Steven R. Mindrup, Suzette E. Sutherland, Jyothi Kesha, and Steven W. Siegel

Metro Urology, Center for Continence Care and Female Urology, Minneapolis/St. Paul, Minnesota

Objective: The purpose of this study was to review our institution’s experience with sacral nerve stimulation (SNS) for the treatment of refractory voiding dysfunction in men.

Methods: We performed a retrospective review of our database containing information about patients who received an implantable pulse generator (IPG) from December 1993 through December 2004. This time period reflects an evolution in SNS, including PNE trials, non-tined (bone or fascial anchored) leads, percutaneous tined leads with two-staged procedures, and percutaneous pudendal trials.

Results: The study population included a total of 106 patients, 13 (12%) of whom were male. In this cohort of patients, the average age at implantation was 52 (range 27-77). Duration of symptoms prior to implantation was 106 months (range 9 – 583). The most frequent primary indication for implantation was refractory urgency/frequency in 11 patients (85%). Five (38%) of the urgency/frequency patients had previously been diagnosed with nonbacterial prostatitis. Nonobstructive urinary retention (NOUR) was the primary diagnosis in the two remaining patients (15%). In the U/F group, the average number of voids per 24 hours decreased from 13 (+ 1.4) to 9 (+2.1), the average number of voids per night decreased from 2.9 (+2.1) to 1.4 (+1.1), and the average number of leaks per 24 hours decreased from 7.1 (+ 6.9) to 1.5 (+1.4). In the NOUR group the number of catheterizations per day decreased from 5 to 1. Overall mean lead durability was 29 months (range 8 – 52 months). Four men experienced reportable events (31%), all of which were mild to moderate in severity. The most common reportable event was loss of efficacy in three patients (23%), followed by infection in one patient (8%). All four reportable events were successfully treated with surgical revision.

Conclusions: In this cohort of men, SNS was an effective, durable treatment for voiding dysfunction from multiple etiologies.

UroToday.com Coverage of SUFU 2007

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