Unilateral versus bilateral stage I neuromodulator lead placement for the treatment of refractory voiding dysfunction. Neurourol Urodyn 2008;27(8):779-81
Date
06/14/2008Pubmed ID
18551562DOI
10.1002/nau.20577Scopus ID
2-s2.0-60849135750 (requires institutional sign-in at Scopus site) 30 CitationsAbstract
AIMS: To determine if bilateral S3 lead placement during the stage I trial period improves the "success" rate for advancing to stage II (permanent) sacral neuromodulator placement.
METHODS: A retrospective chart review of 124 (20 male and 104 female) patients undergoing stage I sacral neuromodulation (InterStim, Medtronic, Minneapolis, Minnesota) implantation for the treatment of refractory voiding dysfunction was performed. Patients were divided into two cohorts based on unilateral versus bilateral stage I lead placement in the S3 foramina. Both groups were then evaluated and compared with regards to overall "success", defined as progression from stage I to stage II placement.
RESULTS: Fifty-five (44%) patients underwent unilateral stage I lead placement and 69 (56%) received bilateral S3 leads. Successful stage I trials were reported in 32/55 (58%) and 53/69 (76%) of unilateral and bilateral cohorts, respectively (P = 0.03). Five wound infections were reported-2 (3.6%) following unilateral and 3 (4.3%) after bilateral stage I lead placement. No other complications were encountered.
CONCLUSIONS: Bilateral stage I neuromodulation trial provides a significantly higher rate of improvement in refractory voiding symptoms to allow for the progress to stage II implantation.
Author List
Pham K, Guralnick ML, O'Connor RCAuthors
Michael Guralnick MD Professor in the Urologic Surgery department at Medical College of WisconsinRobert Corey O'Connor MD Professor in the Urologic Surgery department at Medical College of Wisconsin
MESH terms used to index this publication - Major topics in bold
Chronic DiseaseElectric Stimulation Therapy
Electrodes, Implanted
Female
Humans
Lumbosacral Plexus
Male
Middle Aged
Pain Measurement
Pelvic Pain
Retrospective Studies
Treatment Outcome
Urinary Incontinence
Urinary Retention
Urodynamics