PD36-06 LOWER RISK OF LEAD REVISION BASED ON “OPTIMAL”LEAD PLACEMENT DURING STAGE 1 SACRAL NEUROMODULATION

Abstract

You have accessJournal of UrologyUrodynamics/Lower Urinary Tract Dysfunction/Female Pelvic Medicine: Female Incontinence: Therapy I1 Apr 2016PD36-06 LOWER RISK OF LEAD REVISION BASED ON “OPTIMAL”LEAD PLACEMENT DURING STAGE 1 SACRAL NEUROMODULATION javier Pizarro-Berdichevsky, Adrienne Quirouet, Marisa M Clifton, Bradley C Gill, Elodi J Dielubanza, Henry T Okafor, Anna E Faris, Courtenay K Moore, Raymond R Rackley, Sandip P Vasavada, and Howard B Goldman javier Pizarro-Berdichevskyjavier Pizarro-Berdichevsky More articles by this author , Adrienne QuirouetAdrienne Quirouet More articles by this author , Marisa M CliftonMarisa M Clifton More articles by this author , Bradley C GillBradley C Gill More articles by this author , Elodi J DielubanzaElodi J Dielubanza More articles by this author , Henry T OkaforHenry T Okafor More articles by this author , Anna E FarisAnna E Faris More articles by this author , Courtenay K MooreCourtenay K Moore More articles by this author , Raymond R RackleyRaymond R Rackley More articles by this author , Sandip P VasavadaSandip P Vasavada More articles by this author , and Howard B GoldmanHoward B Goldman More articles by this author View All Author Informationhttps://doi.org/10.1016/j.juro.2016.02.1111AboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookTwitterLinked InEmail INTRODUCTION AND OBJECTIVES During Stage I InterStim procedures responses at all 4 electrodes of the lead are evaluated. For each electrode, a pelvic bellows and plantar flexion of the great toe response are recorded. Therefore, motor response can be graded on a scale of 0 (no response at any electrode) through 8 (positive bellows and toe responses at all 4 electrodes). Currently, there is a paucity of literature defining optimal/suboptimal responses during stage I. Our aim was to describe the correlation of electrode response and lead revision. METHODS A retrospective review of all Stage 1 from 2002-15 was performed. Motor responses were analyzed as a sum of positive bellows and toe responses at all 4 electrodes (of a possible total 8) or either the sum of bellows responses or great toe contractions at all 4 electrodes (both, a possible total of 4). Univariate and multivariate analyses were performed for lead revision risk factors. Inclusion criteria were unilateral staged procedures with operative reports noting motor responses. Descriptive statistics are presented as percentages, mean±SD or median (interquartile range). Spearman’s Rho, Student’s t, Mann-Whitney U, Chi-Square, and Fisher’s Exact tests were used, as appropriate. RESULTS 177 Stage 1 procedures qualified for analysis. The mean age in years was 58.4±15.9, 86.4% were females, 93.2% of the patients had overactive bladder diagnoses, the mean BMI was 30±7.1, 19.9% were diabetic and 19.4% were smokers. The median follow up in months was 10.5(2-36). 34/177(19%) patients had revisions, and these which were negatively associated with total (toe + bellows) responses (p=0.023) or toe responses (p=0.018) regardless of bellows. Predictors of revision on logistic regression included age at implant (>59 years) and less than 4 (of a possible 8) responses (OR 5.5 CI 95% 2-14.7 and OR 4.2 CI 95% 1.4-12.9 respectively). CONCLUSIONS Of an overall 19% revision rate, most occurred in patients with fewer total electrode responses and specifically, fewer toe responses. Older patients (5.5 fold) and those with less than 4 of 8 responses (4.2 fold) were most likely to experience revision. © 2016FiguresReferencesRelatedDetails Volume 195Issue 4SApril 2016Page: e851 Advertisement Copyright & Permissions© 2016MetricsAuthor Information javier Pizarro-Berdichevsky More articles by this author Adrienne Quirouet More articles by this author Marisa M Clifton More articles by this author Bradley C Gill More articles by this author Elodi J Dielubanza More articles by this author Henry T Okafor More articles by this author Anna E Faris More articles by this author Courtenay K Moore More articles by this author Raymond R Rackley More articles by this author Sandip P Vasavada More articles by this author Howard B Goldman More articles by this author Expand All Advertisement Advertisement PDF downloadLoading ...