Sacral neuromodulation for intractable urge incontinence: are there factors associated with cure?
OBJECTIVE
To determine the variables that affect the cure rate in patients with urge incontinence treated with sacral neuromodulation.


METHODS
This prospective analysis of patients with refractory urinary urge incontinence who underwent placement of a neuromodulator lead and generator was undertaken between October 2000 and December 2003. Quantitative assessment of the severity of their urinary leakage was assessed by preoperative and postoperative 3-day bladder diaries documenting leakage episodes, number of pads used per day, and a 24-hour pad weight assessment. Cure was defined as no daily leakage episodes after permanent implantation. Subjective outcome was assessed using the Incontinence Impact Questionnaire. Two-sample independent t tests, two-way chi-square tests, and tests of two proportions were performed when appropriate, with P < 0.05 considered significant.


RESULTS
The mean postimplantation follow-up was 29 months, and the average age was 60 years (range 29 to 83). The cure rate was associated with age, with individuals younger than 55 years having a statistically significant greater cure rate (65% versus 37% for older individuals; P < 0.05). Having three or more chronic conditions was associated with a lower cure rate in both younger and older individuals. Patients with a neurologic condition also had a lower cure rate, but no specific neurologic condition was associated.


CONCLUSIONS
Age older than 55 years and more than three chronic conditions were independent factors associated with a lower cure rate in patients implanted with a sacral neuromodulator for refractory urge incontinence. A neurologic condition may be associated with a decrease in the cure rate.
Amundsen
Cindy L
CL
Division of Urogynecology, Department of Obstetrics and Gynecology, Duke University Medical Center, Durham, North Carolina 27710, USA. amund002@mc.duke.edu
Romero
Audrey A
AA
Jamison
Margaret G
MG
Webster
George D
GD
D000328:Adult; D000367:Age Factors; D000368:Aged; D000369:Aged, 80 and over; D004599:Electric Stimulation Therapy / Q000379:methods; D005260:Female; D006801:Humans; D008160:Lumbosacral Plexus; D008297:Male; D008875:Middle Aged; D011379:Prognosis; D011446:Prospective Studies; D012074:Remission Induction; D014549:Urinary Incontinence / Q000628:therapy*