Please use this identifier to cite or link to this item: http://ahro.austin.org.au/austinjspui/handle/1/16298
Title: Sacral neuromodulation for refractory overactive bladder after prior intravesical onabotulinumtoxinA treatment
Authors: Hoag, Nathan;Plagakis, Sophie;Pillay, Samantha;Edwards, Alisa Wilson;Gani, Johan
Issue Date: 9-Sep-2016
EDate: 2016-09-09
Citation: Neurourology and Urodynamics 2016; online first: 9 September
Abstract: AIMS: Sacral neuromodulation (SNM) is a well-established treatment modality for refractory overactive bladder (OAB). There is a paucity of evidence examining the use of SNM in patients who have received prior intravesical onabotulinumtoxinA (BTXA) treatment. We aim to review those patients who underwent SNM for refractory OAB following treatment with BTXA. METHODS: A retrospective review was conducted to identify patients who had undergone prior intradetrusor BTXA for refractory OAB, then subsequent first-stage SNM. Patient demographics, number/dosage of BTXA, voiding diaries, and patient global impression of improvement (PGI-I) scores were recorded. Successful first-stage SNM was defined as subjective patient improvement of greater than 50%. Patient satisfaction and device use at last follow-up was noted. RESULTS: Eighty-three patients were identified having undergone SNM for OAB, of which 36 had prior BTXA treatment and were included in the series. 23/36 (63.9%) of patients had successful first-stage SNM, and underwent insertion of implantable pulse generator, compared to 33/47 (70.2%) in those who had never been treated with BTXA (Pā€‰=ā€‰0.5). Mean PGI-I score was 2.6 (range 1-4). With a mean follow up of 29.1 months (range 12-53), 17/23 (73.9%) were satisfied, and using the device at last follow-up. CONCLUSION: SNM is a suitable treatment option in those patients who have had prior BTXA treatment for refractory OAB, even in those for whom BTXA proved ineffective. Success rates were within the published range, and comparable to our own results, for SNM in OAB patients without prior BTXA treatment.
URI: http://ahro.austin.org.au/austinjspui/handle/1/16298
DOI: 10.1002/nau.23117
PubMed URL: http://www.ncbi.nlm.nih.gov/pubmed/27612039
Type: Journal Article
Subjects: Botulinum toxin A
Overactive bladder
Sacral neuromodulation
Urgency urinary incontinence
Appears in Collections:Journal articles

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