title: Prospective Trial of Sacral Neuromodulation for Refractory Overactive Bladder Syndrome in Korean Patients.
abstract: OBJECTIVE
  To evaluate the efficacy and safety of sacral neuromodulation for treating patients with refractory overactive bladder based on urodynamic data.
  
  
  METHODS
  Patients older than 18 years of age, with overactive bladder symptoms refractory to conventional therapies were eligible. Patients with more than a 50% reduction in frequency, urgency, or urge incontinence symptoms during a 2-week test stimulation period retained the sacral neuromodulation. Voiding diaries, overactive bladder questionnaires, and urodynamic studies were performed before and 1 year after sacral neuromodulation.
  
  
  RESULTS
  Forty patients received sacral neuromodulation and 31 patients of those were followed more than 1 year. The mean age of the 31 patients was 54.2 ± 15.4 (range, 30-76) years, and the mean duration of symptoms was 4.4 ± 5.7 (range, 1-31) years. After 12 months of sacral neuromodulation, significant decreases in the episodes of daily urgency (from 20.2 to 5.7, P < 0.001), urgency incontinence (from 7.3 to 0.2; P = 0.011), day time micturition (from 21.8 to 9.9; P < 0.001), night time micturition (from 3.2 to 1.2; P = 0.006) and in severity of urgency episodes (from 3.8 to 2.7; P = 0.015) were observed compared to baseline. Significant increases occurred in bladder volume at the first unstable contraction (from 182.4 ± 92.7 to 216.8 ± 115.6 mL), bladder volume at first desire to void (from 150.5 ± 90.8 to 167.8 ± 81.5 mL), maximal cystometric capacity (from 260.7 ± 120.4 to 291.7 ± 124.3 mL) and bladder volume at urgency sensation (from 182.4 ± 92.7 to 208.2 ± 106.6 mL) (all P < 0.05).
  
  
  CONCLUSIONS
  Sacral neuromodulation is an effective and safe treatment for refractory overactive bladder.
authors.affiliation: Department of Urology, Ulsan University Hospital, University of Ulsan College of Medicine, Ulsan, Korea.
authors.forename: Kyung Hyun
authors.initials: KH
authors.lastname: Moon
authors.affiliation: Department of Urology, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea.
authors.forename: Ji-Yeon
authors.initials: JY
authors.lastname: Han
authors.affiliation: Department of Urology, Yonsei University College of Medicine, Seoul, Korea.
authors.forename: Jang Hwan
authors.initials: JH
authors.lastname: Kim
authors.affiliation: Department of Urology, College of Medicine, Ewha Womans University, Seoul, Korea.
authors.forename: Ha Na
authors.initials: HN
authors.lastname: Lee
authors.affiliation: Department of Urology, Sungkyunkwan University School of Medicine, Seoul, Korea.
authors.forename: Kyu-Sung
authors.initials: KS
authors.lastname: Lee
authors.affiliation: Department of Urology, College of Medicine, Korea University, Seoul, Korea.
authors.forename: Jeong Gu
authors.initials: JG
authors.lastname: Lee
authors.affiliation: Department of Urology, Seoul National University Hospital, Seoul National University College of Medicine, Seoul, Korea.
authors.forename: Seung-June
authors.initials: SJ
authors.lastname: Oh
authors.affiliation: Department of Urology, College of Medicine, Ewha Womans University, Seoul, Korea.
authors.forename: Ha Na
authors.initials: HN
authors.lastname: Yoon
authors.affiliation: Department of Urology, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea.
authors.forename: Myung-Soo
authors.initials: MS
authors.lastname: Choo
keywords: efficacy; overactive bladder; sacral neuromodulation