1033 SACRAL NERVE ROOT NEUROMODULATION FOR THE TREATMENT OF INTRACTABLE PAINFUL BLADDER SYNDROME/INTERSTITIAL CYSTITIS: 14 YEARS EXPERIENCE OF ONE CENTER

Abstract

You have accessJournal of UrologyInfections/Inflammation of the Genitourinary Tract: Interstitial Cystitis1 Apr 20101033 SACRAL NERVE ROOT NEUROMODULATION FOR THE TREATMENT OF INTRACTABLE PAINFUL BLADDER SYNDROME/INTERSTITIAL CYSTITIS: 14 YEARS EXPERIENCE OF ONE CENTER Jerzy Gajewski and Ali Alzahrani Jerzy GajewskiJerzy Gajewski More articles by this author and Ali AlzahraniAli Alzahrani More articles by this author View All Author Informationhttps://doi.org/10.1016/j.juro.2010.02.2111AboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookTwitterLinked InEmail INTRODUCTION AND OBJECTIVES To evaluate the long-term success and tolerability of the chronic sacral neuromodulation (SNM) in the control of symptoms of painful bladder syndrome/ interstitial cystitis (PBS/IC). METHODS This is a retrospective study for all the patients who underwent peripheral nerve evaluation (PNE) and then chronic sacral nerve modulation in our urology department for managing symptoms of PBS/IC from 1994 till 2008. We have used the global response scale as a validated tool to measure the success of the chronic SNM. RESULTS A total of 78 patients fulfilled the International Continent Society (ICS) criteria for PBS/IC and showed cystoscopic evidence of glomerulation or ulcer as recommended by the European Society for the Study of IC/PBS (ESSIC). All the patients failed conservative management before considering the SNM. Permanent SNM implanted in 46 (59%) of patient who showed at least 50% improvement in their symptoms with temporarily peripheral nerve evaluation test (PNE). Both female gender and presence of urge incontinence were a good predictor for the PNE success. With a median follow up of 61.5 months (SD±27.7), thirty three (72%) of the patients showed good long term success of the SNM with at least 80% improvement of their symptoms in the global response scale. Presence of urgency was a very good predictor of the long term success. The explantation rate was 28%. The most common reason for the explantation was poor outcome (54% of the removed devices). The revision rate was 50%. The most common indication for revision was lack of stimulation sensation and worsening of the symptoms. The average durability of the pulse generator battery was 93 months. CONCLUSIONS Chronic sacral nerve modulation is an effective treatment to control the symptoms of PBS/IC. It should be considered before any major intervention if conservative measure has failed. It is minimal invasive, safe and has good long term durability. The revision rate is high and patients require lifelong follow-up. Halifax, Canada© 2010 by American Urological Association Education and Research, Inc.FiguresReferencesRelatedDetails Volume 183Issue 4SApril 2010Page: e402 Advertisement Copyright & Permissions© 2010 by American Urological Association Education and Research, Inc.MetricsAuthor Information Jerzy Gajewski More articles by this author Ali Alzahrani More articles by this author Expand All Advertisement Advertisement PDF downloadLoading ...