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Published in: Current Urology Reports 6/2010

01-11-2010

Selection of Ideal Candidates for Neuromodulation in Refractory Overactive Bladder

Authors: Ravi Kacker, Anurag K. Das

Published in: Current Urology Reports | Issue 6/2010

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Abstract

Sacral neuromodulation is a minimally invasive, reversible treatment option that has been approved by the US Food and Drug Administration for patients with urgency/frequency and urge incontinence. While long-term success rates are high, the high treatment cost and the need for operative revision or explantation in cases of failure make the selection of ideal candidates particularly important. Because predictive factors for success and the exact mechanism of action are not known, physicians must rely on a preimplantation test procedure, either in the office or in the operating room, to select patients for implantation of a pulse generator. In this paper, we review the recent literature on performing a test procedure with both temporary and permanent leads and the selection of optimal candidates for sacral neuromodulation therapy.
Literature
1.
go back to reference Abrams P, Cardozo L, Fall M, et al.: The standardization of terminology of lower tract function: report from the Standardization Sub-committee of the International Continence Society. Neurourol Urodyn 2002, 21:167–178CrossRefPubMed Abrams P, Cardozo L, Fall M, et al.: The standardization of terminology of lower tract function: report from the Standardization Sub-committee of the International Continence Society. Neurourol Urodyn 2002, 21:167–178CrossRefPubMed
2.
go back to reference Basra RK, Wagg A, Chapple C, et al.: A review of adherence to drug therapy in patients with overactive bladder. BJU Int 2008, 102:774–779.CrossRefPubMed Basra RK, Wagg A, Chapple C, et al.: A review of adherence to drug therapy in patients with overactive bladder. BJU Int 2008, 102:774–779.CrossRefPubMed
3.
go back to reference Yoshimura N, Seki S, Chancellor MB, et al.: Targeting afferent hyperexcitability for therapy of the painful bladder syndrome. Urology 2002, 59(Suppl 1):61–67CrossRefPubMed Yoshimura N, Seki S, Chancellor MB, et al.: Targeting afferent hyperexcitability for therapy of the painful bladder syndrome. Urology 2002, 59(Suppl 1):61–67CrossRefPubMed
4.
go back to reference Fowler CJ, Swinn MJ, Goodwin RJ, et al.: Studies of the latency of pelvic floor contraction during peripheral nerve evaluation show that the muscle response is reflexly mediated. J Urol 2000; 163:881–883CrossRefPubMed Fowler CJ, Swinn MJ, Goodwin RJ, et al.: Studies of the latency of pelvic floor contraction during peripheral nerve evaluation show that the muscle response is reflexly mediated. J Urol 2000; 163:881–883CrossRefPubMed
5.
go back to reference •• Oerlemans DJ, van Kerrebroeck PE: Sacral nerve stimulation for neuromodulation of the lower urinary tract. Neurourol Urodyn 2008, 27:28–33. This is a review of literature on sacral neuromodulation for overactive bladder and other expanding indications.CrossRefPubMed •• Oerlemans DJ, van Kerrebroeck PE: Sacral nerve stimulation for neuromodulation of the lower urinary tract. Neurourol Urodyn 2008, 27:28–33. This is a review of literature on sacral neuromodulation for overactive bladder and other expanding indications.CrossRefPubMed
6.
go back to reference Brazzelli M, Murray A, Fraser C: Efficacy and safety of sacral nerve stimulation for urinary urge incontinence: a systematic review. J Urol 2006, 175:835–841CrossRefPubMed Brazzelli M, Murray A, Fraser C: Efficacy and safety of sacral nerve stimulation for urinary urge incontinence: a systematic review. J Urol 2006, 175:835–841CrossRefPubMed
7.
go back to reference Schmidt RA, Jonas U, Oleson KA, et al.: Sacral nerve stimulation for treatment of refractory urinary urge incontinence. Sacral Nerve Stimulation Study Group. J Urol 1999, 162:352–357CrossRefPubMed Schmidt RA, Jonas U, Oleson KA, et al.: Sacral nerve stimulation for treatment of refractory urinary urge incontinence. Sacral Nerve Stimulation Study Group. J Urol 1999, 162:352–357CrossRefPubMed
