Long-term follow-up of sacral neuromodulation for lower urinary tract dysfunction

Objective

To report our long-term experience of sacral neuromodulation (SNM) for various lower urinary tract dysfunctions but with a focus on efficacy, safety, re-interventions and degree of success.

Patients and Methods

This is a single tertiary referral centre study that included 217 patients (86% female) who received an implantable pulse generator (IPG) (Interstim (TM), Medtronic, Minneapolis, USA) between 1996 and 2010.

Success was considered if the initial >= 50% improvement in any of primary voiding diary variables persisted compared with baseline, but was further stratified.

Results

The mean duration of follow-up was 46.88 months.

Success and cure rates were approximate to 70% and 20% for urgency incontinence, 68% and 33% for urgency frequency syndrome and 73% and 58% for idiopathic retention.

In those patients with an unsuccessful therapy outcome, the mean time to failure was 24.6 months after implantation.

There were 88 (41%) patients who had at least one device or treatment related surgical re-intervention.

The re-intervention rate was 1.7 per patient with most of them (47%) occurring

Conclusions

SNM appears effective in the long-term with a success rate after definitive IPG implant of approximate to 70% and complete cure rates ranging between 20% and 58% depending on indication.

Patients with idiopathic retention appear to do best.

The re-intervention rate is high with most occurring