MP38-07 EFFECT OF BASELINE CHARACTERISTICS AND TEST STIMULATION RESPONSE ON SACRAL NEUROMODULATION THERAPEUTIC SUCCESS AT 12-MONTHS

Abstract

You have accessJournal of UrologyUrodynamics/Incontinence/Female Urology: Incontinence Therapy II1 Apr 2014MP38-07 EFFECT OF BASELINE CHARACTERISTICS AND TEST STIMULATION RESPONSE ON SACRAL NEUROMODULATION THERAPEUTIC SUCCESS AT 12-MONTHS Suzette E. Sutherland, Steven Siegel, Jason Bennett, Jeffrey Mangel, Craig Comiter, Samuel Zylstra, Erin Bird, Tomas L. Griebling, Daniel Culkin, Karen Noblett, Kellie Berg, and Fangyu Kan Suzette E. SutherlandSuzette E. Sutherland More articles by this author , Steven SiegelSteven Siegel More articles by this author , Jason BennettJason Bennett More articles by this author , Jeffrey MangelJeffrey Mangel More articles by this author , Craig ComiterCraig Comiter More articles by this author , Samuel ZylstraSamuel Zylstra More articles by this author , Erin BirdErin Bird More articles by this author , Tomas L. GrieblingTomas L. Griebling More articles by this author , Daniel CulkinDaniel Culkin More articles by this author , Karen NoblettKaren Noblett More articles by this author , Kellie BergKellie Berg More articles by this author , and Fangyu KanFangyu Kan More articles by this author View All Author Informationhttps://doi.org/10.1016/j.juro.2014.02.1264AboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookTwitterLinked InEmail INTRODUCTION AND OBJECTIVES This abstract aims to characterize the effect of baseline subject characteristics and degree of response during test stimulation on 12-month therapeutic success of sacral neuromodulation (SNM) with the InterStim® System in a prospective, multicenter post-approval study. Subjects with bothersome symptoms of overactive bladder (OAB) including urinary urge incontinence (UI) and/or urgency-frequency (UF), who had not exhausted all medication options (failed at least 1 anticholinergic medication and had at least 1 medication not tried) were included. METHODS Subjects with successful test stimulation using therapeutic success criteria received an SNM implant. UI therapeutic success was defined as a ≥50% improvement in average leaks/day and for UF as a ≥50% reduction in voids/day or a return to normal (<8 voids/day). Subjects with both UI and UF needed therapeutic success for just one indication to be implanted. UI subjects' response to test stimulation was measured as percent improvement in leaks from baseline. UF subjects' response to test stimulation was measured on two factors: whether subjects return to normal and whether they have 50% improvement in voids/day from baseline. Logistic regression was used and therapeutic success was regressed separately for UI and UF subjects on test stimulation reponse. Baseline characteristics including age, race, gender, previous medications tried, age at implant, and years since diagnosis were also included in the models. RESULTS Of the 340 subjects that completed test stimulation, 272 were implanted with SNM. For subjects implanted with a full system, 91% were female and mean age was 57 years. At 12 months, 79% of UI subjects and 69% of UF subjects had therapeutic success. UI subjects were more likely to have 12-month therapeutic success if they had greater reduction in number of leaks at test stimulation (OR (Odds Ratio)=1.02, p=0.021), and with 1 or 2 previous OAB medications tried as compared to 3 or more (OR=3.03, p=0.010). UF subjects were more likely to have 12-month success if they returned to normal at test stimulation (OR=3.60, p=0.002;) compared to not returning to normal at test stimulation. No relationship of previous medication use with UF therapeutic success was observed. CONCLUSIONS This multicenter study shows that test stimulation reponse is a successful predictor for therapeutic success at 12 months in both UI and UF subjects. UI subjects are more likely to achieve therapeutic success if they have tried 2 medications or less, but that was not found for UF subjects. © 2014FiguresReferencesRelatedDetails Volume 191Issue 4SApril 2014Page: e403 Advertisement Copyright & Permissions© 2014MetricsAuthor Information Suzette E. Sutherland More articles by this author Steven Siegel More articles by this author Jason Bennett More articles by this author Jeffrey Mangel More articles by this author Craig Comiter More articles by this author Samuel Zylstra More articles by this author Erin Bird More articles by this author Tomas L. Griebling More articles by this author Daniel Culkin More articles by this author Karen Noblett More articles by this author Kellie Berg More articles by this author Fangyu Kan More articles by this author Expand All Advertisement Advertisement PDF downloadLoading ...