8.
go back to reference Leong RK, De Wachter SG, van Kerrebroeck PE: Current information on sacral neuromodulation and botulinum toxin treatment for refractory idiopathic overactive bladder syndrome: a review. Urol Int 2010, 84:245–253.CrossRefPubMed Leong RK, De Wachter SG, van Kerrebroeck PE: Current information on sacral neuromodulation and botulinum toxin treatment for refractory idiopathic overactive bladder syndrome: a review. Urol Int 2010, 84:245–253.CrossRefPubMed
9.
go back to reference • van Kerrebroeck PE, van Voskuilen AC, Heesakkers JP, et al.: Results of sacral neuromodulation therapy for urinary voiding dysfunction: outcomes of a prospective, worldwide clinical study. J Urol 2007, 178:2029–2034. The data in this article suggest a durable response to sacral neuromodulation for voiding dysfunction.CrossRefPubMed • van Kerrebroeck PE, van Voskuilen AC, Heesakkers JP, et al.: Results of sacral neuromodulation therapy for urinary voiding dysfunction: outcomes of a prospective, worldwide clinical study. J Urol 2007, 178:2029–2034. The data in this article suggest a durable response to sacral neuromodulation for voiding dysfunction.CrossRefPubMed
10.
go back to reference Sievert KD, Amend B, Gakis G, et al.: Early sacral neuromodulation prevents urinary incontinence after complete spinal cord injury. Ann Neurol 2010, 67:74–84.CrossRefPubMed Sievert KD, Amend B, Gakis G, et al.: Early sacral neuromodulation prevents urinary incontinence after complete spinal cord injury. Ann Neurol 2010, 67:74–84.CrossRefPubMed
11.
go back to reference Zabihi N, Mourtzinos A, Maher MG, et al.: Short-term results of bilateral S2–S4 sacral neuromodulation for the treatment of refractory interstitial cystitis, painful bladder syndrome, and chronic pelvic pain. Int Urogynecol J Pelvic Floor Dysfunct 2008, 19:553–557.CrossRefPubMed Zabihi N, Mourtzinos A, Maher MG, et al.: Short-term results of bilateral S2–S4 sacral neuromodulation for the treatment of refractory interstitial cystitis, painful bladder syndrome, and chronic pelvic pain. Int Urogynecol J Pelvic Floor Dysfunct 2008, 19:553–557.CrossRefPubMed
12.
go back to reference Comiter CV: Sacral neuromodulation for the symptomatic treatment of refractory interstitial cystitis: a prospective study. J Urol 2003, 169:1369–1373.CrossRefPubMed Comiter CV: Sacral neuromodulation for the symptomatic treatment of refractory interstitial cystitis: a prospective study. J Urol 2003, 169:1369–1373.CrossRefPubMed
13.
go back to reference •• Powell CR, Kreder KJ: Long-term outcomes of urgency-frequency syndrome due to painful bladder syndrome treated with sacral neuromodulation and analysis of failures. J Urol 2010, 183:173–176. This was a small series with promising long-term results on sacral neuromodulation for overactive bladder in patients with painful bladder syndrome. The type of test procedure did not affect outcome.CrossRefPubMed •• Powell CR, Kreder KJ: Long-term outcomes of urgency-frequency syndrome due to painful bladder syndrome treated with sacral neuromodulation and analysis of failures. J Urol 2010, 183:173–176. This was a small series with promising long-term results on sacral neuromodulation for overactive bladder in patients with painful bladder syndrome. The type of test procedure did not affect outcome.CrossRefPubMed
14.
go back to reference Cohen BL, Tunuguntla HS, Gousse A: Predictors of success for first stage neuromodulation: motor versus sensory response. J Urol 2006, 175:2178–2181.CrossRefPubMed Cohen BL, Tunuguntla HS, Gousse A: Predictors of success for first stage neuromodulation: motor versus sensory response. J Urol 2006, 175:2178–2181.CrossRefPubMed
15.
go back to reference Koldewijn EL, Rosier PF, Meuleman EJ, et al.: Predictors of success with neuromodulation in lower urinary tract dysfunction: results of trial stimulation in 100 patients. J Urol 1994, 152:2071–2075.PubMed Koldewijn EL, Rosier PF, Meuleman EJ, et al.: Predictors of success with neuromodulation in lower urinary tract dysfunction: results of trial stimulation in 100 patients. J Urol 1994, 152:2071–2075.PubMed
