A modified approach to patient’s selection with improved clinical outcomes in sacral nerve modulation

Authors

  • Patrick Richard Centre Hospitalier Universitaire de Sherbrooke, Sherbrooke, QC
  • Maude Carmel Centre Hospitalier Universitaire de Sherbrooke, Sherbrooke, QC
  • Bechir Hage Centre Hospitalier Universitaire de Sherbrooke, Sherbrooke, QC
  • Sophie Ramsay Centre Hospitalier Universitaire de Sherbrooke, Sherbrooke, QC
  • Le Mai Tu Centre Hospitalier Universitaire de Sherbrooke, Sherbrooke, QC

DOI:

https://doi.org/10.5489/cuaj.730

Abstract

Introduction: Since the marketing of the percutaneous permanent
tined leads (PPTL), many centres rely solely on these instead of
the percutaneous nerve evaluation (PNE) as a screening tool. At
our centre, we routinely perform PNE. Moreover, with our limited
hospital resources, we have adopted a stricter definition of success
in the patient selection process using an improvement of more
than 60% as a cut-off point. This study presents our experience
with sacral nerve stimulation using PPTL as an adjunct to PNE to
improve the outcome of the screening method for patients suffering
from refractory voiding dysfunction.

Methods: We reviewed the charts of 106 patients who underwent
a PNE between 2001 and 2008. The outcome of the procedures,
the complication rates and its long-term effect were reviewed.

Results: Overall, 116 PNE were performed and it was successful
in 54%. Forty-five out of the 62 patients with a successful PNE
underwent the stage I procedure. Of these, 93% had a successful
stage I and were later implanted with the implantable pulse generator
(IPG). The remaining 12 patients underwent the simultaneous
implantation of the PPTL and IPG using the open procedure and
it was successful in 10 of them.

Conclusion: The PNE is a good adjunct to the staged procedure
to select the appropriate candidates for sacral nerve stimulation,
especially with limited resources.

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Author Biographies

Patrick Richard, Centre Hospitalier Universitaire de Sherbrooke, Sherbrooke, QC

Maude Carmel, Centre Hospitalier Universitaire de Sherbrooke, Sherbrooke, QC

Bechir Hage, Centre Hospitalier Universitaire de Sherbrooke, Sherbrooke, QC

Sophie Ramsay, Centre Hospitalier Universitaire de Sherbrooke, Sherbrooke, QC

Le Mai Tu, Centre Hospitalier Universitaire de Sherbrooke, Sherbrooke, QC

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How to Cite

Richard, P., Carmel, M., Hage, B., Ramsay, S., & Tu, L. M. (2013). A modified approach to patient’s selection with improved clinical outcomes in sacral nerve modulation. Canadian Urological Association Journal, 5(6), 403–8. https://doi.org/10.5489/cuaj.730

Issue

Vol. 5 No. 6 (2011): December

Section

Original Research

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