Reprogramming Requirements After Sacral Nerve Stimulator Implantation: Correlation With Preoperative Indication

Purpose

Recent publications support sacral nerve stimulator implantation in patients with interstitial cystitis. To our knowledge the reprogramming requirements for all patients following stimulator implantation has not been described and it is unknown whether the number of sessions required vary by pre-implantation diagnosis. We determined overall reprogramming requirements following nerve stimulator implantation and whether requirements vary based on preoperative indication.

Materials and Methods

After obtaining institutional review board approval we retrospectively reviewed the records of all patients who underwent sacral nerve stimulator implantation at our institution between June 2002 and October 2004. The preoperative indication and number of reprogramming sessions during the initial test period (stage 1) and following permanent implantation (stage 2) were compared.

Results

The 17 patients proceeding to stage 2 with a minimum 12-month followup during the study period were included. Mean age was 43 years (range 26 to 78) and all patients except 1 were female. Patients were separated by diagnosis for evaluation purposes, including urgency/frequency/incontinence in 8, urinary retention in 2 and interstitial cystitis in 7. The average number of reprogramming sessions during stage 1 was 0.9, 3.5 and 2.3 for urgency/frequency/incontinence, urinary retention and interstitial cystitis, respectively. The average number of reprogramming sessions after stage 2 was 2.8, 3.0 and 6.9 at 12-month followup for urgency/frequency/incontinence, urinary retention and interstitial cystitis, respectively. No patient had the stimulator removed for reprogramming failure.

Conclusions

Patients in urinary retention appear to require more frequent reprogramming during stage 1, while patients with interstitial cystitis require more sessions after stage 2 implantation.

Key Words: bladder, cystitis, interstitial, electric stimulation, implants and prostheses, urinary incontinence

Abbreviations and Acronyms: FDA, Food and Drug Administration, IC, interstitial cystitis, PNE, percutaneous nerve evaluation, UF, urgency/frequency, UR, urinary retention