Re: Predictors of Nerve Stimulator Success in Patients with Overactive Bladder
Abstract
available at http://www.ncbi.nlm.nih.gov/pubmed/30286584 Editorial Comment: These authors analyzed the results of treatment with sacral nerve stimulation (SNS) with respect to parameters that predicted success and failure. Success was defined, arguably, as permanent implantation of the sacral nerve stimulator. On univariate analysis male gender, prior diagnosis of benign prostatic hyperplasia and lower volume at first urge on urodynamics were associated with an unsuccessful SNS trial. On multivariate analysis male gender (OR 0.145) and lower volume at first urge urodynamics (OR 0.982) were associated with an unsuccessful trial. Within the female group there were no statistically significant associations between observed variables and SNS success. Mean volume at first urge on urodynamics was not statistically significantly associated with failure. In this series women had nearly twice the success rate but in men the SNS trial was successful in only half the cases. There was a high specificity (0.86), suggesting that if a male patient had first urge at less than 100 ml he was highly unlikely to have a successful SNS trial. The authors suggest that “in general, men with obstruction should have a bladder outlet procedure either in lieu of or in complement to overactive bladder treatment.” They conclude, “When counseling patients with overactive bladder for SNS implantation, men, and particularly men with volumes less than 100 ml at first urge on urodynamics, should be counseled…
How strong is the evidence?
Evidence Hub reads this as a randomized trial, done in people. Its evidence level is 2 of 5 (High · randomized trial). Randomized trials of a reasonable size are the strongest single-study design. Reported size: 133 participants or records.
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