Radiographic Position of the Electrode as a Predictor of the Outcome of InterStim Therapy
Purpose Sacral neuromodulation (SNM) therapy is indicated for some refractory urological conditions. The electrode lead position in sacral x-rays during routine follow-up may predict the outcome of SNM therapy. To determine whether the radiographic position of the electrode in the sacral foramen pre...
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| Format: | Article |
| Language: | English |
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Korean Continence Society
2017-12-01
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| Series: | International Neurourology Journal |
| Subjects: | |
| Online Access: | http://www.einj.org/upload/pdf/inj-1734942-471.pdf |
| _version_ | 1811231544065392640 |
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| author | Abdullah Ahmed Gahzi Mai Ahmed Banakhar Dean S. Elterman Magdy Hassouna |
| author_facet | Abdullah Ahmed Gahzi Mai Ahmed Banakhar Dean S. Elterman Magdy Hassouna |
| author_sort | Abdullah Ahmed Gahzi |
| collection | DOAJ |
| description | Purpose Sacral neuromodulation (SNM) therapy is indicated for some refractory urological conditions. The electrode lead position in sacral x-rays during routine follow-up may predict the outcome of SNM therapy. To determine whether the radiographic position of the electrode in the sacral foramen predicted the long-term outcome of SNM therapy. Methods This was a retrospective study of patients who underwent InterStim SNM at Toronto Western Hospital by 2 surgeons from July 2013 to March 2014. The position of electrodes in relation to the sacral bone was assessed on follow-up sacral x-rays. In the lateral view, we determined the location of the radio-opaque marker of the electrode relative to the inner surface of the sacrum (P3, D3, P2, D2, P1, D1, P0, and D0). In the anteroposterior view, the angle between a line through the spinous process shadow and the electrode was measured (0°–30°, 30°–60°, 60°–90°, >90°, or medial). Dissatisfied patients were defined as those who did not improve based on a voiding diary or those who needed salvage treatment after SNM. The primary endpoint was to determine whether the electrode lead position on sacral x-rays predicted the outcome of SNM therapy. Results A total of 69 patients (61 female and 8 male patients) were included, with a median age of 55 years. Forty-two of the patients (60.9%) had refractory overactive bladder, 21 (30.4%) suffered from chronic urinary retention, and 6 (8.7%) had lower urinary tract symptoms and chronic pelvic pain syndrome. The univariate analysis did not show any correlation between SNM response and the electrode position or angle. Dummy regression analysis using response to implantation as the dependent outcome variable did not show any significance for any of the predictors. Conclusions Our study did not show a correlation between the long-term response to SNM and the electrode position on follow-up sacral x-rays. In this study, electrode lead position in sacral x-ray at follow-up was not correlated with the outcome of SNM therapy. |
| first_indexed | 2024-04-12T10:46:54Z |
| format | Article |
| id | doaj.art-af63e1fade01498b8555150323737f80 |
| institution | Directory Open Access Journal |
| issn | 2093-4777 2093-6931 |
| language | English |
| last_indexed | 2024-04-12T10:46:54Z |
| publishDate | 2017-12-01 |
| publisher | Korean Continence Society |
| record_format | Article |
| series | International Neurourology Journal |
| spelling | doaj.art-af63e1fade01498b8555150323737f802022-12-22T03:36:22ZengKorean Continence SocietyInternational Neurourology Journal2093-47772093-69312017-12-0121428929410.5213/inj.1734942.471693Radiographic Position of the Electrode as a Predictor of the Outcome of InterStim TherapyAbdullah Ahmed Gahzi0Mai Ahmed Banakhar1Dean S. Elterman2Magdy Hassouna3 Toronto Western Hospital, Toronto, ON, Canada King Abdulaziz University, Jeddah, Saudi Arabia Toronto Western Hospital, Toronto, ON, Canada Toronto Western Hospital, Toronto, ON, CanadaPurpose Sacral neuromodulation (SNM) therapy is indicated for some refractory urological conditions. The electrode lead position in sacral x-rays during routine follow-up may predict the outcome of SNM therapy. To determine whether the radiographic position of the electrode in the sacral foramen predicted the long-term outcome of SNM therapy. Methods This was a retrospective study of patients who underwent InterStim SNM at Toronto Western Hospital by 2 surgeons from July 2013 to March 2014. The position of electrodes in relation to the sacral bone was assessed on follow-up sacral x-rays. In the lateral view, we determined the location of the radio-opaque marker of the electrode relative to the inner surface of the sacrum (P3, D3, P2, D2, P1, D1, P0, and D0). In the anteroposterior view, the angle between a line through the spinous process shadow and the electrode was measured (0°–30°, 30°–60°, 60°–90°, >90°, or medial). Dissatisfied patients were defined as those who did not improve based on a voiding diary or those who needed salvage treatment after SNM. The primary endpoint was to determine whether the electrode lead position on sacral x-rays predicted the outcome of SNM therapy. Results A total of 69 patients (61 female and 8 male patients) were included, with a median age of 55 years. Forty-two of the patients (60.9%) had refractory overactive bladder, 21 (30.4%) suffered from chronic urinary retention, and 6 (8.7%) had lower urinary tract symptoms and chronic pelvic pain syndrome. The univariate analysis did not show any correlation between SNM response and the electrode position or angle. Dummy regression analysis using response to implantation as the dependent outcome variable did not show any significance for any of the predictors. Conclusions Our study did not show a correlation between the long-term response to SNM and the electrode position on follow-up sacral x-rays. In this study, electrode lead position in sacral x-ray at follow-up was not correlated with the outcome of SNM therapy.http://www.einj.org/upload/pdf/inj-1734942-471.pdfSacral NeuromodulationUrinary Bladder, OveractiveUrinary IncontinenceUrinary Retention |
| spellingShingle | Abdullah Ahmed Gahzi Mai Ahmed Banakhar Dean S. Elterman Magdy Hassouna Radiographic Position of the Electrode as a Predictor of the Outcome of InterStim Therapy International Neurourology Journal Sacral Neuromodulation Urinary Bladder, Overactive Urinary Incontinence Urinary Retention |
| title | Radiographic Position of the Electrode as a Predictor of the Outcome of InterStim Therapy |
| title_full | Radiographic Position of the Electrode as a Predictor of the Outcome of InterStim Therapy |
| title_fullStr | Radiographic Position of the Electrode as a Predictor of the Outcome of InterStim Therapy |
| title_full_unstemmed | Radiographic Position of the Electrode as a Predictor of the Outcome of InterStim Therapy |
| title_short | Radiographic Position of the Electrode as a Predictor of the Outcome of InterStim Therapy |
| title_sort | radiographic position of the electrode as a predictor of the outcome of interstim therapy |
| topic | Sacral Neuromodulation Urinary Bladder, Overactive Urinary Incontinence Urinary Retention |
| url | http://www.einj.org/upload/pdf/inj-1734942-471.pdf |
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