Jamie Drossaerts1,2, Kevin L J Rademakers3,4, Sajjad M Rahnama'i3,4, Tom Marcelissen3, Philip Van Kerrebroeck3,4, Gommert van Koeveringe3,4,5. 1. Department of Urology, Maastricht University Medical Centre (MUMC+), Maastricht, The Netherlands, j.drossaerts@outlook.com. 2. School of Mental Health and Neuroscience (MHeNS), Maastricht University, Maastricht, The Netherlands, j.drossaerts@outlook.com. 3. Department of Urology, Maastricht University Medical Centre (MUMC+), Maastricht, The Netherlands. 4. School of Mental Health and Neuroscience (MHeNS), Maastricht University, Maastricht, The Netherlands. 5. Pelvic Care Centre Maastricht, Maastricht University Medical Centre, Maastricht, The Netherlands.
Abstract
OBJECTIVES: To assess the improvement of symptoms by sacral neuromodulation (SNM) in an objective way by carrying out an ambulatory urodynamic study (ambulatory-UDS). Until now, successful treatment has been defined as a ≥50% improvement recorded on voiding diaries. Voiding diaries are a patient reported outcome tool. A tool with less bias is desired to evaluate the treatment results before an expensive permanent system is implanted. METHODS: Between 2002 and 2015, a total of 334 patients with lower urinary tract symptoms were included consecutively in an ambulatory-UDS database. From this database, a subgroup of patients was selected which underwent SNM. RESULTS: In 51 patients, an ambulatory-UDS was performed both at baseline and during the SNM test period. A positive treatment outcome after test stimulation based on the patients' voiding diary, correlated (p < 0.0001) with an improvement on ambulatory-UDS. Twenty-six of the 30 patients, who have showed improvement of more than 50% on voiding diary parameters and who had subjective improvement of their symptoms, showed an early improvement on ambulatory-UDS. CONCLUSIONS: Ambulatory-UDS can be used in clinical decision making, as it is associated with voiding diary improvement during the SNM test period. Using ambulatory-UDS to confirm success could in the future justify the shortening of the test period.
OBJECTIVES: To assess the improvement of symptoms by sacral neuromodulation (SNM) in an objective way by carrying out an ambulatory urodynamic study (ambulatory-UDS). Until now, successful treatment has been defined as a ≥50% improvement recorded on voiding diaries. Voiding diaries are a patient reported outcome tool. A tool with less bias is desired to evaluate the treatment results before an expensive permanent system is implanted. METHODS: Between 2002 and 2015, a total of 334 patients with lower urinary tract symptoms were included consecutively in an ambulatory-UDS database. From this database, a subgroup of patients was selected which underwent SNM. RESULTS: In 51 patients, an ambulatory-UDS was performed both at baseline and during the SNM test period. A positive treatment outcome after test stimulation based on the patients' voiding diary, correlated (p < 0.0001) with an improvement on ambulatory-UDS. Twenty-six of the 30 patients, who have showed improvement of more than 50% on voiding diary parameters and who had subjective improvement of their symptoms, showed an early improvement on ambulatory-UDS. CONCLUSIONS: Ambulatory-UDS can be used in clinical decision making, as it is associated with voiding diary improvement during the SNM test period. Using ambulatory-UDS to confirm success could in the future justify the shortening of the test period.
Authors: Steve J A Majerus; Sarah J Offutt; Thaddeus S Brink; Vincent Vasoli; Ian Mcadams; Margot S Damaser; Lance Zirpel Journal: IEEE Trans Neural Syst Rehabil Eng Date: 2021-10-13 Impact factor: 4.528