BERKELEY, CA (UroToday.com) - Elhilali and colleagues have reported on the long term results of sacral neuromodulation therapy effectiveness in patients implanted at the McGill University Hospitals over a thirteen year period. In this retrospective study of 52 patients permanently implanted since 1990, a very rigid criterion for implantation was used. Temporary percutaneous nerve evaluation for up to 7 days was employed, and a requirement of 50% improvement required before consideration for implantation. Twenty two of the 41 patients available for long-term evaluation (mean follow-up of 6.45 years) were in the urgency-frequency group. An additional 4 had diagnosed interstitial cystitis with intractable pelvic pain.

In the urgency-frequency group there was a success rate of 45% long term in the group permanently implanted. Of the two patients with interstitial cystitis who had failed bladder augmentation prior to Interstim® placement, neither was successful. In the two patients with severe pelvic pain, one reported long-term improvement.

The surgeon using Interstim® for PBS/IC needs to be familiar with the entire body of literature on use of this treatment in order to be able to council prospective implant recipients in a realistic manner. With its indication for urgency-frequency, its use has become common for PBS/IC, but more studies looking at long-term results are needed before it can be recommended as a standard part of the treatment algorithm.

Urology 2005 June; 65:1114-1117