Sacral neuromodulation outcomes for the treatment of refractory idiopathic detrusor overactivity stratified by indication: Lack of anticholinergic efficacy versus intolerability.
BACKGROUND
Patients may fail oral overactive bladder therapies due to either poor drug efficacy or intolerability. We determined if the success of sacral neuromodulation varies if performed secondary to lack of anticholinergic efficacy versus drug intolerability.


METHODS
A retrospective review was performed on 152 patients undergoing staged sacral neuromodulation from 2004 to 2010 for refractory idiopathic detrusor overactivity with or without urge incontinence. Outcomes following sacral neuromodulation trials were compared based on the primary indication for anticholinergic failure: lack of drug efficacy versus intolerable side effects.


RESULTS
Overall, successful sacral neuromodulation trials were reported in 70% (106/152) of patients. Successful outcomes were noted in 70% (89/128) and 71% (17/24) of patients with poor anti-cholinergic efficacy and drug intolerability, respectively (p = NS).


CONCLUSIONS
We found no significant difference in outcome success in patients undergoing sacral neuromodulation trials for refractory detrusor overactivity due to lack of anticholinergic efficacy versus intolerability.
Department of Urology, Medical College of Wisconsin, Milwaukee, Wisconsin.
Tanya
T
Davis
Department of Urology, Medical College of Wisconsin, Milwaukee, Wisconsin.
Iryna
I
Makovey
Department of Urology, Medical College of Wisconsin, Milwaukee, Wisconsin.
Michael L
ML
Guralnick
Department of Urology, Medical College of Wisconsin, Milwaukee, Wisconsin.
R Corey
RC
O'Connor