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Urethral instability and sacral nerve stimulation-a better parameter to predict efficacy?

P M Groenendijk¹, J P F A Heesakkers, A A B Lycklama A Nijeholt

¹Department of Urology, Leiden University Medical Center, Leiden and Radboud University Nijmegen Medical Centre, Nijmegen, The Netherlands. groenenp@rdgg.nl

The Journal of Urology

|June 16, 2007

Summary

Urodynamic parameters like urethral instability can predict sacral nerve stimulation success in voiding dysfunction. Urethral instability at baseline strongly correlated with positive outcomes in female patients.

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Area of Science:

Urology
Neurology
Medical Devices

Background:

Sacral nerve stimulation (SNS) is a treatment for refractory voiding disorders.
Predicting SNS efficacy using urodynamic parameters remains challenging.

Purpose of the Study:

To evaluate the predictive value of urethral instability and other urodynamic parameters for SNS success.
To identify reliable urodynamic markers for SNS outcomes.

Main Methods:

19 female patients with refractory voiding disorders underwent SNS.
Urodynamic assessment with urethral and bladder sensors was performed at baseline and 6 months.
Urethral instability was defined as pressure variations >15 cm H2O.

Main Results:

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SNS was successful in 13 patients (68%).
18 patients (95%) had baseline urethral instability; 12 of 13 successful patients had this finding.
Urethral instability resolved in 7 of 13 successfully treated patients.

Conclusions:

Urethral instability is a valuable urodynamic parameter for predicting SNS success.
The presence of urethral instability at baseline may indicate a favorable response to SNS.