AIMS: We compared success rates, subsequent complications, and possible indications for success of sacral neuromodulation (SNM) for urinary voiding dysfunction in diabetic and non-diabetic patients. METHODS: Thirty-two diabetic patients (mean age 61.8 years, range 27-83) with urge incontinence, urgency-frequency syndrome, and/or urinary retention refractory to non-surgical treatment were retrospectively evaluated along with 211 non-diabetic patients (mean age 54.1 years, range 20-86) with similar symptoms. All patients who experienced >or=50% reduction in urinary symptoms following a 7- to 21-day test period went on to permanent SNM device implantation. RESULTS: No significant difference was found with respect to successful conversion rates from the test period to permanent implantation between diabetic and non-diabetic patients. Long-term success rates at a mean followup of 29.3 months following permanent device implantation for diabetic patients were 69.2% of those with urge incontinence, 85.7% of those with urgency-frequency, and 66.7% of those with urinary retention. The non-diabetic cohort had success rates of 67.0% for urge incontinence, 67.8% for urgency/frequency, and 58.2% for urinary retention (P = 0.823, 0.157, and 0.631, respectively). No patient experienced intraoperative complications. Nine of 24 (37.5%) devices were explanted postoperatively in diabetic patients compared with 36 of 141 (25.5%) in non-diabetic patients (P = 0.224). The number of explants due to infection was higher in diabetic patients (16.7%) versus non-diabetic patients (4.3%; P = 0.018). CONCLUSIONS: No difference in long-term success rates was seen in diabetic patients when compared with similar, non-diabetic patients. Diabetic patients did, however, have a higher incidence of device explantation due to infection.
AIMS: We compared success rates, subsequent complications, and possible indications for success of sacral neuromodulation (SNM) for urinary voiding dysfunction in diabetic and non-diabeticpatients. METHODS: Thirty-two diabeticpatients (mean age 61.8 years, range 27-83) with urge incontinence, urgency-frequency syndrome, and/or urinary retention refractory to non-surgical treatment were retrospectively evaluated along with 211 non-diabeticpatients (mean age 54.1 years, range 20-86) with similar symptoms. All patients who experienced >or=50% reduction in urinary symptoms following a 7- to 21-day test period went on to permanent SNM device implantation. RESULTS: No significant difference was found with respect to successful conversion rates from the test period to permanent implantation between diabetic and non-diabeticpatients. Long-term success rates at a mean followup of 29.3 months following permanent device implantation for diabeticpatients were 69.2% of those with urge incontinence, 85.7% of those with urgency-frequency, and 66.7% of those with urinary retention. The non-diabetic cohort had success rates of 67.0% for urge incontinence, 67.8% for urgency/frequency, and 58.2% for urinary retention (P = 0.823, 0.157, and 0.631, respectively). No patient experienced intraoperative complications. Nine of 24 (37.5%) devices were explanted postoperatively in diabeticpatients compared with 36 of 141 (25.5%) in non-diabeticpatients (P = 0.224). The number of explants due to infection was higher in diabeticpatients (16.7%) versus non-diabeticpatients (4.3%; P = 0.018). CONCLUSIONS: No difference in long-term success rates was seen in diabeticpatients when compared with similar, non-diabeticpatients. Diabeticpatients did, however, have a higher incidence of device explantation due to infection.
Authors: He Changxiao; Yuan Zhengyong; Yan Shibing; Wu Caiwen; Huang Yingchuan; He Wei; Wang Hanhui; Li Dong; Huang Peng; Lei Jing; Zhou Rui; Liao Jia; Shen Hong Journal: Int Urogynecol J Date: 2014-02-27 Impact factor: 2.894