Scottsdale, Arizona (UroToday.com) Dr. Eileen Gormley presented this retrospective study at five Female Pelvic Medicine and Reconstructive Pelvic Surgery (FPMRS) surgeons at one institution with the first and second stages performed in an operating room.
There were 150 unique patients underwent first stage SNS for one or more reasons: OAB (136), urinary retention (9) and fecal incontinence (15). Thirteen patients did not proceed to a second stage. Ten patients were deceased and excluded. Of the 127 who proceeded to a second stage,38 had their device removed for the following: lack of response (21), infection (4), pain (14) and need for MRI (6). Twenty-eight patients complied with their post-operative visits. These patients have functioning implants and are at a mean of 39 months (4 months-9.5 years) from their initial or subsequent generator. Of the remaining 61 patients,41 have devices over 5 years old. 54/61 patients had functional devices when last seen at a mean of 5.7 years ago. 34/61 patients have not been seen within our system for any care within the last year.
They searched the records from 2001-2019 using three CPT codes (64561,64590,64595). Cases were verified through chart review by two reviewers. The aim of this study to determine the number of patients who had their Sacral Neuromodulation (SNM) device removed, those with functional and non-functional devices, those without follow-up within a year and those with a device greater than five years old that is likely non-functional.
The conclusion was made and reported that SNS can be a very effective treatment for refractory OAB and urinary retention. However, many patients require removal or revision and some patients fail to follow-up. The biggest limitation of this study is the possibility that patients have re-located and/or are getting follow-up elsewhere. This does not negate a large number of devices that remain in patients without adequate follow-up who remain active in our medical records.
Presented by: Eileen Ann Gormley, MD, Dartmouth Hitchcock Medical Center, Lebanon, New Hampshire
Co-Author: Eileen Brandes, MD, Urology Resident at Dartmouth-Hitchcock, Lebanon, New Hampshire
Written by: Bilal Farhan, MD, Assistant Professor, Division of Urology, University of Texas, Medical Branch, Texas; @BilalfarhanMD, at the Society of Urodynamics, Female Pelvic Medicine & Urogenital Reconstruction Winter Meeting, SUFU 2020, February 25 - February 29, 2020, Scottsdale, Arizona