Interstim and PTNS
A 2018 randomized control trial showed PTNS and Pelvic floor training decreases symptoms of nocturia in women. (1) A 2018 retrospective study did show a surprisingly high rate of re-interventions after SNM occured in 13.7% within 1 year, 26.3% within 3 years, and 38.0% within 5 years following SNM placement. 47% were for treatment failure and 47% for device malfunction at 1 year. At 5 years, 33.0% were for treatment failure and 63.8% for device malfunctions with no significant differences between high vs low volume hospitals or surgeons. (2) Another study of 147 found a 13% re-intervention rate with 4% for pain, 4% lack of efficacy, 3% for implant site infection. There was a 7% device pain incidence overall. (4,5)
One study found over 80% of patients stopped OAB medications after interstim. (3)
Lower revision rates are observed with better toe motor responses but not bellows scores. The ideal place is superomedial in the S3 foramen with outward lateral curvature achieving response at low amplitudes of 2 V or less. (6)
One study found over 80% of patients stopped OAB medications after interstim. (3)
Lower revision rates are observed with better toe motor responses but not bellows scores. The ideal place is superomedial in the S3 foramen with outward lateral curvature achieving response at low amplitudes of 2 V or less. (6)
- Furtado-Albanezi, Daniele, et al. "Effects of two nonpharmacological treatments on the sleep quality of women with nocturia: a randomized controlled clinical trial." International urogynecology journal (2018): 1-8.
- Chughtai, Bilal, et al. "Failures of Sacral Neuromodulation for Incontinence." JAMA surgery 153.5 (2018): 493-494.
- Amin, K., Moskowitz, D., Kobashi, K. C., Lee, U. J., & Lucioni, A. (2018). MP75-17 DO PATIENTS DISCONTINUE OVERACTIVE BLADDER MEDICATIONS AFTER SACRAL NEUROMODULATION? The Journal of Urology, 199(4), 973–978.
- Noblett, Karen, et al. “Detailed Analysis of Adverse Events and Surgical Interventions in a Large Prospective Trial of Sacral Neuromodulation Therapy for Overactive Bladder Patients.” Neurourology and Urodynamics, vol. 36, no. 4, 2017, pp. 1136–1139.
- Siegel, Steven, et al. “Results of a Prospective, Randomized, Multicenter Study Evaluating Sacral Neuromodulation With InterStim Therapy Compared to Standard Medical Therapy at 6-Months in Subjects With Mild Symptoms of Overactive Bladder.” Neurourology and Urodynamics, vol. 34, no. 3, 2015, pp. 224–230.
- Pizarro-Berdichevsky, Javier, et al. “Motor Response Matters: Optimizing Lead Placement Improves Sacral Neuromodulation Outcomes.” The Journal of Urology, vol. 199, no. 4, 2017, pp. 1032–1036.