Optimizing the Duration of Assessment of Stage-1 Sacral Neuromodulation in Nonobstructive Chronic Urinary Retention

Elneil, Sohier; Abtahi, Bahareh; Helal, Mohamed; Digesu, Alex; Gonzales, Gwen

doi:10.1111/ner.12017

Cited by 18 publications

(15 citation statements)

References 17 publications

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“…Our statistical analysis may encourage practitioners to employ this straightforward technical modification during Stage 1 SNM. In our present study of >330 patients with either OAB or urinary retention, most voiding parameters improved (P < 0.05) by up to 40% when motor response was performed at ≤3 V. Stage 1 to Stage 2 conversion rates for both OAB and urinary retention were 94% (Table 1), a marked improvement over recent studies reporting a 35.4%, 49.1%, and 63.2% conversion rate [10,[13][14][15][16][17]. Success rates are defined as a ≥50% improvement in voiding parameters for Medicare recipients and serve as an international standard.…”

Section: Discussionsupporting

confidence: 53%

Improving clinical outcomes for women with overactive bladder or urinary retention symptoms: a comparison of motor response voltages (1–9 V) during Stage 1 sacral neuromodulation

Marinkovic

Ford

2018

BJU International

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Significant improvement was noted (up to 40%) in most clinical voiding parameters in the <3-V patients for both OAB and urinary retention. While <3 V will still statistically improve patient outcomes, a voltage <2 V may elicit self-reprogramming pain with severe bellows and plantar flexion movement, which may discourage patients from therapy adjustments. We recommend randomised, controlled trials to confirm these results.

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Section: Discussionsupporting

confidence: 53%

Improving clinical outcomes for women with overactive bladder or urinary retention symptoms: a comparison of motor response voltages (1–9 V) during Stage 1 sacral neuromodulation

Marinkovic

Ford

2018

BJU International

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“…In order to optimize the duration of assessment of stage 1 SNM in women with NOUR, Elneil et al [16] assessed 24 female patients with NOUR after stage 1 SNM over an 8-week period and asked to record the restoration of normal bladder sensation and voiding. Qualitative and quantitative statistics were used to assess the outcomes and the influence of prognostic factors.…”

Section: Other Causes Of Female Voiding Dysfunction and Urinary Retenmentioning

confidence: 99%

“…By day 17, a cumulative percentage of 90% of patients had a normalized bladder sensation and 80% had commenced voiding. Stage 1 SNM may be left in situ for up to 4 weeks to ensure the maximum chance of restoring normal bladder function in this complex group of patients [16].…”

Section: Other Causes Of Female Voiding Dysfunction and Urinary Retenmentioning

confidence: 99%

Dysfunctional voiding

Artibani

Cerruto

2014

Current Opinion in Urology

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In 2013, many diagnostic and therapeutic questions in female voiding dysfunction remain unsolved. However, some data began to emerge. Patients with FDV did not demonstrate a difference in effortful control (effortful control is the ability to regulate one's responses to external stimuli), but did demonstrate a higher rate of surgency (surgency is a trait aspect of emotional reactivity in which a person tends towards high levels of positive affect). Toilet training method in childhood does not seem to have any long-term correlation with FDV. Training with pelvic floor physiotherapy and biofeedback still represents the first-line treatment for FDV. In the management of other causes of female voiding dysfunction, sacral neuromodulation demonstrated a satisfying long-term efficacy in the treatment of nonobstructive urinary retention.

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“…By day 17, 90% had restoration of sensation and 80% voided. This implies that a staged trial may go up to 4 weeks to maximize the chances of a response (44). …”

Section: Surgical Treatment Options For Dumentioning

confidence: 99%

The underactive bladder: diagnosis and surgical treatment options

Gani

Hennessey

2017

Transl. Androl. Urol.

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The underactive bladder (UAB)/detrusor underactivity (DU) is a relatively common condition. It is difficult to diagnose and can be difficult to manage. The aim of this review is to provide a review of the diagnosis and different surgical treatment options for UAB/DU. A comprehensive literature review using medical search engines was performed. The search included a combination of the following terms, UAB, DU, TURP, reduction cystoplasty, bladder diverticulectomy and sacral neuromodulation (SNM). Search results were assessed for their overall relevance to this review. Definitions, general overview and management options were extracted from the relevant medical literature. DU affects up to 45% of men and women >70 years of age. The symptoms of DU overlap significantly with overactive bladder (OAB) and bladder outlet obstruction (BOO). Urodynamic findings include low voiding pressure combined with slow intermittent flow and incomplete bladder emptying. Non-operative management for DU is acceptable; only 1 in 6 male patients may need a TURP and acute urinary retention (AUR) is rare. TURP for DU is feasible and is associated with good short and medium term outcomes, but over time, there is a return to baseline symptoms. Bladder diverticulectomy can also improve DU, but there is a paucity of guidelines on patient selection. SNM provides excellent outcomes for DU, but patient selection is important.

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Optimizing the Duration of Assessment of Stage-1 Sacral Neuromodulation in Nonobstructive Chronic Urinary Retention

Cited by 18 publications

References 17 publications

Improving clinical outcomes for women with overactive bladder or urinary retention symptoms: a comparison of motor response voltages (1–9 V) during Stage 1 sacral neuromodulation

Improving clinical outcomes for women with overactive bladder or urinary retention symptoms: a comparison of motor response voltages (1–9 V) during Stage 1 sacral neuromodulation

Dysfunctional voiding

The underactive bladder: diagnosis and surgical treatment options

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