Battery Explantation After Sacral Neuromodulation in the Medicare Population

Overview

Journal Neurourol Urodyn

Date 2012 Aug 1

PMID 22847359

Citations 13

Authors

Anne P Cameron

Jennifer T Anger

Rodger Madison

Christopher S Saigal

J Quentin Clemens

Affiliations

Soon will be listed here.

Abstract

Aims: To determine sacral neuromodulation battery life and the patient and provider risk factors for early explantation in a population-based sample.

Methods: A 5% sample of Medicare beneficiaries from 1997 to 2007 served as the data source. All patients who had a sacral neuromodulation device implanted in that time period were included. Variables included in a multivariate analysis of risk factors for removal included gender, age, race, diagnosis, type of test phase, provider specialty, and volume. The number of device reprogramming events was also recorded in this time period.

Results: Mean follow-up was 60.5 months. Patients on average had 2.15 reprogramming episodes in their first year, with that number decreasing over subsequent years. Out of the 558 batteries implanted 63 (11.3%) were explanted. Of the 19 implanted individuals who carried the diagnosis of interstitial cystitis (IC), 11 (57.9%) had the battery removed. This was the only variable that predicted early removal, with an odds ratio of explantation of 10.5 (95% CI: 3.9-28.4).

Conclusion: Very few sacral neuromodulation batteries, once implanted, are removed prematurely. Patients with IC, however, are at very high risk of requiring premature battery removal.

Citing Articles

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Zhang Y, Meng L, Zhang P, Tian X, Chen G, Li Y Transl Androl Urol. 2021; 10(5):1966-1975.

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Predictive Factors in Sacral Neuromodulation: A Systematic Review.

Jairam R, Drossaerts J, Marcelissen T, Van Koeveringe G, Vrijens D, Van Kerrebroeck P Urol Int. 2021; 106(4):323-343.

PMID: 34058731 PMC: 9153358. DOI: 10.1159/000513937.

References

Cameron A, Anger J, Madison R, Saigal C, Clemens J . National trends in the usage and success of sacral nerve test stimulation. J Urol. 2011; 185(3):970-5. PMC: 3285387. DOI: 10.1016/j.juro.2010.10.060. View

Sutherland S, Lavers A, Carlson A, Holtz C, Kesha J, Siegel S . Sacral nerve stimulation for voiding dysfunction: One institution's 11-year experience. Neurourol Urodyn. 2006; 26(1):19-28. DOI: 10.1002/nau.20345. View

JANKNEGT R, Hassouna M, Siegel S, Schmidt R, Gajewski J, Rivas D . Long-term effectiveness of sacral nerve stimulation for refractory urge incontinence. Eur Urol. 2001; 39(1):101-6. DOI: 10.1159/000052420. View

Amend B, Khalil M, Kessler T, Sievert K . How does sacral modulation work best? Placement and programming techniques to maximize efficacy. Curr Urol Rep. 2011; 12(5):327-35. DOI: 10.1007/s11934-011-0204-2. View

Peters K, Feber K, Bennett R . A prospective, single-blind, randomized crossover trial of sacral vs pudendal nerve stimulation for interstitial cystitis. BJU Int. 2007; 100(4):835-9. DOI: 10.1111/j.1464-410X.2007.07082.x. View

Hijaz A, Vasavada S, Daneshgari F, Frinjari H, Goldman H, Rackley R . Complications and troubleshooting of two-stage sacral neuromodulation therapy: a single-institution experience. Urology. 2006; 68(3):533-7. DOI: 10.1016/j.urology.2006.03.020. View

van Voskuilen A, Oerlemans D, Weil E, de Bie R, Van Kerrebroeck P . Long term results of neuromodulation by sacral nerve stimulation for lower urinary tract symptoms: a retrospective single center study. Eur Urol. 2006; 49(2):366-72. DOI: 10.1016/j.eururo.2005.11.009. View

Gajewski J, Al-Zahrani A . The long-term efficacy of sacral neuromodulation in the management of intractable cases of bladder pain syndrome: 14 years of experience in one centre. BJU Int. 2010; 107(8):1258-64. DOI: 10.1111/j.1464-410X.2010.09697.x. View

White W, Mobley 3rd J, Doggweiler R, Dobmeyer-Dittrich C, Klein F . Incidence and predictors of complications with sacral neuromodulation. Urology. 2009; 73(4):731-5. DOI: 10.1016/j.urology.2008.11.047. View

10.

Powell C, Kreder K . Long-term outcomes of urgency-frequency syndrome due to painful bladder syndrome treated with sacral neuromodulation and analysis of failures. J Urol. 2009; 183(1):173-6. DOI: 10.1016/j.juro.2009.08.142. View

11.

Comiter C . Sacral neuromodulation for the symptomatic treatment of refractory interstitial cystitis: a prospective study. J Urol. 2003; 169(4):1369-73. DOI: 10.1097/01.ju.0000053863.96967.5a. View

12.

Siegel S, Catanzaro F, Dijkema H, Elhilali M, Fowler C, Gajewski J . Long-term results of a multicenter study on sacral nerve stimulation for treatment of urinary urge incontinence, urgency-frequency, and retention. Urology. 2000; 56(6 Suppl 1):87-91. DOI: 10.1016/s0090-4295(00)00597-5. View

13.

Zabihi N, Mourtzinos A, Maher M, Raz S, Rodriguez L . Short-term results of bilateral S2-S4 sacral neuromodulation for the treatment of refractory interstitial cystitis, painful bladder syndrome, and chronic pelvic pain. Int Urogynecol J Pelvic Floor Dysfunct. 2007; 19(4):553-7. DOI: 10.1007/s00192-007-0466-x. View