Abstract Details

Title Patient Profile Of Sacral Neuromodulation Success In Underactive Bladder

Topic Neuromuscular and Clinical Neurophysiology (EMG)

Presentation(s) P2 - Poster Session 2 (8:00 AM-9:00 AM)

Poster/Presentation
Number 7-002

Objective To evaluate the urodynamic profiles of patients with neurogenic underactive bladder (UAB) with successful sacral neuromodulation (SNM) and of those who did not have SNM success.

Background

SNM is a minimally invasive therapy used to manage neurogenic bladder. Studies have supported SNM success for overactive bladder, but there is limited knowledge regarding patient factors associated with SNM success for neurogenic UAB.

Design/Methods We conducted a retrospective institutional chart review of 32 UAB patients with SNM over the past 5 years. Demographic and urodynamic data [post-void residual (PVR), maximum detrusor pressure (Pdet max), detrusor pressure at maximum flow rate (Pdet at Qmax), maximum flow rate (Qmax), average flow rate (Qave), and end filling detrusor pressure (End Filling Pdet)], initial visit PVR (ivPVR), valsalva voiding, catheter use, and comorbidities were collected. The success cohort (SC) was defined as implantable pulse generator placement with >50% reduction in urinary symptoms on bladder diary, and non-success cohort (NSC) as no substantial improvement.

Results 28 (87%) patients were SC, 4 (13%) NSC. 25 (78%) patients were female, 7 (22%) male. Mean SC and NSC age was 57 years (SD 17.32), 57 years (SD 26.56), respectively. Data showed greater male proportion in NSC versus SC (75% vs. 14%, p=0.02), more prior bladder surgeries in NSC versus SC (50% vs. 4%, p=0.03), lower catheter dependency in SC versus NSC (25% vs. 100%, p<0.01), lower ivPVR in SC versus NSC (65mL vs. 675mL, p<0.01), and significant preoperative/postoperative PVR difference in the SC (p<0.01). On logistic regression, gender and average PVR were non-significant factors influencing SNM success.

Conclusions

This study provides insights that SNM can be therapeutic for patients with neurogenic UAB. Knowledge gained includes difference in the demographic and urodynamic profiles of patients with SNM success, and avenues to guide physician counseling for SNM success in patients with neurogenic UAB.

Authors/Disclosures
Greeshma Venigalla PRESENTER	Ms. Venigalla has nothing to disclose.
Braian Ledesma, MD	Dr. Ledesma has nothing to disclose.
Katherine Amin, MD	Dr. Amin has nothing to disclose.
Raveen Syan, MD	Dr. Syan has nothing to disclose.

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