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Minimum 6-year outcomes for interstitial cystitis treated with sacral neuromodulation.

Serge P Marinkovic1, Lisa M Gillen, Christina M Marinkovic

  • 1Department of Urology and Urogynecology, Women's and Children's Hospital, Lafayette, LA 70508, USA. urourogyn@yahoo.com

International Urogynecology Journal
|September 18, 2010
PubMed
Summary

Sacral neuromodulation significantly improves pelvic pain and urinary urgency in interstitial cystitis patients unresponsive to conventional treatments. This therapy offers a viable medium-term solution for managing recalcitrant symptoms.

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Area of Science:

  • Urology
  • Neurology
  • Pain Management

Background:

  • Interstitial cystitis (IC) is a chronic condition characterized by pelvic pain, urinary urgency, and frequency.
  • Standard drug therapies often fail to provide adequate relief for many IC patients.
  • Exploring alternative treatments like sacral neuromodulation is crucial for managing refractory IC.

Purpose of the Study:

  • To evaluate the medium-term efficacy and safety of sacral neuromodulation (SNM) in patients with interstitial cystitis.
  • To assess symptom improvement in IC patients who have not responded to conventional drug therapies.
  • To determine if SNM can be successfully implemented with acceptable morbidity rates in this patient population.

Main Methods:

  • An observational, retrospective, case-controlled study was conducted from January 2002 to March 2004.

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  • Thirty-four female patients with interstitial cystitis underwent stage 1 and 2 InterStim (sacral neuromodulation device) placements.
  • Data analysis included simple means and medians for pre- and post-operative scores and follow-up duration.

    • Main Results:

    • Significant reductions in pelvic pain and urinary urgency/frequency scores were observed post-SNM (p < 0.01).
    • Mean visual analog pain scale (VAPS) scores decreased significantly from 6.5 to 2.4 (p < 0.01).
    • The average follow-up duration was 86 ± 9.8 months (approximately 7.2 years), exceeding the 6-year minimum.

    Conclusions:

    • Sacral neuromodulation provides adequate and sustained improvement for the symptoms of recalcitrant interstitial cystitis.
    • SNM is a successful therapeutic option for medium-term management of IC in patients refractory to drug therapies.
    • The procedure demonstrated acceptable outcomes for managing debilitating IC symptoms over a minimum of six years.