16.
go back to reference Everaert K, Kerckhaert W, Caluwaerts H, et al.: A prospective randomized trial comparing the 1-stage with the 2-stage implantation of a pulse generator in patients with pelvic floor dysfunction selected for sacral nerve stimulation. Eur Urol 2004, 45:649–654CrossRefPubMed Everaert K, Kerckhaert W, Caluwaerts H, et al.: A prospective randomized trial comparing the 1-stage with the 2-stage implantation of a pulse generator in patients with pelvic floor dysfunction selected for sacral nerve stimulation. Eur Urol 2004, 45:649–654CrossRefPubMed
17.
go back to reference Van Voskuilen AC, Oerlemans DJ, Weil EH, et al.: Medium-term experience of sacral neuromodulation by tined lead implantation. BJU Int 2007, 99:107–110.CrossRefPubMed Van Voskuilen AC, Oerlemans DJ, Weil EH, et al.: Medium-term experience of sacral neuromodulation by tined lead implantation. BJU Int 2007, 99:107–110.CrossRefPubMed
18.
go back to reference Kessler TM, Madersbacher H, Kiss G: Prolonged sacral neuromodulation testing using permanent leads: a more reliable patient selection method. Eur Urol 2005, 47:660–665.CrossRefPubMed Kessler TM, Madersbacher H, Kiss G: Prolonged sacral neuromodulation testing using permanent leads: a more reliable patient selection method. Eur Urol 2005, 47:660–665.CrossRefPubMed
19.
go back to reference Weil EH, Ruiz-Cerdá JL, Eerdmans PH, et al.: Clinical results of sacral neuromodulation for chronic voiding dysfunction using unilateral sacral foramen electrodes. World J Urol 1998, 16:313–321.CrossRefPubMed Weil EH, Ruiz-Cerdá JL, Eerdmans PH, et al.: Clinical results of sacral neuromodulation for chronic voiding dysfunction using unilateral sacral foramen electrodes. World J Urol 1998, 16:313–321.CrossRefPubMed
20.
go back to reference Das AK, Carlson AM, Hull M; U.S. MDT-103 Study Group: Improvement in depression and health-related quality of life after sacral nerve stimulation therapy for treatment of voiding dysfunction. Urology 2004, 64:62–68.CrossRefPubMed Das AK, Carlson AM, Hull M; U.S. MDT-103 Study Group: Improvement in depression and health-related quality of life after sacral nerve stimulation therapy for treatment of voiding dysfunction. Urology 2004, 64:62–68.CrossRefPubMed
21.
go back to reference Siegel SW, Catanzaro F, Dijkema HE, et al.: Long-term results of a multicenter study on sacral nerve stimulation for treatment of urinary urge incontinence, urgency-frequency, and retention. Urology 2000, 56(6 Suppl 1):87–91.CrossRefPubMed Siegel SW, Catanzaro F, Dijkema HE, et al.: Long-term results of a multicenter study on sacral nerve stimulation for treatment of urinary urge incontinence, urgency-frequency, and retention. Urology 2000, 56(6 Suppl 1):87–91.CrossRefPubMed
22.
go back to reference Hijaz A, Vasavada S: Complications and troubleshooting of sacral neuromodulation therapy. Urol Clin North Am 2005, 32:65–69.CrossRefPubMed Hijaz A, Vasavada S: Complications and troubleshooting of sacral neuromodulation therapy. Urol Clin North Am 2005, 32:65–69.CrossRefPubMed
23.
go back to reference • Wantanabe JH, Campbell JD, Ravelo A, et al.: Cost Analysis of Intervention of Antimuscarinic Refractory Patients with Overactive Bladder. Urology 2010 Apr 28 [Epub ahead of print]. This study estimates US payer costs for up to 3 years for patients with overactive bladder symptoms refractory to pharmacologic therapy. • Wantanabe JH, Campbell JD, Ravelo A, et al.: Cost Analysis of Intervention of Antimuscarinic Refractory Patients with Overactive Bladder. Urology 2010 Apr 28 [Epub ahead of print]. This study estimates US payer costs for up to 3 years for patients with overactive bladder symptoms refractory to pharmacologic therapy.
Metadata
Title
Selection of Ideal Candidates for Neuromodulation in Refractory Overactive Bladder
Authors
Ravi Kacker
Anurag K. Das
Publication date
01-11-2010
Publisher
Current Science Inc.
Published in
Current Urology Reports / Issue 6/2010
Print ISSN: 1527-2737
Electronic ISSN: 1534-6285
DOI
https://doi.org/10.1007/s11934-010-0137-1

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