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Reoperation after sacral neuromodulation therapy: a single-institution experience
Cheryl Shih1, Jane L Miller, Michael Fialkow
1Department of Urology, University of Washington, Seattle, WA 98195, USA. csshih@uw.edu
Female Pelvic Medicine & Reconstructive Surgery
|April 25, 2013
Summary
Sacral neuromodulation for lower urinary tract dysfunction has a high reoperation rate, with 38.2% of patients needing revision or explantation. Predictors for these complications remain unclear, necessitating patient counseling before surgery.
Area of Science:
- Urology
- Biomedical Engineering
Background:
- Sacral neuromodulation is a common treatment for lower urinary tract dysfunction.
- Despite technological advancements, sacral neuromodulation faces significant reoperation rates.
Purpose of the Study:
- To report the reoperation rates of sacral neuromodulation using the InterStim device.
- To identify potential predictors for reoperation in patients undergoing sacral neuromodulation.
Main Methods:
- Retrospective review of patients who received the InterStim device for lower urinary tract dysfunction.
- Data collected from April 1999 to December 2011.
- Analysis of reoperation, revision, and explantation rates.
Main Results:
- 155 InterStim devices were implanted in 142 patients.
- 55 patients (38.2%) required reoperation (revision or explantation).
- Revisions (21.1%) were mainly due to mechanical failure, battery issues, or pain. Explantations (24.6%) were primarily for poor symptom control or loss of response.
Conclusions:
- Sacral neuromodulation exhibits substantial revision and explantation rates.
- No clear predictors for reoperation were identified.
- Pre-operative patient counseling regarding potential complications is crucial.
