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Unilateral versus bilateral stage I neuromodulator lead placement for the treatment of refractory voiding dysfunction

✍ Scribed by Khanh Pham; Michael L. Guralnick; R. Corey O'Connor


Publisher
John Wiley and Sons
Year
2008
Tongue
English
Weight
77 KB
Volume
27
Category
Article
ISSN
0733-2467

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✦ Synopsis


Abstract

Aims

To determine if bilateral S3 lead placement during the stage I trial period improves the “success” rate for advancing to stage II (permanent) sacral neuromodulator placement.

Methods

A retrospective chart review of 124 (20 male and 104 female) patients undergoing stage I sacral neuromodulation (InterStim®, Medtronic, Minneapolis, Minnesota) implantation for the treatment of refractory voiding dysfunction was performed. Patients were divided into two cohorts based on unilateral versus bilateral stage I lead placement in the S3 foramina. Both groups were then evaluated and compared with regards to overall “success”, defined as progression from stage I to stage II placement.

Results

Fifty‐five (44%) patients underwent unilateral stage I lead placement and 69 (56%) received bilateral S3 leads. Successful stage I trials were reported in 32/55 (58%) and 53/69 (76%) of unilateral and bilateral cohorts, respectively (P = 0.03). Five wound infections were reported—2 (3.6%) following unilateral and 3 (4.3%) after bilateral stage I lead placement. No other complications were encountered.

Conclusions

Bilateral stage I neuromodulation trial provides a significantly higher rate of improvement in refractory voiding symptoms to allow for the progress to stage II implantation. Neurourol. Urodynam. 27:779–781, 2008, © 2008 Wiley‐Liss, Inc.