Long-term Outcomes of Sacral Nerve Stimulation in Pelvic Floor Dysfunctions

Purpose The aim of this study was to analyze the long-term outcomes of sacral nerve stimulation (SNS) in both idiopathic and neurogenic pelvic floor disorders in patients treated at a referral center. Methods This retrospective observational study analyzed the records of 106 patients tested at our d...

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Main Authors: David Hernández-Hernández, Bárbara Padilla-Fernández, Milagros Castro Romera, Stephany Hess Medler, David Castro-Díaz
Format: Article
Language:English
Published: Korean Continence Society 2021-12-01
Series:International Neurourology Journal
Subjects:
Online Access:http://www.einj.org/upload/pdf/inj-2040364-182.pdf
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author David Hernández-Hernández
Bárbara Padilla-Fernández
Milagros Castro Romera
Stephany Hess Medler
David Castro-Díaz
author_facet David Hernández-Hernández
Bárbara Padilla-Fernández
Milagros Castro Romera
Stephany Hess Medler
David Castro-Díaz
author_sort David Hernández-Hernández
collection DOAJ
description Purpose The aim of this study was to analyze the long-term outcomes of sacral nerve stimulation (SNS) in both idiopathic and neurogenic pelvic floor disorders in patients treated at a referral center. Methods This retrospective observational study analyzed the records of 106 patients tested at our department from December 1999 to January 2017. The efficacy variables evaluated were the Global Response Assessment (range, 0%–100%) and, according to the clinical indication, other specific variables such International Consultation on Incontinence QuestionnaireShort Form, number of catheterizations or pads/day, and the numerical pain scale. The safety variables analyzed were complications (pain, migration, infection), reinterventions and explants. Patients’ quality of life (QoL) and satisfaction with the procedure were evaluated through telephone interviews. Results The clinical indications were overactive bladder (OAB) (n=36), urinary retention (UR) (n=37), bladder pain syndrome/interstitial cystitis (BPS/IC) (n=19), fecal incontinence (FI) (n=8), and double incontinence (DI) (n=6). The implant rates according to the clinical indication were as follows: OAB, 55.6%; UR, 56.8%; BPS/IC, 63.15%; FI, 87.5%; and DI, 66.7%. Clinical and/or statistically significant improvements in all efficacy variables were observed. Loss of therapeutic effect at 75 months of follow-up was observed in 34% of patients. Device-related pain appeared in 25 patients (39%); in 20 patients, it was resolved by reprogramming and 5 patients required device removal. An overall improvement in QoL and high levels of satisfaction with the procedure were observed. More than 90% of patients would recommend SNS to a friend or relative. Conclusions SNS is a minimally invasive procedure that offers a real alternative to patients with refractory pelvic floor dysfunction. Its safety profile is very favorable and it provides a long-lasting improvement in symptoms and QoL.
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spelling doaj.art-6e8a34bd7a8a4ae5bbaa750e5e64f1972022-12-22T04:13:01ZengKorean Continence SocietyInternational Neurourology Journal2093-47772093-69312021-12-0125431932610.5213/inj.2040364.182924Long-term Outcomes of Sacral Nerve Stimulation in Pelvic Floor DysfunctionsDavid Hernández-Hernández0Bárbara Padilla-Fernández1Milagros Castro Romera2Stephany Hess Medler3David Castro-Díaz4 Servicio de Urología, Hospital Universitario de Canarias, Tenerife, Spain Servicio de Urología, Hospital Universitario de Canarias, Tenerife, Spain Servicio de Cirugía, Hospital Universitario de Canarias, Tenerife, Spain Departamento de Psicología Clínica, Psicobiología y Metodología, Universidad de La Laguna, Tenerife, Spain Servicio de Urología, Hospital Universitario de Canarias, Tenerife, SpainPurpose The aim of this study was to analyze the long-term outcomes of sacral nerve stimulation (SNS) in both idiopathic and neurogenic pelvic floor disorders in patients treated at a referral center. Methods This retrospective observational study analyzed the records of 106 patients tested at our department from December 1999 to January 2017. The efficacy variables evaluated were the Global Response Assessment (range, 0%–100%) and, according to the clinical indication, other specific variables such International Consultation on Incontinence QuestionnaireShort Form, number of catheterizations or pads/day, and the numerical pain scale. The safety variables analyzed were complications (pain, migration, infection), reinterventions and explants. Patients’ quality of life (QoL) and satisfaction with the procedure were evaluated through telephone interviews. Results The clinical indications were overactive bladder (OAB) (n=36), urinary retention (UR) (n=37), bladder pain syndrome/interstitial cystitis (BPS/IC) (n=19), fecal incontinence (FI) (n=8), and double incontinence (DI) (n=6). The implant rates according to the clinical indication were as follows: OAB, 55.6%; UR, 56.8%; BPS/IC, 63.15%; FI, 87.5%; and DI, 66.7%. Clinical and/or statistically significant improvements in all efficacy variables were observed. Loss of therapeutic effect at 75 months of follow-up was observed in 34% of patients. Device-related pain appeared in 25 patients (39%); in 20 patients, it was resolved by reprogramming and 5 patients required device removal. An overall improvement in QoL and high levels of satisfaction with the procedure were observed. More than 90% of patients would recommend SNS to a friend or relative. Conclusions SNS is a minimally invasive procedure that offers a real alternative to patients with refractory pelvic floor dysfunction. Its safety profile is very favorable and it provides a long-lasting improvement in symptoms and QoL.http://www.einj.org/upload/pdf/inj-2040364-182.pdfsacral neuromodulationefficacybladder dysfunctionfecal incontinencebladder pain syndrome
spellingShingle David Hernández-Hernández
Bárbara Padilla-Fernández
Milagros Castro Romera
Stephany Hess Medler
David Castro-Díaz
Long-term Outcomes of Sacral Nerve Stimulation in Pelvic Floor Dysfunctions
International Neurourology Journal
sacral neuromodulation
efficacy
bladder dysfunction
fecal incontinence
bladder pain syndrome
title Long-term Outcomes of Sacral Nerve Stimulation in Pelvic Floor Dysfunctions
title_full Long-term Outcomes of Sacral Nerve Stimulation in Pelvic Floor Dysfunctions
title_fullStr Long-term Outcomes of Sacral Nerve Stimulation in Pelvic Floor Dysfunctions
title_full_unstemmed Long-term Outcomes of Sacral Nerve Stimulation in Pelvic Floor Dysfunctions
title_short Long-term Outcomes of Sacral Nerve Stimulation in Pelvic Floor Dysfunctions
title_sort long term outcomes of sacral nerve stimulation in pelvic floor dysfunctions
topic sacral neuromodulation
efficacy
bladder dysfunction
fecal incontinence
bladder pain syndrome
url http://www.einj.org/upload/pdf/inj-2040364-182.pdf
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