1160 CORRELATION BETWEEN PRE-IMPLANTATION DIAGNOSIS AND CAUSES OF SACRAL NEUROSTIMULATOR EXPLANTATION: 10 YEARS EXPERIENCE

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You have accessJournal of UrologyUrodynamics/Incontinence/Female Urology: Incontinence - Evaluation & Therapy1 Apr 20111160 CORRELATION BETWEEN PRE-IMPLANTATION DIAGNOSIS AND CAUSES OF SACRAL NEUROSTIMULATOR EXPLANTATION: 10 YEARS EXPERIENCE Yahya Ghazwani, Mohamed Elkelini, and Magdy Hassouna Yahya GhazwaniYahya Ghazwani Toronto, Canada More articles by this author , Mohamed ElkeliniMohamed Elkelini Toronto, Canada More articles by this author , and Magdy HassounaMagdy Hassouna Toronto, Canada More articles by this author View All Author Informationhttps://doi.org/10.1016/j.juro.2011.02.770AboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookTwitterLinked InEmail INTRODUCTION AND OBJECTIVES Sacral neuromodulation has gained its popularity as an effective therapy for various voiding dysfunctions refractory to conservative and medical therapy.InterStim® is approved by FDA for treating urgency-incontinence, urgency/frequency syndrome and non-obstructive urinary retention. Sacral neuromodulation has also showed favorable results in relieving urinary symptoms and pelvic pain associated with Bladder Pain Syndrome. Despite all modifications in the surgical technique and implanted leads, explantation is still encountered in 5–15% of implanted InterStim® therapy. Our aim was to determine the association between indications of the InterStim® therapy and causes for explantation after long term follow-up. METHODS A retrospective chart review of patients who underwent permanent sacral implantation from 2000–2009 was carried out. All patients who had their InterStim® explanted were included. Ages, gender, pre-implantation diagnosis, duration of symptoms, duration of stimulation, and reason for explantation were retrieved. The causes of explantation included loss of efficacy and pain (at the site of IPG, or ipsilateral lower limb), infection, trauma and as precautions for MRI. RESULTS 167 patients were permanently implanted, 142 (85%) females and 25 (15%) males. Indications of implantation were: Overactive Bladder (OAB) 82 (49%) patients, 46 (28%) patients with urinary retention (UR), and 39 (23%) patients with Bladder Pain Syndrome (BPS). In total, 37 (22%) patients were explanted. Table 1 shows the reasons for explantation Loss of efficacy (59%) followed by pain (27%) represented the predominant causes of explantation. Average duration of stimulation in explanted patients was 4.5 ± 2.6 yrs. Patients who were explanted due to loss of efficacy had longer duration of stimulation when compared to patients who were explanted due to pain, (5.32± 2.5) Vs (3.1±0.1) yrs, p =0.011. BPS as an indication for Sacral neuromodulation was significantly correlated with pain as a cause of explantation (r=0.41, p=0.012). CONCLUSIONS In our cohort, explantation rate of sacral neurostimulator was 20% caused predominantly by loss of efficacy. We however found that explantation due to pain was associated with BPS. © 2011 by American Urological Association Education and Research, Inc.FiguresReferencesRelatedDetails Volume 185Issue 4SApril 2011Page: e465-e466 Advertisement Copyright & Permissions© 2011 by American Urological Association Education and Research, Inc.MetricsAuthor Information Yahya Ghazwani Toronto, Canada More articles by this author Mohamed Elkelini Toronto, Canada More articles by this author Magdy Hassouna Toronto, Canada More articles by this author Expand All Advertisement Advertisement PDF downloadLoading ...