Abstract

IntroductionOver the years, sacral neuromodulation (SNM) has become an established and effective treatment for chronic urinary system retention and incontinence. The process of SNM is performed in two stages, the first is an evaluation phase and the second an implant phase. This study aimed to assess the rate of failure of progression from the evaluation to the implantation stage and the factors predicting the outcome of this commonplace procedure.Materials and methodsThis retrospective cross-sectional study took place at King Abdulaziz Medical City (KAMC), Riyadh, Saudi Arabia. All the patients who underwent SNM implantation from January 1, 2016 to January 1, 2021 were included. Patients younger than 14 years and patients who had the SNM implantation in a different hospital and were only followed-up at KAMC were excluded. Patient-related information were extracted from the BESTCare system. Frequency and percentage were used for the categorical variables, and the mean, median, and standard deviation to display the continuous variables. Chi-square test and Mann-Whitney U test were used to test for the association of the categorical variables.ResultsAmong 28 patients, 46.4% (n=13) failed to progress from the evaluation phase to the implantation phase. Gender, age, having a co-morbidity, and SNM indication were not significant factors for predicting the outcome of the SNM evaluation phase.ConclusionThe observed failure rate was marginally higher than the ones detected in other studies. Although no significant association was detected between evaluation stage failure and the assigned predictors, the results need to be interpreted with caution due to the small population size. Larger multicenter studies need to be done in order to investigate the link between patient characteristics and the efficacy of SNM. Establishing a concrete evidence would further refine the targeted patient population and indications for SNM.

Highlights

  • Over the years, sacral neuromodulation (SNM) has become an established and effective treatment for chronic urinary system retention and incontinence

  • There is emerging evidence that other parameters, such as age, gender, SNM indication, and body mass index (BMI) could have a role in increasing the likelihood of failure to progress to the implantation stage

  • Unlike our study which found no link between SNM indication and trial outcomes, a Turkish study evaluating the progression rates from the evaluation phase to the implantation phase stated that all the patients who failed to progress had an underlying diagnosis of an overactive bladder [3]

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Summary

Objectives

This study aimed to assess the rate of failure of progression from the evaluation to the implantation stage and the factors predicting the outcome of this commonplace procedure

Methods
Discussion
Conclusion
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