Nonobstructive urinary retention (NUR) presents a significant clinical challenge.
- Sacral nerve stimulation (SNS) with InterStim is a treatment option for NUR.
- Predicting successful SNS outcomes is crucial for patient selection.
Purpose of the Study:
- To identify factors predicting successful stage II (permanent) InterStim implantation in patients with NUR.
- To evaluate the role of pre-implantation voiding ability in SNS success.
Main Methods:
- Retrospective review of 29 NUR patients undergoing SNS from 1999-2006.
- Patients completed voiding logs and a 2-week test stimulation trial.
- Success defined by ≥50% improvement in void volume or catheterization frequency.
Main Results:
- 18 of 29 patients could void pre-implantation; 12 (67%) had successful permanent SNS.
- 11 of 29 patients could not void pre-implantation; only 2 (18%) had successful SNS.
- Pre-implantation voiding ability was a statistically significant predictor of test stimulation success (p=0.02).
Conclusions:
- Patient's ability to void is a key predictor of successful first-stage SNS test stimulation.
- This finding aids in counseling patients with NUR regarding the likelihood of successful InterStim outcomes.
- SNS remains an option for patients unable to void, but with potentially lower success rates.
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