Abstract
Purpose
The efficacy of sacral neuromodulation for treating refractory idiopathic lower urinary tract dysfunction is now well established. Nevertheless, results of this technique in neurological patients are still controversial. The aim of this retrospective study was to assess the results of sacral neuromodulation in neurogenic bladder dysfunction.
Materials and Methods
Between 1998 and 2008, a percutaneous nerve evaluation or a twoβstage technique was performed in 62 patients (mean age 50.5βΒ±β14.8 years) with neurogenic lower urinary tract dysfunction. Before and during the temporary stimulation, each patient had a urodynamic evaluation and performed a bladder diary. The test was considered positive if the clinical and urodynamic improvement was over 50% and if the symptoms reappeared after turning the stimulation off.
Results
Lower urinary tract dysfunction was detrusor overactivity in 34 cases and chronic urinary retention in 28 cases. A detrusorβsphincter dyssynergia (DSD) was associated in nine cases. Out of the 62 patients, 41 patients (66.1%) had more than 50% improvement on urodynamic evaluation and bladder diary and 37 were implanted. With a mean followβup of 4.3βΒ±β3.7 years, results remained similar to the evaluation phase in 28 cases (75.7%), were partially altered in three cases (8.1%) and lost in six cases (16.2%). In these six cases, neuromodulation failed on average 12.0βΒ±β12.4 months after implantation.
Conclusion
Sacral neuromodulation seems to constitute a serious therapeutic option for patients with neurogenic lower urinary tract dysfunction. However, its results depend on the type of the underlying neurologic disease and in particular, whether it may progress or not. 30:547β550, 2011. Β© 2011 WileyβLiss, Inc.