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Trends and Clinical Practice Patterns of Sacral Neuromodulation for Overactive Bladder
Dean S Elterman, Bilal Chughtai1, Emily Vertosick2
1Department of Urology, Weill Cornell Medical College.
Female Pelvic Medicine & Reconstructive Surgery
|June 29, 2017
Summary
Sacral neuromodulation (SNM) has significantly increased for refractory overactive bladder (OAB) treatment among American urologists. Augmentation cystoplasty (AC) rates remained stable but declined proportionally.
Area of Science:
- Urology
- Surgical Practice Patterns
- Overactive Bladder Management
Background:
- Refractory overactive bladder (OAB) presents a significant management challenge for urologists.
- Treatment options for refractory OAB include sacral neuromodulation (SNM) and augmentation cystoplasty (AC).
Purpose of the Study:
- To investigate the surgical practice patterns of American urologists in treating refractory OAB over the past decade.
- To analyze trends in the utilization of SNM and AC for refractory OAB.
Main Methods:
- Data on SNM and AC procedures performed between 2003 and 2012 were obtained from the American Board of Urology (ABU) case logs.
- Associations between surgeon characteristics and procedure utilization were evaluated.
Main Results:
- 756 out of 6355 urologists performed SNM or AC for refractory OAB.
- SNM procedures increased dramatically from 48 to 2068 cases between 2003 and 2012.
- Augmentation cystoplasty (AC) cases remained stable (14-38 annually) but decreased from 25% to <1% of total procedures.
Conclusions:
- Sacral neuromodulation (SNM) has seen a dramatic increase in utilization for refractory overactive bladder (OAB) among ABU-certified urologists.
- Augmentation cystoplasty (AC) rates have remained stable in absolute numbers but have declined significantly relative to SNM procedures.
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