Anna E R Faris1, Bradley C Gill2, Javier Pizarro-Berdichevsky3, Elodi Dielubanza4, Marisa M Clifton4, Henry Okafor4, Howard B Goldman5, Courtenay K Moore5, Raymond R Rackley5, Sandip P Vasavada6. 1. Lerner College of Medicine, Education Institute, Cleveland Clinic, Cleveland, Ohio. 2. Department of Biomedical Engineering, Lerner Research Institute, Cleveland Clinic, Cleveland, Ohio. 3. Department of Urology, Glickman Urological and Kidney Institute, Cleveland Clinic, Cleveland, Ohio; Urogynecology Unit, Dr. Sotero del Rio Hospital, Santiago, Chile; Division de Obstetricia y Ginecologia, Pontificia Universidad Catolica de Chile, Santiago, Chile. 4. Department of Urology, Glickman Urological and Kidney Institute, Cleveland Clinic, Cleveland, Ohio. 5. Lerner College of Medicine, Education Institute, Cleveland Clinic, Cleveland, Ohio; Department of Urology, Glickman Urological and Kidney Institute, Cleveland Clinic, Cleveland, Ohio. 6. Lerner College of Medicine, Education Institute, Cleveland Clinic, Cleveland, Ohio; Department of Urology, Glickman Urological and Kidney Institute, Cleveland Clinic, Cleveland, Ohio. Electronic address: VasavaS@ccf.org.
Abstract
PURPOSE: We investigated the influence of patient age on sacral nerve stimulation trial outcomes, device implantation and treatment durability. MATERIALS AND METHODS: We analyzed a database of all sacral nerve stimulation procedures performed between 2012 and 2014 at a high volume institution for associations of patient age with sacral nerve stimulation indication, trial stimulation success, device revision and device explantation. RESULTS: In a cohort of 356 patients those with nonobstructive urinary retention and urgency-frequency were younger than patients with urgency urinary incontinence. Trial stimulation success did not differ by age in stage 1 and percutaneous nerve evaluation trials (p = 0.51 and 0.84, respectively). Logistic regression identified greater odds of trial success in females compared to males (OR 2.97, 95% CI 1.32-6.04, p = 0.009) and for urgency urinary incontinence compared to urgency-frequency (OR 3.02, 95% CI 1.39-6.50, p = 0.006). In analyzed patients there were 119 surgical revisions, including battery replacement, and 53 explantations. Age was associated with a decreased risk of revision with 3% lower odds per each additional year of age (OR 0.97, 95% CI 0.95-0.98, p <0.0001). While age did not influence explantation, for each body mass index unit there was a 5% decrease in the odds of explantation (OR 0.95, 95% CI 0.91-0.98). CONCLUSIONS: In contrast to previous studies, older patients experienced no difference in the sacral nerve stimulation response in stimulation trials and no difference in the implantation rate. Furthermore, age was modestly protective against device revision. This suggests that age alone should not negatively predict sacral nerve stimulation responses.
PURPOSE: We investigated the influence of patient age on sacral nerve stimulation trial outcomes, device implantation and treatment durability. MATERIALS AND METHODS: We analyzed a database of all sacral nerve stimulation procedures performed between 2012 and 2014 at a high volume institution for associations of patient age with sacral nerve stimulation indication, trial stimulation success, device revision and device explantation. RESULTS: In a cohort of 356 patients those with nonobstructive urinary retention and urgency-frequency were younger than patients with urgency urinary incontinence. Trial stimulation success did not differ by age in stage 1 and percutaneous nerve evaluation trials (p = 0.51 and 0.84, respectively). Logistic regression identified greater odds of trial success in females compared to males (OR 2.97, 95% CI 1.32-6.04, p = 0.009) and for urgency urinary incontinence compared to urgency-frequency (OR 3.02, 95% CI 1.39-6.50, p = 0.006). In analyzed patients there were 119 surgical revisions, including battery replacement, and 53 explantations. Age was associated with a decreased risk of revision with 3% lower odds per each additional year of age (OR 0.97, 95% CI 0.95-0.98, p <0.0001). While age did not influence explantation, for each body mass index unit there was a 5% decrease in the odds of explantation (OR 0.95, 95% CI 0.91-0.98). CONCLUSIONS: In contrast to previous studies, older patients experienced no difference in the sacral nerve stimulation response in stimulation trials and no difference in the implantation rate. Furthermore, age was modestly protective against device revision. This suggests that age alone should not negatively predict sacral nerve stimulation responses.
Authors: Rachel A High; William Winkelman; Joseph Panza; Derrick J Sanderson; Hyde Yuen; Gabriela Halder; Courtney Shaver; Erin T Bird; Rebecca G Rogers; Jill M Danford Journal: Int Urogynecol J Date: 2020-06-25 Impact factor: 2.894
Authors: Ranjana Jairam; Jamie Drossaerts; Tom Marcelissen; Gommert van Koeveringe; Desiree Vrijens; Philip van Kerrebroeck Journal: Urol Int Date: 2021-05-31 Impact factor: 1.934
Authors: Thomas C Dudding; Paul A Lehur; Michael Sørensen; Stefan Engelberg; Maria Paola Bertapelle; Emmanuel Chartier-Kastler; Karel Everaert; Philip Van Kerrebroeck; Charles H Knowles; Lilli Lundby; Klaus E Matzel; Arantxa Muñoz-Duyos; Mona B Rydningen; Stefan de Wachter Journal: Neuromodulation Date: 2021-07-15