Efficacy and Safety of Sacral Neuromodulation (Interstim(R)) for the Treatment of Refractory Overactive Bladder Symptoms and Chronic Pelvic Pain / 대한비뇨기과학회지

ABSTRACT

PURPOSE: We evaluated the efficacy and safety of sacral neuromodulation for treating the patients suffering with an overactive bladder(OAB) or chronic pelvic pain(CPP) that was refractory to conservative therapies. MATERIALS AND METHODS: Between November 2002 and May 2006, a total of 30 patients underwent testing with sacral nerve modulation via either a traditional percutaneous approach or a staged procedure to predict the efficacy of this treatment for refractory OAB and/or CPP. 17 patients had 50% or greater improvement in their presenting symptoms and they underwent a procedure to implant a permanent sacral nerve stimulator. The results of the treatment were evaluated according to the 3 day-voiding records, the severity of pain, the patients' perception of their bladder condition and the benefits of the treatment. RESULTS: Twelve patients had CPP and 5 had OAB. The number and severity of their urgency episodes were improved. However, the number of times they passed urine was not significantly changed. The number of incontinence episodes was reduced for the 7 patients who suffered with urge incontinence. For 12 patients with CPP, the severity of their average pain was significantly decreased. There was a reduction in the number of the patients with a moderate or more severe bladder condition, from 17 to 10, after sacral neuromodulation. The overall rate of the patients' perceiving treatment benefit was 53%. The complications were lower limb numbness in 2 cases, wound infection in 1, foreign body sensation in 1, anal pain in 1 and lead migration in 1. CONCLUSIONS: Sacral Neuromodulation using Interstim(R) significantly improves the OAB symptoms and CPP in the patients who did not respond to other therapies.