Abstract:
AIMS:Sacral neurostimulation (SNS) involves a two-stage procedure to assess outcomes prior to permanent implantation. Stage 1 involves placement of a sacral lead that is externalized and tested for 2 weeks. Stage 2 is the implantation of a pulse generator in responders (≥ 50% improved). This study's purpose was to determine the overall response rate, costs of a two-staged versus single-stage approach, and explore predictors of a positive response. METHODS:A prospective database of 145 patients undergoing SNS was analyzed. Demographics, history, and operative data were collected from the medical records. Cost data were collected from our institutions' reported average reimbursement for all stages of Interstim implantation and explantation in 2008. Wilcoxon rank test were used for analysis. RESULTS:Of 145 patients, 131 (90.3%) progressed to Stage 2 and 14 (9.7%) had removal. Explanted patients were older (mean 63 years) than implanted patients (56 years); however, this was not statistically significant. Total Medicare and Blue Cross/Blue Shield (BCBS) reimbursement for a two-stage procedure was calculated at $21,428/case and $26,968. Implanting the lead and generator as a single-stage would cost Medicare and BCBS $20,696 and $21,602, respectively. Since 9.7% were explanted, overall cost saving might be significant: a single-stage approach would yield savings of $3,655/case (BC/BS) over a two-stage approach (after the cost of explantation is factored in). CONCLUSIONS:The majority of patients tested with SNS would benefit from a single-stage procedure (90.3%). This would reduce operative and anesthesia risks, time lost from work, and burden on patients and providers.
journal_name
Int Urol Nephroljournal_title
International urology and nephrologyauthors
Nikolavsky D,Killinger K,Boura J,Peters Kdoi
10.1007/s11255-011-9919-8subject
Has Abstractpub_date
2011-12-01 00:00:00pages
997-1002issue
4eissn
0301-1623issn
1573-2584journal_volume
43pub_type
杂志文章abstract:PURPOSE:In low and middle- income countries, due to lack of financial resources, the number of patients receiving one or two hemodialysis (HD) sessions a week has increased, leading to a large number of complications. Protein-energy wasting (PEW) and overhydration (OH) are common complications; nevertheless, the eviden...
journal_title:International urology and nephrology
pub_type: 杂志文章
doi:10.1007/s11255-020-02697-3
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abstract::Primary sclerosing lipogranuloma is an unusual benign condition of the genitalia typically presenting as a painless mass affecting the penis and scrotum. Its importance lies in differentiating it from malignancy to avoid extensive surgery. It is normally treated with total or partial excision. This is the first report...
journal_title:International urology and nephrology
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abstract::The effects of haemodialysate and its three peptide fractions on acetylcholinesterase (AChE, E.C. 3.1.1.7) activity in erythrocytes from healthy subjects and patients with terminal renal insufficiency treated by repeated haemodialyses have been studied. It was shown that erythrocytes from haemodialysed patients displa...
journal_title:International urology and nephrology
pub_type: 杂志文章
doi:
更新日期:1993-01-01 00:00:00
abstract::This paper describes the case of a patient with HCV, without previous evidence of nephropathy, who following two well-tolerated cycles of treatment with interferon alone developed nephrotic syndrome after a third attempt with ribavirin associated with peginterferon alfa 2b. The patient exhibited a total remission when...
journal_title:International urology and nephrology
pub_type: 杂志文章
doi:10.1007/s11255-007-9241-7
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journal_title:International urology and nephrology
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journal_title:International urology and nephrology
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journal_title:International urology and nephrology
pub_type: 杂志文章
doi:10.1007/s11255-011-9899-8
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journal_title:International urology and nephrology
pub_type: 杂志文章
doi:10.1007/s11255-008-9463-3
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journal_title:International urology and nephrology
pub_type: 杂志文章
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journal_title:International urology and nephrology
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journal_title:International urology and nephrology
pub_type: 临床试验,杂志文章
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journal_title:International urology and nephrology
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doi:10.1007/s11255-015-1099-5
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journal_title:International urology and nephrology
pub_type: 杂志文章
doi:10.1007/BF02550604
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journal_title:International urology and nephrology
pub_type: 杂志文章
doi:10.1007/BF02550565
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abstract::Protein Z (PZ) is a vitamin K-dependent protein isolated from human and bovine plasmas. Although the exact role of PZ in the haemostatic system is presently unknown, it is suggested that PZ deficiency may cause bleeding tendency. Haemostatic alterations in end-stage renal failure (ESRF) are certainly complex and invol...
journal_title:International urology and nephrology
pub_type: 杂志文章
doi:10.1023/a:1007179631603
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journal_title:International urology and nephrology
pub_type: 杂志文章
doi:10.1007/BF02549531
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journal_title:International urology and nephrology
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doi:10.1007/s11255-019-02230-1
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pub_type: 杂志文章
doi:10.1007/BF02551334
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journal_title:International urology and nephrology
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journal_title:International urology and nephrology
pub_type: 杂志文章
doi:10.1007/s11255-012-0263-4
更新日期:2013-04-01 00:00:00
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journal_title:International urology and nephrology
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doi:10.1023/a:1014410026495
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abstract::The authors present four cases of operatively confirmed anorchism. The plasma levels of testosterone and 11-deoxy-17-ketosteroids and dehydroisoandrosterone in urine were low in all cases. After stimulation with HCG, plasma testosterone levels increased in two cases and did not change in another two. The levels of 11-...
journal_title:International urology and nephrology
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abstract::Non-refluxing non-obstructive megaureter is a rare condition, usually diagnosed in asymptomatic neonates. We present the case of a 39-year-old male, who presented with a 6-month history of recurrent UTIs and intermittent frank haematuria. IVU, flexible cystoscopy and micturating cystogram confirmed characteristically ...
journal_title:International urology and nephrology
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journal_title:International urology and nephrology
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doi:10.1007/s11255-006-9144-z
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