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Sacral neuromodulation for the treatment of refractory urinary urge incontinence after stress incontinence surgery.

Abstract：

OBJECTIVE:This study was undertaken to evaluate the response to sacral neuromodulation in women with refractory, nonobstructive urinary urge incontinence after stress incontinence surgery. STUDY DESIGN:We reviewed the medical records of women in whom sacral neuromodulation was performed for worsening or de novo urinary urge incontinence after a stress incontinence procedure. All patients had undergone preliminary test stimulation. Demographics, surgical and urogynecologic history, including bladder diary and pad weight test, and urodynamic parameters were evaluated. RESULTS:Of 34 women, 22 (65%) responded to the test stimulation and underwent permanent lead implant. There was no difference between responders and nonresponders with respect to type of stress incontinence surgery. Incontinence or urodynamic parameters were not different between responders and nonresponders. Factors that were predictive of a positive response were women aged less than 55 years (P = .01), the test stimulation performed within 4 years of the stress incontinence procedure (P = .01), and evidence of pelvic floor muscle activity (P = .03). CONCLUSION:Sacral neuromodulation is a viable option for the treatment of refractory urinary urge incontinence that occurs after stress urinary incontinence surgery. Older women with no pelvic floor activity who are remote from their incontinence surgery may have a suboptimal response.

journal_name

Am J Obstet Gynecol

journal_title

American journal of obstetrics and gynecology

authors

Sherman ND,Jamison MG,Webster GD,Amundsen CL

doi

10.1016/j.ajog.2005.07.038

subject

Has Abstract

pub_date

2005-12-01 00:00:00

pages

2083-7

issue

6

eissn

0002-9378

issn

1097-6868

pii

S0002-9378(05)01088-4

journal_volume

193

pub_type

杂志文章

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