Percutaneous nerve evaluation in women: lessons learned

: The primary aim of this study was to identify patient characteristics potentially affecting response to office-based percutaneous nerve evaluation (PNE). Secondarily, we aimed to identify appropriate candidates to undergo office-based PNE.

: A retrospective chart review was conducted from 2000 to 2011 of female patients who underwent office-based PNE. Data were separated into 3 groups based on outcome: success, equivocal, and failure. Data examined included patient demographics, voiding dysfunction diagnosis, comorbidities, evidence of previous pelvic nerve injury, systemic hormonal status, and neurological insult of such varieties as stroke and Parkinson disease. All data were analyzed using χ analysis and analysis of variance. P < 0.05 was considered statistically significant.

: One hundred twelve women underwent office-based PNE. Seventy-four patients (66.1%) had a successful outcome, 15 (13.4%) had an equivocal outcome, and 23 patients (20.5%) failed PNE trial. Neurological insult was the only factor of significance identified in those patients with an equivocal or unsuccessful trial of office-based PNE. After categorizing body mass index according to the World Health Organization's 2011 guidelines, no significance was found for body mass index between successful outcomes, equivocal outcomes, and failures.

: Our cohort demonstrates that those patients who had an equivocal or failed outcome of office-based PNE were more likely to have a neurological insult. Patients with neurological insult who are considered appropriate candidates for neuromodulation trial should undergo staged implantation with quadruple tined lead in the operating room to provide these patients with the greatest opportunity for successful outcome.