Pd07-10 an Analysis of Sacral Neuromodulation and Intradetrusor Botulinum Toxin for Urge Urinary Incontinence in Post Stroke Patients

You have accessJournal of UrologyUrodynamics/Lower Urinary Tract Dysfunction/Female Pelvic Medicine: Neurogenic Voiding Dysfunction (PD07)1 May 2024PD07-10 AN ANALYSIS OF SACRAL NEUROMODULATION AND INTRADETRUSOR BOTULINUM TOXIN FOR URGE URINARY INCONTINENCE IN POST STROKE PATIENTS Tyler Trump, Po-Ming Chow, Omer Anis, and Howard Goldman Tyler TrumpTyler Trump , Po-Ming ChowPo-Ming Chow , Omer AnisOmer Anis , and Howard GoldmanHoward Goldman View All Author Informationhttps://doi.org/10.1097/01.JU.0001008552.16893.70.10AboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookLinked InTwitterEmail Abstract INTRODUCTION AND OBJECTIVE: Urge incontinence (UUI) is common in patients who have experienced a stroke (CVA) and is associated with impaired quality of life. Anticholinergic medications are used with caution in these patients and beta-3 agonists often have prescribing limitations. As a result, third-line therapy is common. The objective of this study is to compare the outcomes of botulinum toxin (BTX) and sacral neuromodulation (SNM) in patients with UUI following CVA. METHODS: Retrospective analysis was performed to identify patients with UUI following CVA who underwent third-line therapy with SNM or BTX between 01/2016 and 12/2022 at a large academic medical center. Patient demographics and co-morbidities were recorded. The primary outcome was patient symptom response to third-line therapy. Treatment response was defined as 0, 1-50%, 51-75%, and>75% improvement.>50% improvement was defined as a significant response. Secondary endpoints were proportion of patients achieving total dry and duration of therapy for those achieving significant response. RESULTS: 177 patients were identified with UUI following CVA who subsequently underwent third-line therapy (95 BTX, 82 SNM). Patients in the BTX group were older (71.9 years vs 67.4 years, p=0.02) with otherwise similar demographics. Rate of symptom improvement to >50% of baseline was similar between the groups (66% of BTX, 61% of SNM, p=0.46) as was rate of patients experiencing total dryness (24% of BTX, 16% of SNM, p=0.17). Among patients achieving significant improvement there was no difference in continuation of therapy between the BTX and SNM groups. Younger age was identified as a predictor of >50% symptom improvement (OR 0.96, p=0.04) and treatment discontinuation (HR 0.97, p=0.04) in SNM. Most common adverse events were urinary tract infection in BTX (11%) and pain in SNM (4%). CONCLUSIONS: BTX and SNM have similar efficacy for UUI in post-CVA patients with regard to degree of treatment response and continuation of therapy. Source of Funding: None © 2024 by American Urological Association Education and Research, Inc.FiguresReferencesRelatedDetails Volume 211Issue 5SMay 2024Page: e171 Advertisement Copyright & Permissions© 2024 by American Urological Association Education and Research, Inc.Metrics Author Information Tyler Trump More articles by this author Po-Ming Chow More articles by this author Omer Anis More articles by this author Howard Goldman More articles by this author Expand All Advertisement PDF downloadLoading ...