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Sacral Neuromodulation Reprogramming Rates: Understanding Office-Based Requirement.

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    Sacral neuromodulation (SNM) reprogramming occurs in 31.5% of patients, with higher rates in those with fecal incontinence. This suggests a need for closer monitoring and potential adjustments for these patients.

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    Area of Science:

    • Urology
    • Medical Devices
    • Patient Outcomes

    Background:

    • Sacral neuromodulation (SNM) offers adjustable therapy for lower urinary and fecal dysfunction.
    • Reprogramming is a key feature for managing patient symptoms and optimizing SNM therapy.
    • Understanding reprogramming rates is crucial for patient management and healthcare resource allocation.

    Purpose of the Study:

    • To determine the incidence of office-based SNM reprogramming in a large, multi-site patient cohort.
    • To analyze differences in reprogramming rates based on the primary indication for SNM implantation (urinary vs. fecal incontinence).

    Main Methods:

    • Retrospective analysis of the TriNetX database using ICD-10 and CPT codes.
    • Inclusion of female adult patients diagnosed with urinary retention, urgency urinary incontinence, or fecal incontinence (FI).
    • Primary outcome: rate of SNM reprogramming CPT codes from 6 weeks to 5 years post-implantation.

    Main Results:

    • 31.5% of 9,501 patients underwent office-based SNM reprogramming.
    • The probability of never needing reprogramming by 5 years was 52.5%.
    • Patients with fecal incontinence (FI) indications had a significantly higher risk of requiring reprogramming compared to those with only urinary indications (55% vs. 50%, P < 0.001).

    Conclusions:

    • Office-based SNM reprogramming is common, affecting nearly a third of patients.
    • Rates may be underestimated, highlighting potential underreporting.
    • Fecal incontinence diagnoses are associated with an increased likelihood of requiring SNM reprogramming.