Sacral neuromodulation for symptomatic chronic urinary retention in females: do age and comorbidities make a difference?
- PDF / 475,331 Bytes
- 13 Pages / 595.276 x 790.866 pts Page_size
- 20 Downloads / 182 Views
ORIGINAL ARTICLE
Sacral neuromodulation for symptomatic chronic urinary retention in females: do age and comorbidities make a difference? Rachel A. High 1 & William Winkelman 2 & Joseph Panza 3 & Derrick J. Sanderson 4 & Hyde Yuen 5 & Gabriela E. Halder 6 & Courtney Shaver 7 & Erin T. Bird 8 & Rebecca G. Rogers 6 & Jill M. Danford 8 Received: 2 June 2020 / Accepted: 30 July 2020 # The International Urogynecological Association 2020
Abstract Objectives To evaluate if age and medical comorbidities are associated with progression to implantation of sacral neuromodulation devices in women with symptomatic chronic urinary retention. Methods This multisite retrospective cohort included women with symptomatic chronic urinary retention who had a trial phase of sacral neuromodulation. The primary outcome was progression to implantation. Post-implantation outcomes were assessed as stable response versus decreased efficacy. A sub-analysis of catheter-reliant (intermittent-self catheterization or indwelling) patients was performed. Age was analyzed by 10-year units (decades of age). Multivariate logistic regression determined odds ratios for outcomes of implantation and for post-implantation stable response. Results Implantation occurred in 86% (243/284) women across six academic institutions. Most patients (160/243, 66%) were catheter reliant at the time of trial phase. Increased decade of age was associated with reduced implantation in all women [OR 0.54 (95% CI 0.42, 0.70)] and in the subgroup of catheter-reliant women [OR 0.52 (95% CI 0.37, 0.73)]. Post-implantation stable response occurred in 68% (193/243) of women at median follow-up of 2 years (range 0.3–15 years). Medical comorbidities present at the time of trials did not impact progression to implantation or post-implantation success. Conclusions Increasing decade of age is associated with reduced implantation in women with symptomatic chronic urinary retention. There is no age cutoff at which outcomes change. Post-implantation stable response was not associated with age or medical comorbidities. Keywords Aging . Elderly . Urinary retention . Sacral neuromodulation
Introduction Patients with symptomatic chronic urinary retention (SUR) experience bothersome lower urinary tract symptoms (LUTS)
such as urinary urgency, weak stream, straining, nocturia, and urinary frequency [1]. SUR significantly impacts quality of life, leading patients to seek treatment [1]. With significantly elevated post-void residuals (PVRs), chronic retention may require
This work was presented at the second joint meeting of the American Urogynecology Association-International Urogynecological Association September 24th–28th, 2019, in Nashville, TN, USA. * Rachel A. High [email protected] 1
2
Department of Obstetrics and Gynecology, Baylor Scott & White Health, Temple, TX, USA Department of Obstetrics and Gynecology, Mount Auburn Hospital, Cambridge, and the Department of Obstetrics and Gynecology, Beth Israel Deaconess Medical Center, and the Department of Obstetrics, Gynecology,
Data Loading...
