PMID- 19193415
OWN - NLM
STAT- MEDLINE
DCOM- 20090505
LR  - 20090702
IS  - 1527-9995 (Electronic)
IS  - 0090-4295 (Linking)
VI  - 73
IP  - 4
DP  - 2009 Apr
TI  - Incidence and predictors of complications with sacral neuromodulation.
PG  - 731-5
LID - 10.1016/j.urology.2008.11.047 [doi]
AB  - OBJECTIVES: To determine the incidence and predictors of complications with 
      sacral nerve stimulation (SNS). METHODS: A prospective, longitudinal analysis of 
      all patients treated with SNS was performed to define the incidence of 
      complications and identify the predictors of these adverse events (AEs). All 
      patients underwent staged SNS placement with the InterStim device for treatment 
      of refractory voiding dysfunction. The patients were followed up for evidence of 
      AEs and device efficacy. The patient and device variables were examined 
      statistically for evidence of predictive value. RESULTS: From September 2001 to 
      March 2008, 221 patients with a mean age of 48.8 years underwent SNS lead 
      placement for the treatment of intractable urinary urgency/frequency (n = 121), 
      urge incontinence (n = 63), or urinary retention (n = 37). Of this group, 202 
      patients (91.4%) experienced a >50% improvement in symptoms and underwent 
      implantable pulse generator placement. At a mean follow-up of 36.9 months, 67 
      patients (30.3%) had experienced AEs (pain in 6, elective removal in 10, lack of 
      efficacy in 11, trauma in 18, infection in 7, hematoma in 3, and lead migration 
      in 12) requiring 44 lead revisions and 47 implantable pulse generator revisions. 
      The significant predictors of AEs included a history of trauma (P < .001), a 
      change in body mass index class (P < .001), enrollment in a pain clinic (P = 
      .008), the duration of follow-up (P = .002), and a history of AEs (P < .001). 
      CONCLUSIONS: The results of our study have shown that SNS is an effective 
      treatment for patients with intractable voiding dysfunction. Complications are 
      not uncommon but can be minimized with better patient selection.
FAU - White, Wesley M
AU  - White WM
AD  - Division of Urologic Surgery, University of Tennessee Medical Center, Knoxville, 
      Knoxville, Tennessee 37920, USA. wwhite@mc.utmck.edu
FAU - Mobley, Joe D 3rd
AU  - Mobley JD 3rd
FAU - Doggweiler, Regula
AU  - Doggweiler R
FAU - Dobmeyer-Dittrich, Cindy
AU  - Dobmeyer-Dittrich C
FAU - Klein, Frederick A
AU  - Klein FA
LA  - eng
PT  - Journal Article
DEP - 20090204
PL  - United States
TA  - Urology
JT  - Urology
JID - 0366151
SB  - IM
CIN - Urology. 2009 Jul;74(1):233. PMID: 19567302
MH  - Adult
MH  - Aged
MH  - Aged, 80 and over
MH  - Electric Stimulation Therapy/*adverse effects/*instrumentation
MH  - Female
MH  - Humans
MH  - Incidence
MH  - Male
MH  - Middle Aged
MH  - Prospective Studies
MH  - Prostheses and Implants/*adverse effects
MH  - Urination Disorders/*therapy
MH  - Young Adult
EDAT- 2009/02/06 09:00
MHDA- 2009/05/06 09:00
CRDT- 2009/02/06 09:00
PHST- 2008/08/26 00:00 [received]
PHST- 2008/10/30 00:00 [revised]
PHST- 2008/11/04 00:00 [accepted]
PHST- 2009/02/06 09:00 [entrez]
PHST- 2009/02/06 09:00 [pubmed]
PHST- 2009/05/06 09:00 [medline]
AID - S0090-4295(08)01992-4 [pii]
AID - 10.1016/j.urology.2008.11.047 [doi]
PST - ppublish
SO  - Urology. 2009 Apr;73(4):731-5. doi: 10.1016/j.urology.2008.11.047. Epub 2009 Feb 
      4.