Pd59-04 Prior Bladder Outlet Procedures Result in Lower Sacral Neuromodulation Success Rates in Men: Results From a Small Case Series

You have accessJournal of UrologyUrodynamics/Lower Urinary Tract Dysfunction/Female Pelvic Medicine: Neuromodulation (PD59)1 May 2024PD59-04 PRIOR BLADDER OUTLET PROCEDURES RESULT IN LOWER SACRAL NEUROMODULATION SUCCESS RATES IN MEN: RESULTS FROM A SMALL CASE SERIES Maxwell Towe, Alan J. Wein, Katherine Amin, and Raveen Syan Maxwell ToweMaxwell Towe , Alan J. WeinAlan J. Wein , Katherine AminKatherine Amin , and Raveen SyanRaveen Syan View All Author Informationhttps://doi.org/10.1097/01.JU.0001009544.34256.8a.04AboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookLinked InTwitterEmail Abstract INTRODUCTION AND OBJECTIVE: Sacral neuromodulation (SNM) represents a promising treatment for detrusor underactivity (DUA) and/or refractory overactive bladder (OAB), with success rates in women approaching 70% and 90%, respectively. The aim of this study was to examine success rates in men, which are not well described, with a focus on men with bladder outlet obstruction (BOO) requiring prior BOO procedures. METHODS: We retrospectively reviewed all male patients with lower urinary tract dysfunction (LUTD) who underwent SNM treatment from July 2021 to August 2023. Baseline data was collected for each patient including age, race, comorbidities, and urinary symptoms. Urodynamic studies were used to classify type of LUTD. Success after SNM implantation was defined as subjective improvement in symptoms frequency, urgency, nocturia, improved bladder emptying, and/or a decreased need for urinary catheterization at postoperative visits. Patients were further stratified by whether they had a diagnosis of BOO and subsequently underwent a BOO procedure prior to SNM implantation. RESULTS: In total, 19 males underwent placement of a SNM device during the study period, with average age 62.9 (±17.5). Approximately 32%, 26%, and 16% of patients had a history of hypertension, neurological disorder, or diabetes, respectively. Of note, 9 (47%) patients were classified with DUA and 9 (47%) with OAB as their primary LUTD. Eight (42%) reported prior urinary catheter use, and the average postvoid residual at initial visit was 306.3 (±277.0 mL). Overall, 13/19 (68%) of patients reported improvement in symptoms after SNM implantation. Ten (53%) patients underwent ≥1 BOO procedures prior to SNM implantation with the average latency between procedures being 13.8 (±15.4) months. Of these, 5 (50%) reported improvement in symptoms. Of the 9 patients without prior BOO procedures, 7 (78%) reported improvement in their symptoms after implantation. In patients with DUA and prior BOO procedures (7), only 3 (43%) reported improvement. CONCLUSIONS: Men with a history of BOO requiring procedures to relieve obstruction had lower symptom improvement rates with SNM than those without. Men without BOO had success rates similar to those seen in women. These results can allow clinicians to offer tailored counseling based on prior history for men undergoing SNM. Source of Funding: NA © 2024 by American Urological Association Education and Research, Inc.FiguresReferencesRelatedDetails Volume 211Issue 5SMay 2024Page: e1222 Advertisement Copyright & Permissions© 2024 by American Urological Association Education and Research, Inc.Metrics Author Information Maxwell Towe More articles by this author Alan J. Wein More articles by this author Katherine Amin More articles by this author Raveen Syan More articles by this author Expand All Advertisement PDF downloadLoading ...