1010 SACRAL NEUROMODULATION WITH INTERSTIMTM THERAPY FOR CHRONIC URINARY DISORDERS: A SINGLE-CENTRE EXPERIENCE

INTRODUCTION AND OBJECTIVES: To analyse the efficacy and safety of sacral neuromodulation with InterStimTM Therapy in patients with urinary incontinence and retention implanted at our centre. METHODS: This prospective observational study included all patients undergoing permanent implantation of a neurostimulator for SNM at our centre between 1996 and July 2010. Baseline and follow-up voiding diary variables, clinical improvement, and patient satisfaction were evaluated. The impact of age, sex, disease duration, and diagnosis (neurogenic or non-neurogenic), and implantation methodology (oneor two-stage implant) on clinical outcome was evaluated. RESULTS: The database included 165 patients (mean age 59 years, 85% females), including 69% with non-neurogenic cause of dysfunction. The principal diagnoses were overactive bladder syndrome (OAB, N 137) and urinary retention (N 22). At last follow-up, mean patient satisfaction with treatment at 0–12 months, 12–60 months and 60 months was 65.8%, 67.5%, and 75.0%, respectively. No differences were observed between retention and incontinence patients or between patients with neurogenic and non-neurogenic dysfunction. At last follow-up, clinical improvement of 50% and 90% was seen in 80% and 34% of patients, respectively. Clinical improvement of 50% or 90% was seen significantly more in patients with two-stage implant than in patients with one-stage implant (p 0.0001 and P 0.0023, respectively). Diagnosis (neurogenic or non-neurogenic; OAB or retention), sex, or disease duration before implantation ( 5 years or 5 years) were not significantly predictive of clinical improvement. 49 patients (29.7%) had 1 adverse event (AEs), of which pain (12.7%) occurred most frequently. Loss of efficacy occurred in 26.7% of patients. CONCLUSIONS: Sacral neuromodulation with InterStim Therapy seems to be an effective and well tolerated treatment in the short and the long term for patients with OAB and retention.