Is sacral neuromodulation effective in patients with Parkinson's disease? A retrospective review
Introduction and Objective Parkinson's disease (PD) is the second‐most common degenerative neurologic disease worldwide. Overactive bladder (OAB) is prevalent in this population but can be challenging to treat. Sacral neuromodulation (SNM) is an attractive option but remains understudied. We ha...
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Veröffentlicht in: | Neurourology and urodynamics 2022-04, Vol.41 (4), p.955-961 |
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Sprache: | eng |
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Zusammenfassung: | Introduction and Objective
Parkinson's disease (PD) is the second‐most common degenerative neurologic disease worldwide. Overactive bladder (OAB) is prevalent in this population but can be challenging to treat. Sacral neuromodulation (SNM) is an attractive option but remains understudied. We have utilized SNM in PD patients and herein describe our outcomes.
Methods
We performed a retrospective chart review of PD patients who underwent peripheral nerve evaluation (PNE) or Stage 1 SNM from 2000 to 2020. The primary outcome was progression to a permanent implant. The impact of PD stage and preprocedural urodynamic (UDS) parameters on test‐phase outcome were investigated. Long‐term efficacy was assessed using Wilcoxon matched‐pairs test looking at a change in urinary symptoms (frequency, nocturia, incontinence episodes, and pad use) documented at follow‐up visits and further need for treatment.
Results
Thirty‐four patients underwent test phase SNM (7 PNE and 27 Stage 1). Median follow‐up was 11 (interquartile range 5.8–29.8) months. Indications included refractory OAB (30/34) and nonobstructive urinary retention (4/34). Overall, 82% (28/34) of patients proceeded to a permanent implant. 71% (5/7) of PNEs were successful. Test‐phase success did not differ based on PD disease severity or UDS parameters. In patients with OAB/urgency incontinence who progressed to the permanent implant, there was a statistically significant improvement in their urinary symptoms from baseline. Most (68%) patients were able to discontinue OAB medications post‐implant. The overall lead revision rate was 14% (4/28) and 3 devices required removal.
Conclusions
SNM is an efficacious treatment option for PD patients with a high percentage of patients having improvement in their urinary symptoms. |
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ISSN: | 0733-2467 1520-6777 |
DOI: | 10.1002/nau.24900 |