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Sacral neuromodulation: standardized tined lead implantation technique: two-year clinical outcome and sensory response upon lead stimulation comparing the use of the curved versus straight stylet


Vaganée, Donald; Kessler, Thomas M; Van de Borne, Sigrid; De Win, Gunter; de Wachter, Stefan (2019). Sacral neuromodulation: standardized tined lead implantation technique: two-year clinical outcome and sensory response upon lead stimulation comparing the use of the curved versus straight stylet. BJU International, 123(5A):E7-E13.

Abstract

OBJECTIVES To assess clinical follow-up data over 24 months using the standardized tined lead implantation technique, comparing the use of the curved vs straight stylet. PATIENTS AND METHODS Single tertiary center, prospective study (August 2013 - June 2015) involving 40 patients with overactive bladder and 15 with non-obstructive urinary retention refractory to first-line treatment. PRIMARY OUTCOME successful tined lead procedure; intention to treat analysis at 12 and 24 months. Secondary outcome: number of optimal electrode configurations during programming. Statistical analysis was performed by plain non-parametric tests for numeric and categorical data. RESULTS 33/35 (94%) patients implanted with the curved stylet had a successful tined lead procedure versus 13/20 (65%) implanted with the straight stylet (p=0.005). Intention to treat analysis at 12 and 24 months was 94% and 91% for the patients with the curved stylet compared to 65% and 45% for those with the straight stylet (p=0.002 and p<0.001). 60% and 25% of the electrode configurations in the curved group were considered optimal and bad in comparison to 40% and 37% in the straight group (p<0.001). The main limitation is the non-randomized study design. CONCLUSIONS The use of the standardized implantation technique with the curved stylet leads to more successful tined lead procedures, better success rates after 2-years follow-up and more optimal electrode configurations when compared to use of the straight stylet placement. This article is protected by copyright. All rights reserved.

Abstract

OBJECTIVES To assess clinical follow-up data over 24 months using the standardized tined lead implantation technique, comparing the use of the curved vs straight stylet. PATIENTS AND METHODS Single tertiary center, prospective study (August 2013 - June 2015) involving 40 patients with overactive bladder and 15 with non-obstructive urinary retention refractory to first-line treatment. PRIMARY OUTCOME successful tined lead procedure; intention to treat analysis at 12 and 24 months. Secondary outcome: number of optimal electrode configurations during programming. Statistical analysis was performed by plain non-parametric tests for numeric and categorical data. RESULTS 33/35 (94%) patients implanted with the curved stylet had a successful tined lead procedure versus 13/20 (65%) implanted with the straight stylet (p=0.005). Intention to treat analysis at 12 and 24 months was 94% and 91% for the patients with the curved stylet compared to 65% and 45% for those with the straight stylet (p=0.002 and p<0.001). 60% and 25% of the electrode configurations in the curved group were considered optimal and bad in comparison to 40% and 37% in the straight group (p<0.001). The main limitation is the non-randomized study design. CONCLUSIONS The use of the standardized implantation technique with the curved stylet leads to more successful tined lead procedures, better success rates after 2-years follow-up and more optimal electrode configurations when compared to use of the straight stylet placement. This article is protected by copyright. All rights reserved.

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Additional indexing

Item Type:Journal Article, refereed, original work
Communities & Collections:04 Faculty of Medicine > Balgrist University Hospital, Swiss Spinal Cord Injury Center
Dewey Decimal Classification:610 Medicine & health
Language:English
Date:1 May 2019
Deposited On:04 Jan 2019 12:53
Last Modified:24 Sep 2019 23:59
Publisher:Wiley-Blackwell Publishing, Inc.
ISSN:1464-4096
Additional Information:This is the peer reviewed version of the following article: BJU Int. 2018 Dec 11. doi: 10.1111/bju.14650, which has been published in final form at https://doi.org/10.1111/bju.14650. This article may be used for non-commercial purposes in accordance with Wiley Terms and Conditions for Use of Self-Archived Versions. (http://www.wileyauthors.com/self-archiving)
OA Status:Closed
Free access at:Publisher DOI. An embargo period may apply.
Publisher DOI:https://doi.org/10.1111/bju.14650
PubMed ID:30537223

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