In patients undergoing neuromodulation for intractable urge incontinence a reduction in 24-hr pad weight after the initial test stimulation best predicts long-term patient satisfaction (original) (raw)

2007, Neurourology and Urodynamics

Aims: To evaluate long-term patient satisfaction of sacral neuromodulation and to correlate satisfaction with incontinence parameters. Methods: Patients at least 1-year remote from sacral neuromodulation were mailed a questionnaire to evaluate satisfaction and assess incontinence symptoms. Results: Fifty-two patients were consecutively enrolled in the study. Forty-nine questionnaires (94.2%) were returned. The average interval between implantation and questionnaire completion was 27.2 (range 12^52) months. 83.7% of respondents were satis¢ed and 79.6% of patients would '' do it all over again. '' Compared to dissatis¢ed subjects during test stimulation, the satis¢ed patients had a signi¢cant decrease in 24-hr pad weight (84.5% vs. 60.6%, P ¼ 0.002) but did not di¡er in daily pad usage (4.5 fewer pads per day vs. 3.4, P ¼ 0.190). At long-term follow-up, satis¢ed patients noted signi¢cantly greater improvement in their Incontinence Impact Questionnaire score versus dissatis-¢ed patients (mean improvement 53 vs. 10 points, P ¼ 0.0003). Using multiple logistic regression, change in 24-hr pad weight, but not change in average daily pad usage, was correlated with longterm satisfaction. Conclusions: Eighty-four percent of patients were satis¢ed with sacral neuromodulation at a mean of 27 months. An 84.5% reduction in 24-hr pad weight correlated with long-term patient satisfaction. In addition to lack of e⁄cacy, device pain was a contributing factor to dissatisfaction. Neurourol. Urodynam. 26:213^217, 2007. ß 2006

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