Results of a prospective, multicenter study evaluating quality of life, safety, and efficacy of sacral neuromodulation at twelve months in subjects with symptoms of overactive bladder

Neurourol Urodyn. 2016 Feb;35(2):246-51. doi: 10.1002/nau.22707. Epub 2014 Dec 24.

Abstract

Aims: This prospective, multicenter post-approval study evaluated the success rate of sacral neuromodulation (SNM) with the InterStim® System at 12-months. Subjects with bothersome symptoms of overactive bladder (OAB) including urinary urge incontinence (UI) or urgency-frequency (UF), who failed at least one anticholinergic medication and had at least one not tried were included.

Methods: Subjects with successful test stimulation received an SNM implant. Therapeutic success (≥50% improvement in average leaks/day or voids/day or a return to normal voiding frequency [<8 voids/day]) and quality of life through 12 months were evaluated for implanted subjects.

Results: Of the 340 subjects that went through test stimulation, 272 were implanted with SNM. Of these, 91% were female, mean age was 57, UI subjects had 3.1 ± 2.7 leaks/day, UF subjects had 12.6 ± 4.5 voids/day. The analysis which includes all implanted subjects with diary data at baseline and 12 months showed an OAB therapeutic success rate of 85% at 12 months. UI subjects had a mean reduction of 2.2 ± 2.7 leaks/day; UF subjects had a mean reduction of 5.1 ± 4.1 voids/day (both P < 0.0001). Subjects showed significant improvement from baseline in all measures of ICIQ-OABqol (all P < 0.0001). 80% of subjects reported improved changes in their urinary symptom interference at 12 months. Device-related adverse events occurred in 16% (56/340) of subjects during test stimulation and 30% (82/272) of subjects post-implant.

Conclusions: This multicenter study shows SNM is safe and effective and results in improved outcomes through 12 months in subjects with OAB symptoms, without requiring failure of all medications.

Keywords: overactive bladder; quality of life; sacral neuromodulation; urgency frequency; urinary incontinence.

Publication types

  • Multicenter Study
  • Randomized Controlled Trial

MeSH terms

  • Adult
  • Aged
  • Female
  • Humans
  • Male
  • Middle Aged
  • Neural Prostheses
  • Prospective Studies
  • Quality of Life*
  • Recovery of Function
  • Sacrum*
  • Spinal Cord Stimulation / adverse effects
  • Spinal Cord Stimulation / instrumentation
  • Spinal Cord Stimulation / methods*
  • Surveys and Questionnaires
  • Time Factors
  • Treatment Outcome
  • Urinary Bladder / innervation*
  • Urinary Bladder, Overactive / diagnosis
  • Urinary Bladder, Overactive / physiopathology
  • Urinary Bladder, Overactive / psychology
  • Urinary Bladder, Overactive / therapy*
  • Urinary Incontinence, Urge / diagnosis
  • Urinary Incontinence, Urge / physiopathology
  • Urinary Incontinence, Urge / psychology
  • Urinary Incontinence, Urge / therapy*
  • Urodynamics