Long-term results of sacral neuromodulation for women with urinary retention.
OBJECTIVE ; To review the long-term results of sacral nerve stimulation in the treatment of women with Fowler's syndrome, over a 6-year period at one tertiary referral centre.


METHODS
Between 1996 and 2002, 26 women with urinary retention were treated by implanting a sacral nerve stimulator. Their case records were reviewed for follow-up, complications and revision procedures, and the most recent uroflowmetry results.


RESULTS
There were 20 patients (77%) still voiding spontaneously at the time of review (with two having deactivated their stimulator because of pregnancy). Fourteen patients (54%) required revision surgery, and the most common complications included loss of efficacy, implant-related discomfort and leg pain. The mean postvoid residual volume was 75 mL and mean maximum flow rate 20.8 mL/s.


CONCLUSIONS
In young women with retention, for whom there is still no alternative to lifelong self-catheterization, sacral neuromodulation is effective for up to 5 years after implantation. However, there was a significant complication rate, in line with other reports, which may be improved by new technical developments.
National Hospital for Neurology & Neurosurgery, Department of Uro-Neurology, Queen Square, London, UK. ranandg@yahoo.co.uk
Ranan
R
Dasgupta
Oliver J
OJ
Wiseman
Neil
N
Kitchen
Clare J
CJ
Fowler
D000328:Adult; D004599:Electric Stimulation Therapy / Q000379:methods*; D004567:Electrodes, Implanted; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008160:Lumbosacral Plexus; D008875:Middle Aged; D016896:Treatment Outcome; D016055:Urinary Retention / Q000503:physiopathology / Q000628:therapy*; D014554:Urination / Q000502:physiology