title: Initial experience with sacral neuromodulation for the treatment of lower urinary tract dysfunction in Brazil.
abstract: OBJECTIVE
  We report on the short-term outcomes of sacral neuromodulation (SNM) for treatment of idiopathic lower urinary tract dysfunction in Brazil (procedures performed before 2014).
  
  
  METHODS
  Clinical data and surgical outcomes of patients who underwent SNM staged procedures were retrospective evaluated. Urological assessment included a focused medical history and physical examination, measurement of postvoid residual volumes, urodynamics, and bladder diaries. A successful test phase has been defined by improvement of at least 50% of the symptoms, based on bladder diaries.
  
  
  RESULTS
  From January 2011 to December 2013, eighteen consecutive patients underwent test phase for SNM due to refractory overactive bladder (15 patients), non-obstructive chronic urinary retention (2 patients), and bladder pain syndrome/interstitial cystitis (1 patient). All patients underwent staged procedures at four outpatient surgical centers. Mean age was 48.3±21.2 (range 10-84 years). There were 16 women and 2 men. Median follow-up was 3 months. Fifteen patients (83.3%) had a successful test phase and underwent implantation of the pulse generator (IPG). Median duration of the test phase was 7 days (range 5-24 days). Mean age was 45.6±18.19 years in responders versus 61.66±34.44 years in non-responders (p=0.242). Mean operative time (test phase) was 99±33.12 min in responders versus 95±35 min for non-responders (p=0.852). No severe complications were reported.
  
  
  CONCLUSIONS
  SNM is a minimally invasive treatment option for patients with refractory idiopathic lower urinary tract dysfunction. Our initial experience with staged technique showed that tined-lead electrodes yielded a high rate of responders and favorable clinical results in the short-term follow-up.
authors.affiliation: Deparamento de Urologia, Hospital Albert Einstein, SP, Brasil.
authors.forename: Luis Augusto Seabra
authors.initials: LA
authors.lastname: Rios
authors.affiliation: Departamento de Urologia, Hospital Moinhos de Vento, Porto Alegre, RS, Brasil.
authors.forename: Marcio Augusto
authors.initials: MA
authors.lastname: Averbeck
authors.affiliation: Universidade Federal de São Paulo, Escola Paulista de Medicina, SP, Brasil.
authors.forename: Wagner
authors.initials: W
authors.lastname: Franca
authors.affiliation: Departamento de Urologia, AC Camargo Hospital, SP, Brasil.
authors.forename: Carlos Alberto Ricetto
authors.initials: CA
authors.lastname: Sacomani
authors.affiliation: Universidade Federal de São Paulo, Escola Paulista de Medicina, SP, Brasil.
authors.forename: Fernando G
authors.initials: FG
authors.lastname: Almeida
authors.affiliation: Departamento de Urologia, Faculdade de Medicina da Universidade de São Paulo, SP, Brasil.
authors.forename: Cristiano Mendes
authors.initials: CM
authors.lastname: Gomes
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D002648:Child; D002908:Chronic Disease; D004599:Electric Stimulation Therapy / Q000379:methods*; D005260:Female; D006801:Humans; D059411:Lower Urinary Tract Symptoms / Q000503:physiopathology / Q000628:therapy*; D008297:Male; D008875:Middle Aged; D061646:Operative Time; D019736:Prostheses and Implants; D015203:Reproducibility of Results; D012189:Retrospective Studies; D012445:Sacrococcygeal Region; D013997:Time Factors; D016896:Treatment Outcome; D014563:Urodynamics; D055815:Young Adult