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A Supervised 3 Weeks Test Phase in Sacral Neuromodulation with a 1-Year Followup
Sam Tilborghs1,2, Sigrid Van de Borne1,2, Donald Vaganée1,2
1Department of Urology, Antwerp University Hospital, Edegem, Belgium.
The Journal of Urology
|July 28, 2020
Summary
A 3-week supervised test phase for sacral neuromodulation significantly improves success rates. Patients initially not responding can become successful candidates with reprogramming, achieving similar long-term outcomes.
Area of Science:
- Urology
- Neurology
- Medical Devices
Background:
- Sacral neuromodulation is a treatment for refractory lower urinary tract symptoms.
- Optimizing the initial test phase is crucial for patient selection and treatment success.
Purpose of the Study:
- To evaluate if an extended interventional test phase for sacral neuromodulation increases the cumulative success rate.
- To compare the 1-year success rates between patients who responded early and those requiring reprogramming.
Main Methods:
- A prospective study of 90 patients with overactive bladder or nonobstructive urinary retention refractory to first-line treatments.
- Weekly evaluations during a 3-week test phase, with reprogramming for non-responders.
- Primary outcomes assessed were success rates after the 3-week test phase and 1-year follow-up.
Main Results:
- After 3 weeks, 62% of patients were successful; prolonged testing increased cumulative success.
- No significant difference in 1-year success rates was observed between early responders and those needing reprogramming (p=0.562).
- Demographic and indication-based comparisons showed no significant differences between groups.
Conclusions:
- A supervised 3-week test phase for sacral neuromodulation enhances cumulative success rates.
- Reprogramming during the test phase converted 42% of initial non-responders into successful candidates.
- The study strongly recommends a supervised 3-week test phase for sacral neuromodulation.
