Re-operation rates after permanent sacral nerve stimulation for refractory voiding dysfunction in women

Area of Science:

• Urology
• Neuromodulation
• Medical Devices

Background:

• Sacral nerve stimulation (SNS) is a treatment for lower urinary tract dysfunction.
• The Interstim device has been used for SNS since 1998.
• Understanding re-operation rates is crucial for long-term patient management.

Purpose of the Study:

• To evaluate the development and effectiveness of screening tests for sacral nerve stimulation (SNS).
• To determine re-operation rates and their characteristics after permanent implantation of the Interstim device.
• To identify factors influencing the success and longevity of SNS therapy.

Main Methods:

• Retrospective chart review of women undergoing SNS between January 1998 and December 2005.
• Analysis of demographic, clinical, and surgical data.
• Statistical comparison of response rates between peripheral nerve evaluation (PNE) and staged tined leads.

Main Results:

• Tined lead implantation yielded higher response rates (67%) compared to PNE (40%).
• Urinary retention showed the highest response rate (71%).
• Revisions occurred in 33% and explants in 15% of implanted devices, primarily due to loss of efficacy or pain.

Conclusions:

• The staged tined-lead technique for SNS demonstrates superior efficacy over PNE.
• Unobstructive urinary retention is a strong indicator for successful SNS.
• The timing of re-operations for SNS implants is often predictable based on the reason for intervention.