Does patient age impact outcomes of neuromodulation?
OBJECTIVE
We evaluated whether patients stratified by age have the same level of risks/benefits after a staged neuromodulation procedure for refractory voiding symptoms.


METHODS
Urologic diagnosis, complications, and revisions were collected from medical records of adults enrolled in our prospective observational study. Symptoms were assessed over 2 years with diaries, Interstitial Symptom-Problem Indices (ICSI-PI), and the Overactive Bladder Questionnaire-SF (OAB-q SF). 12-item Short-Form Health Survey (SF-12v2®) mental (MCS) and physical (PCS) component summaries evaluated quality of life. Data were examined with Pearson Chi-square or Fisher's Exact test, Kruskal-Wallis tests, and repeated measures analyses.


RESULTS
Patients (83% female) were grouped by age (years): <40 (n = 46), 40-64 (n = 146), and ≥65 (n = 136). Urge incontinence was predominant in the older groups and more patients <40 had interstitial cystitis/painful bladder syndrome (IC/PBS). In the <40, 40-64, and ≥65 groups, respectively, generator implant (91%, 88%, and 89%) and explant (15%, 12%, and 10%) rates were similar. Complications (24%, 14%, and 9%; P = 0.031) and revisions (20%, 5%, and 6%; P = 0.0025) differed. For the three respective groups, urinary frequency (P < 0.0001 for all), nocturia (P < 0.0001 for all), incontinence episodes (P < 0.0001 for all), urgency (P = 0.0474, P < 0.0001, P = 0.0020), ICSI-PI (P = 0.0015, P < 0.0001, P < 0.0001), and OAB-q scores improved over time. Incontinence severity improved in those >65 (P = 0.0015). SF-12 PCS improved in those 40-64 (P = 0.0482) and MCS scores improved in the <40 and 40-64 age groups (P = 0.013 and P = 0.0440, respectively).


CONCLUSIONS
These data suggest that neuromodulation success is not age dependent, however continued study is needed to confirm findings.
Oakland University William Beaumont School of Medicine, Rochester, Michigan, USA.
Kenneth M
KM
Peters
Kim A
KA
Killinger
Jason
J
Gilleran
Judith A
JA
Boura
D000328:Adult; D000367:Age Factors; D000368:Aged; D000369:Aged, 80 and over; D004599:Electric Stimulation Therapy; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D011788:Quality of Life; D011795:Surveys and Questionnaires; D016896:Treatment Outcome; D053201:Urinary Bladder, Overactive / Q000628:therapy*; D053202:Urinary Incontinence, Urge / Q000628:therapy*