Adult urologyPredictive factors for sacral neuromodulation in chronic lower urinary tract dysfunction
Section snippets
Material and methods
The study population consisted of all patients who underwent a PNE between May 1988 and May 1999 at the University Hospital Maastricht. All patients with refractory urge incontinence, urgency-frequency syndrome, and urinary retention who underwent a PNE were included. Patients with other indications, such as pelvic pain syndrome, were excluded from this study. All patients underwent a comprehensive evaluation consisting of history taking, physical examination, and urodynamic investigation. To
Results
The data from 50 men (23.7%) and 161 women (76.3%) were reviewed. The mean patient age was 51.5 years (SD 10.5, range 25 to 79). The men (55.3 years, SD 10.1) were significantly older (Student’s t test, P = 0.003) than the women (50.3 years, SD 10.4). In total, 15 patients (7.0%) were diagnosed with urgency-frequency syndrome, 94 (43.7%) with motor urge incontinence, 13 (6.0%) with sensory urge incontinence, 41 (19.1%) with complete chronic urinary retention, and 48 (22.3%) with incomplete
Comment
Sacral neuromodulation is an effective therapy for patients with various voiding dysfunctions. However, until now, no single predictive factor has been found to predict which patients with voiding dysfunction will benefit from this therapy. Reports addressing this subject have shown no conclusive predictive factor, possibly because the patient numbers were too small to achieve statistical significance.8, 14, 15, 17
This analysis of the data from a larger group of patients found several
Conclusions
In this study, some indicators to predict PNE outcome were found. A higher chance of a positive PNE was present in patients who underwent IDP surgery and in patients with urge incontinence. A higher chance of a negative PNE was found with patients with neurogenic bladder dysfunction and in patients with a relatively long duration of lower urinary tract dysfunction. However, the PNE is still necessary to determine objectively whether patients can be successfully implanted.
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