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Sacral Neuromodulation: Determining Predictors of Success
Tara Nikonow Morgan1, Natalie Pace2, Anand Mohapatra1
1UPMC Magee Women's Hospital, Pittsburgh, PA.
Urology
|July 4, 2020
Summary
Older age and prior onabotulinumtoxinA treatments predict failure to complete sacral neuromodulation. Pelvic floor physical therapy also reduces success rates for overactive bladder, urinary retention, and fecal incontinence.
Area of Science:
- Urology
- Neuroscience
- Pelvic Health
Background:
- Sacral neuromodulation (SNM) is a treatment for overactive bladder, urinary retention, and fecal incontinence.
- Predictors of success for SNM are not fully understood, particularly in women.
Purpose of the Study:
- To identify predictors of success for sacral neuromodulation in women.
- To analyze factors influencing the completion of stage II SNM implantation and patient-reported success.
Main Methods:
- Retrospective chart review of 198 women undergoing staged SNM implantation (2007-2018).
- Analysis of clinical and procedural characteristics, including intraoperative motor responses.
- Endpoints: stage II implant completion, tined lead revision, and patient-reported success.
Main Results:
- Stage II implant completion was 92.4%; 83.3% reported initial success, 70.3% at 6 months.
- Negative predictors for stage II completion: age >65 years (OR=0.2) and prior onabotulinumtoxinA (OR=0.2).
- Prior pelvic floor physical therapy was a negative predictor for patient-reported success (OR=0.25).
Conclusions:
- Patient age over 65 and prior onabotulinumtoxinA treatment are associated with failure to complete stage II SNM.
- Previous pelvic floor physical therapy correlates with lower reported success rates post-SNM.
- Intraoperative motor response in fewer than 4 electrodes did not affect patient-reported success.
